Kudos to PhD student Yesol Yang and her mentor Cristina Hendrix for the submission of his American Cancer Society (ACS), Doctoral Degree Scholarship in Cancer Nursing application entitled “Caregiver Reaction and Cognitive Function in Breast Cancer Patients." This proposal requests funding for a two-year period with a start date of July 1, 2019.

Up to 75% of women diagnosed with breast cancer self-report changes in their cognitive function such as frequent forgetfulness, slow processing speeds, and difficulties in concentration, multitasking and word retrieval, especially during chemotherapy treatment. Compared to patients with other illness, breast cancer patients and their caregivers seldom anticipate the cognitive challenges patients could face while receiving their chemotherapy treatments. Cognitive changes that patients experience may not be readily observed by others, but patients are aware that they are not functioning at the same level as before their cancer diagnosis. These cognitive changes have negative effects on their social relationships, overall life satisfaction and treatment adherence. Cancer studies have shown that such changes are caused by 1) adverse effects of chemotherapy, and/or 2) symptoms of anxiety, fatigue, or depression that co-occur with cognitive changes. However, some studies suggest that caregivers can be another contributing factor for changes in a patient's cognitive function.

 A caregiver whom the patient chooses as one's main support person, provides various types of support to the patient ranging from providing transportation to managing cancer-related symptoms. Caregivers may respond to their new position in various ways. Some caregivers may express that caring for the patient is burdensome (i.e. negative reactions), while others may feel there is great honor and value found in providing care to patients (i.e. positive reactions). One study reported that cancer patients demonstrated less memory problems when caregivers showed acceptance towards their new role as caregiver. In contrast, several neurocognitive studies stated that patients demonstrated cognitive decline when their caregivers reported high burden of care. Taken together, caregiver reaction appears to influence a patient's cognitive function.

This study will explore the influence of caregiver reaction on cognitive function among women with breast cancer undergoing chemotherapy. The proposed study will evaluate patterns of patient cognitive function and relate these results to caregiver reaction. I believe that results from this study will inform the need for considering both patients and their caregivers (dyads) when establishing treatment strategies for patient cognitive function. Furthermore, this research will provide a foundation for developing a dyadic intervention for patients and caregivers. For example, programs that help decrease caregiver burden could be provided to caregivers with the aim of improving patient cognitive function. This dyadic intervention will help patients during their aggressive medical treatments while also supporting their caregivers. Based on the findings of this study, I will develop dyadic interventions that can create synergistic benefits that are more effective at improving patient cognitive function than simply treating the patient alone.