Schuurs, A., & Green, H.J. (2012). A feasibility study of group cognitive rehabilitation for cancer survivors: Enhancing cognitive function and quality of life. Psycho-Oncology. [e-pub ahead of print].10.1002/pon.3102
The intervention, based on self-regulatory cognitive rehabilitation and cognitive behavioral principles, consisted of four weekly two-hour group sessions with between-session homework. Each session consisted of psycho-education, group discussion, and reinforcement of the content by skill development and application. Subject matter included overall information on cognition with specific information on memory, attention, and the impact of fatigue and emotions on cognition. Application exercises focused on goal setting, problem solving, relaxation, compensatory and enhancement strategies, and cognitive-behavioral strategies related to emotional adjustment, fatigue, sleep, and self-care.
All participants receiving the intervention were assessed at baseline, post-treatment (six weeks after the baseline assessment), and follow-up (three months after the second assessment). Study participants not receiving the intervention were assessed at similar time frames but only for the first two time periods.
The clinical application is for late effects and survivorship.
The study consisted of a controlled trial with repeated measures.
In contrast to the cancer and community comparison groups, the intervention group had a significant improvement in immediate memory (p < 0.01), visuospatial skill (p < 0.001), language (p < 0.001), attention/concentration (p < 0.05), delayed memory (p < 0.001), and total cognitive score (p < 0.001) over the six-week time interval as measured by the RBANS. No change was found in either information processing speed as measured by the TMT-A or executive function as measured by the TMT-B.
The intervention group was re-evaluated three months later; improvements remained, or were sustained, in immediate memory (p < 0.001), visuospatial skill (p < 0.001), delayed memory (p < 0.001), and total cognitive score (p < 0.001), but not in language or attention/concentration. At the final assessment, a significant improvement was also found on the TMT-A (p < 0.01). Although no change was found in self-report of cognitive function as measured by the MASQ, a significant improvement was found over time as measured by the FACT-Cog (p < 0.05).
Significant improvement was found in several cognitive domains for patients who received the group intervention. Many of these improvements were sustained three months after the completion of the intervention. The results of the subjective measures of cognitive function were mixed. This study found that a short group intervention may improve cognitive ability for cancer survivors over a limited period of time.
Further research is indicated, with larger sample sizes and longer follow-up, to determine whether group cognitive rehabilitation might be warranted to treat cognitive impairments. More detailed information regarding the intervention is needed to determine whether it could be facilitated by nurses rather than the clinical psychologists in the study.