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Attention and Symptom Distress in Women With and Without Breast Cancer

Cimprich, Bernadine; Ronis, David L.


Background: The cognitive capacity to direct attention (CDA) is essential for self-care and independent functioning. Older women may be more vulnerable to fatigue-related losses in CDA following surgery for breast cancer. Normal functional variations in CDA associated with aging might affect attentional responses in older women newly diagnosed with breast cancer, and factors such as extent of surgery or symptom distress might influence CDA over time.

Objectives: To examine (a) differences in CDA and symptom distress in older women newly diagnosed with breast cancer as compared to a control group of older women without breast cancer; (b) the pattern of change in CDA and symptom distress from the pretreatment period to 3 months after surgery; and (c) to examine the relationship of CDA with symptom distress and extent of surgery over time.

Methods: Women, 55 to 79 years of age, newly diagnosed with breast cancer (N = 47), were assessed with measures of CDA and symptom distress: (a) before surgery, (b) at 2 weeks postsurgery, and (c) 3 months postsurgery. To account for normal variations associated with aging, 48 women of similar age without breast cancer were assessed following a routine screening mammogram and 3 months later.

Results: Before treatment, the breast cancer group scored significantly lower than the control group (p < .05) on measures of CDA and higher on symptom distress. Repeated measures ANOVA showed significant main effects of group, but not time, for the measures of CDA and symptom distress with the breast cancer group having worse status than the control group. For CDA only, there was a significant group by time interaction effect (p = .005) so that the breast cancer group showed a gradual gain in CDA over time.

Conclusions: Reduced performance in a cognitive function was observed before treatment and found to persist over an extended interval in older women newly diagnosed with breast cancer.

Bernadine Cimprich, PhD, RN, is Associate Professor, University of Michigan, Ann Arbor, Michigan.

David L. Ronis, PhD, is Associate Research Scientist, University of Michigan, and Research Health Science Specialist, Department of Veterans Affairs, Ann Arbor, Michigan.

Accepted for publication May 5, 1999.

Supported by the University of Michigan Comprehensive Cancer Center Program Grant, Breast Cancer in Elderly Women, grant number: NIH, NIA, PO-AG13094

Address reprint requests to Bernadine Cimprich, PhD, RN, University of Michigan, School of Nursing, 400 N. Ingalls, Room 2172, Ann Arbor, MI 48109-0482.

© 2001 Lippincott Williams & Wilkins, Inc.