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Relationship of Self-reported Attentional Fatigue to Perceived Work Ability in Breast Cancer Survivors

Von Ah, Diane PhD, RN, FAAN; Storey, Susan PhD, RN, AOCNS; Crouch, Adele BSN, RN; Johns, Shelley A. PsyD, ABPP; Dodson, Jill SW; Dutkevitch, Sarah BSN, RN, OCN

doi: 10.1097/NCC.0000000000000444

Background: Breast cancer survivors (BCSs) have identified attentional fatigue, a decrease in the ability to focus, as a persistent daily challenge; however, little is known regarding its impact on work ability.

Objective: The purpose of this study was to examine the relationship between attentional fatigue and perceived work ability in BCSs controlling for the known covariates of age, education, household income, and time posttreatment.

Methods: A cross-sectional, descriptive design was used. Breast cancer survivors who were currently employed and at least 1 year post–adjuvant treatment participated. Breast cancer survivors completed the Attentional Function Index and Work Ability Index questionnaires. Descriptive statistics, linear regression, and Fisher exact test were used for analysis.

Results: Sixty-eight female BCSs, ranging from 29 to 68 years of age (mean, 52.1 [SD, 8.6]) and on average 4.97 (SD, 3.36) years posttreatment, participated. More than one-fourth of BCSs (26.5%) reported poor to moderate perceived work ability, indicating substantial concerns regarding work performance. Attentional fatigue was found to significantly predict perceived work ability (P < .001), explaining 40% of the variance of perceived work ability.

Conclusions: Attentional fatigue is a prevalent symptom posttreatment that is negatively related to perceived work ability in BCSs.

Implications for Practice: Nurses are in a prime position to assess and intervene to alleviate attentional fatigue to improve work ability. Findings suggest a need for individual, comprehensive survivorship care plans to effectively address symptoms that impact work ability and, ultimately, the quality of life of cancer survivors.

Author Affiliations: Indiana University School of Nursing (Drs Von Ah and Storey and Mrs Crouch), Indiana University School of Medicine (Dr Johns), and Indiana University Hospital North Medical Center (Mss Dodson and Dutkevitch), Indianapolis.

Funding for this study was supported by a grant from the Walther Cancer Institute (0155.01, principal investigator: D.V.A.

The authors have no conflicts of interest to disclose.

Correspondence: Diane Von Ah, PhD, RN, FAAN, Department of Community & Health Systems, 600 Barnhill Dr, NU470, Indianapolis, IN 46202 (

Accepted for publication September 7, 2016.

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