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Hanne Bess Boelsbjerg

Combining subjective and objective appraisals of cognitive dysfunction in patients with cancer: a deeper understanding of meaning and impact on suffering?

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Patients with advanced cancer often experience cognitive dysfunction, which may influence decision making, selfperception, and existential well-being. However, there is little evidence regarding this issue. This study analysed associations
between objective neuropsychological measures and patients’ self-report of cognitive dysfunction interfering with everyday life, general well-being, and sense of existential value.
A mixed method study assessed 13 adult patients with advanced cancer with validated neuropsychological tests, which assessed sustained attention, psychomotor speed, memory/attention, mental flexibility, and a measure of global cognitive function. These were followed by semi-structured interviews focusing on subjective experiences of cognitive dysfunction. Agreement between subjective and objective measures were analysed by Cohen’s Kappa (k). Thematic analysis explored associations with cognitive deficits.
Poor cognitive performance on the neuropsychological tests was observed regarding sustained attention (n = 8), psychomotor speed (n = 1), memory/attention (n = 2), mental flexibility (n = 9), and global cognitive function (n = 3). Almost all patients (n = 12) had complaints of cognitive dysfunction. However, the agreement between the two assessments was weak (k ≤ 0.264). Cognitive dysfunction challenged the patients with regard to practice everyday life including their existential values related to meaning of life and well-being. Adjustment of the sense of living according to one’s existential values and
changes of self-perception were also related positively and negatively to existential well-being.
Despite the weak agreement between objective and subjective measures of cognitive function, many of the
patients reported experiences of cognitive dysfunction that had an impact on their daily life and existential well-being, adding to the suffering experienced.
Original languageEnglish
JournalSupportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer
Pages (from-to)3603-3612
Number of pages10
Publication statusPublished - Jan 2022

    Research areas

  • Cognitive dysfunction, Neuropsychological tests, Patient-reported outcome measures, Neoplasms, Existential well-being

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