A NETWORK ANALYSIS OF CHEMOTHERAPY-RELATED COGNITIVE IMPAIRMENT AND RELATED SYMPTOMS IN COLORECTAL CANCER SURVIVORS.

Background & Significance: Colorectal cancer is the third most common cancer and the second leading cause of cancer-related death in the U.S., with approximately 1.5 million survivors. Colorectal cancer survivors (CRCS) often experience cancer-related cognitive impairment (CRCI) and co-occurring sym...

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Publicado en:Oncology Nursing Forum Vol. 53; no. 2; pp. 24 - 26
Autores principales: Storey, Susan, Han, Claire, Von Ah, Diane
Formato: Journal Article
Publicado: Oncology Nursing Society Mar2026
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Mar2026
      vid: 53
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      pid: 12496
      pub: Oncology Nursing Society
      place: Pittsburgh, Pennsylvania
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        10.1188/26.ONF.e26535273
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        atl: A NETWORK ANALYSIS OF CHEMOTHERAPY-RELATED COGNITIVE IMPAIRMENT AND RELATED SYMPTOMS IN COLORECTAL CANCER SURVIVORS.
      aug:
        au:
          Storey, Susan
          Han, Claire
          Von Ah, Diane
        affil: PhD, RN, AOCNS, FCNS, Indiana University School of Nursing, Indianapolis, IN
      sug:
      ab: Background & Significance: Colorectal cancer is the third most common cancer and the second leading cause of cancer-related death in the U.S., with approximately 1.5 million survivors. Colorectal cancer survivors (CRCS) often experience cancer-related cognitive impairment (CRCI) and co-occurring symptoms, or symptom clusters, following diagnosis and treatment. However, how CRCI interacts with other symptoms and psychosocial domains remains unclear. Network analysis provides a framework to visualize and understand interconnections among these variables by identifying central factors that shape symptom experiences and potential intervention targets. Purpose: This study aimed to (1) examine networks of CRCI (function and concerns) and related symptoms across psychological, behavioral, and social domains in post-chemotherapy CRCS and (2) explore interconnections among CRCI, symptoms (fatigue, anxiety, depression, sleep, and pain), psychological (stress, positive and negative affect), behavioral (coping, physical function), and social (social support) factors. Methods: A secondary analysis was conducted using data from a national sample of CRCS (N = 64) who reported CRCI. Eligibility criteria included age ≥ 21 years, cancer stage I-III, ≥ 6 months post-treatment, and self-reported CRCI. Network analysis was performed in Python using pairwise Spearman correlations to create weighted networks. Centrality measures (degree, betweenness, closeness) identified influential nodes within the network. Findings and Interpretations: Stress, pain, and CRCI-concerns emerged as key central nodes bridging cognitive, physical, and psychosocial domains. Stress showed negative correlations with physical function (r = -0.389, p < .01) and positive links with pain and CRCI, indicating its broad influence. Pain correlated with CRCI-concerns (r = 0.451, p < .001) and fatigue (r = 0.356, p < .01), forming a multi-symptom cluster with anxiety, depression, sleep, and negative affect. Coping was inversely related to anxiety and CRCI, while social support was positively correlated with coping (r = 0.351, p < .01) but had few direct links to other variables. Higher physical function was indirectly associated with lower CRCI-concerns, better sleep, and reduced stress. Discussion: Stress was the most central and bridging factor across domains, followed by pain. Coping showed stronger and more direct connections with CRCI and other symptoms than social support. Findings highlight the need for multidimensional interventions addressing stress, pain, and coping to mitigate CRCI and improve overall survivorship outcomes. Network analysis can facilitate clinicians and researchers to better prioritize symptom management strategies and explore pathways for improving patient outcomes.
      pubtype: Academic Journal
      doctype: Journal Article
      ougenre: Article
    language: English
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