Improve the management of cancer-related cognitive impairment in clinical settings: a European Delphi study.

IF 3.1 2区 医学 Q2 ONCOLOGY
Journal of Cancer Survivorship Pub Date : 2024-12-01 Epub Date: 2023-11-07 DOI:10.1007/s11764-023-01436-8
Mylène Duivon, Marie Lange, Giulia Binarelli, Johan Lefel, Isabelle Hardy-Léger, Régine Kiasuwa-Mbengi, Jean-Baptiste Méric, Cécile Charles, Florence Joly
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引用次数: 0

Abstract

Purpose: Cancer-related cognitive impairment (CRCI) is under-addressed by healthcare professionals owing to a lack of clinical management guidelines. This European Delphi study proposes recommendations to healthcare professionals for the management of CRCI in patients with non-central nervous system (non-CNS) cancers.

Methods: Twenty-two recommendations were developed based on a literature review and authors' clinical experience, split into three categories: screening, cognitive assessment, intervention. The survey included European professionals, experts in CRCI. The Delphi method was used: experts rated the clinical relevancy of recommendations on a 9-point Likert scale in three rounds. A recommendation was accepted if all votes were between 7 and 9. Recommendations not accepted in round 1 and round 2 were deleted, or modified and rated in round 3.

Results: Eighteen professionals (psychologists, physicians, researchers) voted and accepted 15 recommendations. Experts recommended the systematic screening of CRCI, followed by a short objective cognitive assessment, if complaints screened. A comprehensive evaluation is recommended if CRCI persists 6 months post-treatment. Cognitive rehabilitation, physical activity, meditative-movement therapy, and multimodal intervention should be offered. Recommendations about frequency and duration of interventions, the professional to administer cognitive rehabilitation and the use of meditation and cognitive training without psychoeducation were not accepted.

Conclusions: This survey provides 15 recommendations to assist healthcare professionals in detecting, assessing and offering interventions for CRCI.

Implications for cancer survivors: These recommendations should be included in supportive care to help healthcare professionals to detect CRCI and propose the best available intervention for patients with cognitive complaints. Developing CRCI management in clinical settings would improve patients' quality of life.

改善临床环境中癌症相关认知障碍的管理:欧洲德尔福研究。
目的:由于缺乏临床管理指南,医疗保健专业人员对癌症相关认知障碍(CRCI)的处理不足。这项欧洲德尔菲研究向医疗保健专业人员提出了关于非中枢神经系统(非CNS)癌症患者CRCI管理的建议。方法:根据文献综述和作者的临床经验制定了22项建议,分为三类:筛查、认知评估和干预。调查对象包括欧洲专业人士、CRCI专家。使用德尔菲法:专家在三轮中以9分的Likert量表对建议的临床相关性进行评分。如果所有票数都在7票到9票之间,则建议被接受。在第1轮和第2轮中未被接受的建议在第3轮中被删除或修改和评级。结果:18名专业人员(心理学家、医生、研究人员)投票接受了15项建议。专家建议对CRCI进行系统筛查,如果对投诉进行筛查,则进行简短的客观认知评估。如果CRCI在治疗后持续6个月,建议进行综合评估。应提供认知康复、体育活动、冥想运动疗法和多模式干预。关于干预的频率和持续时间、管理认知康复的专业人员以及在没有心理教育的情况下使用冥想和认知训练的建议未被接受。结论:本调查提供了15项建议,以帮助医疗保健专业人员检测、评估和提供CRCI干预措施。对癌症幸存者的影响:这些建议应包括在支持性护理中,以帮助医护人员检测CRCI,并为认知障碍患者提出最佳干预措施。在临床环境中发展CRCI管理将提高患者的生活质量。
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来源期刊
CiteScore
7.00
自引率
10.80%
发文量
149
审稿时长
>12 weeks
期刊介绍: Cancer survivorship is a worldwide concern. The aim of this multidisciplinary journal is to provide a global forum for new knowledge related to cancer survivorship. The journal publishes peer-reviewed papers relevant to improving the understanding, prevention, and management of the multiple areas related to cancer survivorship that can affect quality of care, access to care, longevity, and quality of life. It is a forum for research on humans (both laboratory and clinical), clinical studies, systematic and meta-analytic literature reviews, policy studies, and in rare situations case studies as long as they provide a new observation that should be followed up on to improve outcomes related to cancer survivors. Published articles represent a broad range of fields including oncology, primary care, physical medicine and rehabilitation, many other medical and nursing specialties, nursing, health services research, physical and occupational therapy, public health, behavioral medicine, psychology, social work, evidence-based policy, health economics, biobehavioral mechanisms, and qualitative analyses. The journal focuses exclusively on adult cancer survivors, young adult cancer survivors, and childhood cancer survivors who are young adults. Submissions must target those diagnosed with and treated for cancer.
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