Women's perceptions of chemotherapy-induced cognitive side affects on work ability: a focus group study

Aims & objectives: To investigate women’s awareness of chemotherapy-induced cognitive changes, their perception of cognitive limitations in carrying out daily tasks and subsequent return to work decisions and perceptions of work ability. Background: Evidence suggests that women diagnosed with breast cancer experience cognitive changes as a consequence of chemotherapy treatment. Although these changes tend to be subtle deficits in memory, concentration, and the ability to organise information, there has been no published research identifying how they can impact patient’s ability to work and subsequent employment decisions. Design: This was a qualitative study Method: Data were collected from breast cancer survivors using semi-structured interviews with two focus groups (n = 6, n = 7). Interviews were transcribed verbatim and analysed using Template Analysis. Results: Data were categorised into four main themes: 1) Awareness of cognitive changes during and following chemotherapy, 2) Cognitive ability and confidence in return to work, 3) Impact of cognitive changes on work ability, and 4) Information on the cognitive side effects of chemotherapy. Conclusion: The views and experiences of breast cancer survivors toward returning to work and subsequent work ability were affected by chemotherapy induced cognitive impairment. More specifically the appraisal of returning to work and ability to manage work were influenced by three interrelated factors: 1) actual cognitive ability following chemotherapy, 2) awareness of cognitive failures by the women and their families, and 3) the subsequent impact on their confidence in carrying out daily tasks including work tasks. Relevance to clinical practice: More information and support is needed to help cancer patients manage chemotherapy-induced cognitive impairments within home and workplace. Nurses are increasingly asked about the impact of cancer and its treatment on work, and are therefore well positioned to offer this advice. Subsequently, nurses require additional knowledge and guidance to provide this information and support.