McDougall, G.J., Becker, H., Acee, T.W., Vaughan, P.W., & Delville, C.L. (2011). Symptom management of affective and cognitive disturbance with a group of cancer survivors. Archives of Psychiatric Nursing, 25, 24–35.

To evaluate effectiveness of a memory training intervention as compared to a health training group intervention for management of cognitive impairment in older adult cancer survivors

Measures were performed pre-intervention, post-intervention, post-booster intervention, and six months afterwards. The memory training intervention consisted of eight sessions incorporating 20 minutes of relaxation, a targeted memory topic, and 30 minutes of targeted practice with role model. Participants received a memory improvement book at end of the memory intervention. The health training consisted of providing 18 health-related topics over two months; the frequency of the training was not provided. Booster sessions consisted of four weekly mandatory two-hour sessions over one month conducted within three months after completion of initial training. 

• A total of 22 patients participated in the study. Eight received the memory intervention, and 14 received health training.
• Participants' mean age was 73.8 years(SD = 4.82 years).
• The sample was 41% male and 59% female.
• Participants had been diagnosed with breast cancer (n = 8), prostate cancer (n = 5), facial or nose basal cell carcinoma (n = 3), uterine cancer (n = 2), leukemia/lymphoma (n = 2), throat cancer (n = 1), or lung cancer (n = 1).
• 86% of the sample was Caucasian.
• On average, participants had completed 16 years of education.
• Socioeconomic status varied among the sample.
• The length of time from oncology treatment was unknown.

• Mutli-site
• Outpatient setting
• Austin, TX

• Patients were undergoing long-term follow-up.
• The study has clinical applicability for older adult care.

Randomized clinical trial

• Hopkins Verbal Learning Test–Revised (HVLT-R)     
• Brief Visuospatial Memory Test–Revised (BVMT-R)
• Rivermead Everyday Behavioural Memory Test (REBMT)
• Metamemory in Adulthood QuestionnaireDirect Assessment of Functional Status
• Memory Self-Efficacy Questionnaire
• Mini-Mental Status Examination

Visual memory as measured by the BVMT-R was improved (p < 0.1 for the group by time interaction) for participants who received the memory training intervention. Trends toward improvement in verbal memory as measured by the HVLT-R and overall memory as measured on the standardized profile scale of the REBMT were observed for participants who received the memory intervention, but they were not significant. Improvements were seen in self-reported memory components in locus, capacity, and control (p < 0.05 for the group by time interaction) and use of internal strategies (p < 0.1 for time). Memory complaints decreased (p < 0.05 for the group by time interaction). 

Significant improvements in visual memory were obtained and sustained, and trends for improving verbal and global memory were observed in those who participated in the memory training. In addition, those who participated in memory training maintained their use of internal compensatory strategies and reported significant improvements in subjective aspects of cognitive function, including increased confidence, greater capacity, belief that they could better manage issues with their memory, and decreased complaints of their memory performance.

• The sample was small at less than 30 participants.
• The generalizability of the results was limited.
• The feasibility of replicating the memory training intervention was limited.

Cognitive impairments present ongoing symptom management issues for older adult cancer survivors. Memory training has been effective in older individuals and may offer opportunities for improvements in memory difficulties for older adult cancer survivors. The authors suggested that their memory training intervention may be adjusted to meet the specific cognitive issues that older cancer survivors report. Further studies are needed to determine feasibility and generalizability to patients with cancer.