癌症相關輕微認知功能障礙之評估與處置

Assessment and Management of Mild Cognitive Impairment of Cancer Patients

楊卉穎(Hui-Ying Yang) ； 孫秀卿(Shiow-Ching Shun)

《源遠護理》 14卷1期 (2020/03) Pp. 5-15

https://doi.org/10.6530/YYN.202003_14(1).0001

摘要

癌症相關認知功能障礙發生率高達75%，是癌症病人接受癌症相關治療過程常見且感到困擾的症狀，常影響記憶、專注、執行功能等認知層面，而對日常生活功能與生活品質帶來漸進與長期的嚴重影響。然而，由於其障礙程度多屬輕微而較不易評估、評估工具種類多樣且費時、有效介入措施仍未有一致定論，以及在臨床上醫護專業人員對此相關症狀仍缺乏敏感度，導致提供癌症存活者完善認知障礙的照護上充滿挑戰。本文將藉由介紹癌症相關輕微認知功能障礙之定義、症狀與影響，探討常用之客觀與主觀認知功能評估工具以及目前以實證為基礎之相關照護處置，提供臨床護理人員對於認知功能照護的進一步了解，以增加臨床認知障礙之評估與照護能力。

關鍵字

癌症 ； 輕微認知功能障礙 ； 評估 ； 處置

並列摘要

Up to 75% of cancer patients have cancer-related cognitive impairment, which is the common distress symptom during cancer-related treatment. It generally influences memory, attention, and executive function and profoundly affects patients' daily life and quality of life in short- and long-term. However, it is still a challenge for nurses to offer the cancer survivors with the comprehensive care for cognitive impairment because of being not easy to assess mild impairment, diverse and time consuming assessment tools, controversy for the effective evidence-based interventions, and lacking of attention and sensitivities on assessing cognitive impairment by nurses. Therefore, this article mainly focuses on reporting the definition, symptoms, and its impact of mild cognitive impairment, objective and subjective assessment tools, and briefly summary of evidence-based intervention. It will help the clinical nurses to more understanding care of cognitive function in cancer patients and to enhance the ability to assess and manage cognitive impairment.

並列關鍵字

cancer ； mild cognitive impairment ； assessment ； management

參考文獻

李麗紅、陳于群、楊政議（2018）．癌症病人化療後認知功能障礙之照護．腫瘤護理雜誌，18（2），5-11。doi:10.6880/TJON.201812_18(2).01

Von Ah, D., Jansen, C. E., & Allen, D. H. (2014). Evidence-based interventions for cancer- and treatment-related cognitive impairment. Clinical Journal of Oncology Nursing, 18 Suppl, 17-25. doi:10.1188/14.CJON.S3.17-25

Von Ah, D., Storey, S., Tallman, E., Nielsen, A., Johns, S. A., & Pressler, S. (2016). Cancer, cognitive impairment, and work-related outcomes: An integrative review. Oncology Nursing Forum, 43(5), 602-616. doi:10.1188/16.ONF.602-616

Wefel, J. S., Vardy, J., Ahles, T., & Schagen, S. B. (2011). International cognition and cancer task force recommendations to harmonise studies of cognitive function in patients with cancer. The Lancet Oncology, 12(7), 703-708. doi:10.1016/s1470-2045(10)70294-1

Zeng, Y., Cheng, A. S., & Chan, C. C. (2016). Meta-analysis of the effects of neuropsychological interventions on cognitive function in non-central nervous system cancer survivors. Integrative Cancer Therapies, 15(4), 424-434. doi:10.1177/1534735416638737