The proposed project evaluates the efficacy of a new intervention for attentional and functional restoration in women newly diagnosed with breast cancer. Preliminary data demonstrated that breast cancer patients manifested an attentional fatigue with reduced capacity to direct attention (CDA) during the three months following surgery and that such directed attention fatigue (DAF) could be ameliorated by a theoretically-based intervention involving regular exposure to natural restorative environment. Building on these findings, the project's specific aims are to determine whether: (a) a restorative environmental intervention can prevent or minimize losses in CDA over a longer period during and following breast cancer treatment; (b) any differences exist in the pattern and severity of DAF and the efficacy of the experimental intervention by type of breast cancer; (c) DAF produces an impairment in overall cognitive functioning; and (d) DAF is associated with poorer functional adjustment over time. Two hundred women, newly diagnosed with Stage I or II breast cancer, who will be treated either with breast conserving surgery plus radiation or mastectomy plus adjuvant chemotherapy, will be randomly assigned to receive usual care or an experimental intervention; a home-based program of 120 minutes per week of exposure to a natural restorative environment. Subjects will be assessed at five time points: before surgery (pre-intervention), about 2 weeks post-surgery, and at 3, 6, and 9 months post-surgery. The efficacy of the intervention over time on parameters of DAF, i. e., measures of the capacity to inhibit competing stimuli, will be evaluated using repeated measures ANOVA. Repeated measures ANOVA will also be used to compare the efficacy of the intervention within and between breast cancer treatment subgroups and any variations in pattern and severity of DAF. The ability to predict cognitive impairment in measures of short-term memory, higher level cognitive activities and cognitive control by DAF parameters will be tested using correlational and linear panel analyses. Finally, the associations between parameters of DAF and indicators of poorer functional adjustment, i.e. functional status, psychological distress, symptom distress, capacity to exert physical effort, and selected biological indices, will be examined. The ultimate aim of the research is to develop a theoretically based, low-cost intervention to restore attention and improve overall functioning in women treated for breast cancer.
| Cimprich, Bernadine; So, Heeyoung; Ronis, David L et al. (2005) Pre-treatment factors related to cognitive functioning in women newly diagnosed with breast cancer. Psychooncology 14:70-8 |
| Cimprich, Bernadine; Ronis, David L (2003) An environmental intervention to restore attention in women with newly diagnosed breast cancer. Cancer Nurs 26:284-92; quiz 293-4 |
