European journal of oncology nursing : the official journal of European Oncology Nursing Society · 2025
Pathways between activity behaviors, emotional distress, and subjective cognitive impairment in middle-aged and older breast cancer patients receiving chemotherapy: a cross-sectional study.
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Zhang Ni, Zhang Baoyi, Chen Lili, Yan Jingwen, Zhang Yiheng, Zhang Ye, Fang Jia, Zhang Meifen
Аннотация
PURPOSE: To examine the pathways between activity behaviors, emotional distress, and subjective cognitive impairment (SCI) in middle-aged and older breast cancer patients (BCs) receiving chemotherapy.
METHODS: In this cross-sectional study, patients were recruited via convenience sampling at a tertiary hospital in Guangzhou, China. SCI, depressive symptoms, anxiety symptoms, physical activity, and sedentary behavior were assessed using the Functional Assessment of Cancer Therapy-Cognitive Function, the 10-item version of the Center for Epidemiological Studies Depression Scale, the Brief Generalized Anxiety Disorder Scale, and the short form of the International Physical Activity Questionnaire. Structural equation modelling was conducted to test a hypothesized path model with depressive and anxiety symptoms as mediators.
RESULTS: A total of 356 BCs (mean age = 54.07 years) were included. Depressive symptoms showed a strong association with higher SCI (β = 0.441, P < 0.001). Physical activity showed an indirect association with lower SCI through reduced depressive symptoms (β = -0.079, 95 %CI: -0.146 to -0.031). Physical activity was also negatively related to anxiety symptoms (β = -0.113, P < 0.05). After excluding anomalous cases, anxiety symptoms were additionally found to be significantly associated with SCI (β = 0.142, P < 0.001).
CONCLUSIONS: These findings highlight the potential relevance of depressive symptoms in the experience of SCI among middle-aged and older BCs receiving chemotherapy. The observed indirect association suggests that patients with low physical activity levels may warrant particular attention, as they may be at greater risk for depressive symptoms and cognitive complaints. Further interventional studies are needed to examine the potential benefit of physical activity for emotional well-being and SCI in this population.
METHODS: In this cross-sectional study, patients were recruited via convenience sampling at a tertiary hospital in Guangzhou, China. SCI, depressive symptoms, anxiety symptoms, physical activity, and sedentary behavior were assessed using the Functional Assessment of Cancer Therapy-Cognitive Function, the 10-item version of the Center for Epidemiological Studies Depression Scale, the Brief Generalized Anxiety Disorder Scale, and the short form of the International Physical Activity Questionnaire. Structural equation modelling was conducted to test a hypothesized path model with depressive and anxiety symptoms as mediators.
RESULTS: A total of 356 BCs (mean age = 54.07 years) were included. Depressive symptoms showed a strong association with higher SCI (β = 0.441, P < 0.001). Physical activity showed an indirect association with lower SCI through reduced depressive symptoms (β = -0.079, 95 %CI: -0.146 to -0.031). Physical activity was also negatively related to anxiety symptoms (β = -0.113, P < 0.05). After excluding anomalous cases, anxiety symptoms were additionally found to be significantly associated with SCI (β = 0.142, P < 0.001).
CONCLUSIONS: These findings highlight the potential relevance of depressive symptoms in the experience of SCI among middle-aged and older BCs receiving chemotherapy. The observed indirect association suggests that patients with low physical activity levels may warrant particular attention, as they may be at greater risk for depressive symptoms and cognitive complaints. Further interventional studies are needed to examine the potential benefit of physical activity for emotional well-being and SCI in this population.