Purpose

The purpose of this study was to review the international literature on intervention studies for patients with cognitive impairment related to cancer treatment and to draw implications for the role of nurses from the interventions and their outcomes.

Methods

A literature search was conducted using the MEDLINE and CINAHL databases from January 2014 to December 2021. Search terms were limited to the English language using the keywords "cognitive dysfunction", "cancer-related cognitive impairment", "cancer", and "nursing". Eight articles that met the selection criteria were analyzed.

Results

Interventions for patients with cancer treatment-related cognitive dysfunction in the international literature included four cognitive-behavioral therapies and four complementary and alternative therapies. All interventions were offered to patients with Stage I-III breast cancer, aged 20-75 years, and who had completed alternative adjuvant therapy or were continuing hormonal therapy. Cognitive-behavioral therapy consisted of a combination of computer-based brain training, group education, and compensatory cognitive training interventions. Complementary and alternative medicine included interventions such as mindfulness-based stress reduction, qigong, and individual piano lessons. All interventions showed improvements in cognitive function, fatigue related to cognitive function, and quality of life.

Discussion

Interventions for patients with cognitive dysfunction related to cancer treatment require a long period of time and need to be identified early. The role of nurses is to educate patients about cognitive dysfunction from the time of pre-treatment orientation, and to coordinate and collaborate with professionals who have skills in complementary and alternative therapies. Furthermore, nurses also play an important role in providing ongoing support, including community collaboration, so that intervention methods can be incorporated into patients' lives and become a habit.

Abstract　Post-intensive care syndrome （PICS） refers to a decline of physical and cognitive functions and symptoms of mental health disorder that persist from the time intensive care is received to well after discharge in critically ill patients. PICS may have a significant impact both on the daily lives and quality of life （QOL） of patients and their families. Therefore, adoption of prophylactic measures against the development and early detection of PICS by nurses in intensive care units （ICUs） is important. We developed a PICS assessment tool for early detection of PICS by ICU nurses. This study aimed to evaluate the feasibility of the assessment tool. We employed a descriptive research approach. Nurses in ICU who had at least 1 year of work experience（ N = 56） evaluated patients’ conditions based on their routine observation using the assessment tool. The concordance rate for the results between their evaluation and medical record information was confirmed by interviewing the nurses. In addition, Fisher’s exact test was used to evaluate the participants’ opinions about the tool’s ease of use and usefulness in daily nursing. The mean time to complete the assessment was <10 min. Regardless of their nursing experience in ICUs and their level of understanding of PICS, a majority of participants thought that they could use the assessment tool routinely based on the number of items and quality of information. Our findings suggest the feasibility of using the novel assessment tool for the early detection of PICS.

The purpose of this study was to clarify the difficulties nurses face in consensus decision support between patients/families and health care providers, and to examine the implications for education to enable nurses to actively engage in consensus decision support.

Focus group interviews were conducted with 12 nurses working at two cancer treatment base hospitals.

Respondents were divided into four groups and analyzed qualitatively and inductively.

The difficulties nurses face in providing decision support to cancer patients and their families were classified into eight categories: ［Family intentions are emphasized and patient's independent decisionmaking is hindered］,［ Unable to grasp the feelings and intentions of the patient and family and unable to step forward to support decision-making through consensus building］, ［Distressed that treatment proceeds without knowing whether the patient has made an independent decision］, ［Wonder if it was a good choice for a terminally ill patient to be treated without consensus by family and healthcare providers］, ［Difficulty in obtaining agreement between healthcare providers and patients/families on treatment choices in BSC situations］, ［Communication between patients/family members and medical staff is not sufficient, and decision-making support through consensus building cannot be established］,［ As a nursing care team, we cannot continuously support decision-making through consensus building］, and

［Lack of skills makes it impossible to follow the process of decision support through consensus building in accordance with the changing patient's situation］.

We found that nurses are concerned about situations in which the rights and intentions of cancer patients are not respected, but they are unable to approach patients to solve the problem. To improve the quality of decision-making support in cancer care, it is important for nurses to recognize that they themselves have a role to play, to accumulate practice, and to make patients and physicians aware of the role of nurses.