Effects Of The Cognitive Behavioral Therapy On Postoperative Memory Ability Of Breast Cancer Patients With Adjuvant Chemotherapy

Background and Objective In China,the breast cancer ranks the first among various cancers carried by female patients with an annual growth rate of 3% to 4% and younger ages of onset.The chemotherapy plays a very important role in breast cancer treatment which can reduce risks of tumor recurrence and metastasis and prolong the survival time of patients.Breast cancer has gradually become a chronic disease and a lot of relevant unpleasant side effects of chemotherapy have also emerged.In recent years,clinical studies show that chemotherapy drugs can cause a mild decline in the postoperative cognitive ability of patients,namely the mild cognitive impairment(MCI),which mainly manifests as memory recession,inattention,executive function impairment and language disorder.The memory recession is the most prominent manifestation among those above cognitive impairments of patients,which greatly affects patients' physical and psychological health,social adaptability as well as the quality of their daily life.How to improve both cognitive and memory abilities and the quality of patients' life is now an urgent clinical problem to be solved.The status quo of researches at home and abroad: since 1990 s,studies have shown that chemotherapy can cause mild cognitive impairment(MCI).In tests of patients' postoperative cognitive ability,the main manifestations are memory recession and low concentration.Besides,there are more and more researches which support this.In recent years,there have been more studies on the mechanism of cognitive impairment related to chemotherapy,but less on its intervention.Many scholars believe that Donepezil,EPO,and Ginkgo biloba preparations are useful to treat cognitive impairment,but none of them have been proved to be effective in this respect.At the same time,cognitive behavioral therapy(CBT)has been reported to contribute to the improvement of the cognitive ability.Thus more researches are in need to support CBT to play its potential role in treatments.This study is aimed to apply the cognitive evaluation and rehabilitation system to intervention treatments of 60 breast cancer patients with adjuvant chemotherapy in order to investigate its effects on patients' memory abilities.Analyses of the effects of intervention on postoperative memory ability of breast cancer patients with adjuvant chemotherapy will provide feasible plans for the treatment of cognitive impairment caused by chemotherapy so as to improve the quality of patients' life.Methods Based on the inclusion and exclusion criteria,60 breast cancer patients with adjuvant chemotherapy were selected as research objects who were treated by the department from January to December in 2015.They were randomly divided into the control group(30 cases)and the experimental group(30 cases).The control group received conventional treatment and rehabilitation guidance,while the experimental group received extra training of the cognitive evaluation and rehabilitation system on the basis of the former group.These 60 patients went through tests of three phrases,namely T1(before chemotherapy),T2(within one week after chemotherapy)and T3(six month S after chemotherapy)which were measured by the Neuropsychological battery �WMS,and QLQ-BR53.By comparing changes of various indicators for patients' memory ability and the quality of patients' life.General data of all research objects in terms of age,educational level,pathological result,etc.were collected to establish the database.The statistical software package of SPSS17.0 was also appliedin data processing.Continuous variables were expressed with mean � standard deviation(�s)and measurement data were expressed with the number of cases(percentage).The t test and x2 test were used for statistical data processing.P < 0.05 was considered statistically significant.Result 1.The differences between the control group and the experimental group in terms of age,educational level,pathological stages and other indicators were not statistically significant.(P > 0.05)2.The two groups of patients were tested before chemotherapy by respectively using WMS and QLQ-BR53 to evaluate the memory ability and the quality of life.Compare these two results.The difference was not statistically significant.(P > 0.05)3.Various indicators for the memory ability of patients from the control group and the experimental group during T2 and T3 were all lower than that of the same group during T1,among which the comparative differences in terms of number,recognition,associative memory,memory by understanding and touching,MQ,etc.were all statistically significant.(P1 < 0.05,P2 < 0.05).On the contrary,differences compared in the aspects of experience,orientation,picture memory,visual reproduction,number memorizing,etc.were not statistically significant.(P > 0.05)The results show that chemotherapy can lead to memory recession.4.Various indicators for the memory ability of patients from the experimental group during T2 and T3 were all higher than that of the control group during T1,among which the comparative differences in terms of number,recognition,associative memory,memory by understanding and touching,MQ,etc.are all statistically significant.(P < 0.05)On the contrary,differences compared in the aspects of experience,orientation,picture memory,visual reproduction,number memorizing,etc.were not statistically significant.(P > 0.05)The results show that the cognitive behavioral therapy can efficiently improve the memory of breast cancer patients with adjuvant chemotherapy as well as mitigate memory recession.5.Various functional indicators for patients from the experimental group during T2 and T3 were all higher than that of the control group in the same periods,among which the comparative differences in terms of cognitive function,emotional function,general health condition,role function,personal views for the future,etc.were all statistically significant.(P < 0.05)On the contrary,differences compared in the aspects of shape,physical function,sexual pleasure,sexual function,etc.were not statistically significant.(P > 0.05)Besides,various symptomatic indicators for patients from the experimental group during T2 and T3 were all lower than that of the control group in the same periods,among which the comparative differences in terms of annoyance,tiredness,sleep quality,arms symptoms,etc.were all statistically significant.(P < 0.05)On the contrary,differences compared in the aspects of appetite,nausea and vomiting,financial difficulties,pains,diarrhea,shortness of breath,breast symptoms,etc.were not statistically significant.(P > 0.05).The results show that the cognitive behavioral therapy can efficiently improve the quality of breast cancer patients' postoperative life.Conclusion 1.The cognitive behavioral therapy can effectively mitigate the memory recession of breast cancer patients with adjuvant chemotherapy.2.The cognitive behavioral therapy can significantly improve the quality of patients' postoperative life.