The lived experience of cognitive impairment in women treated with chemotherapy for breast cancer.

A growing body of literature supports that a subgroup of women treated with chemotherapy for breast cancer may experience of cognitive impairment after therapy. Few studies have described the lived experience of cognitive impairment. The purpose of this dissertation study was to describe the lived experience of self reported cognitive impairment in a sample of women who were treated with chemotherapy for breast cancer. This exploratory study used both descriptive and interpretive Gadamerian phaenomenological theory to examine the experience of cognitive impairment on day-to-day life. Ten women treated with chemotherapy for breast cancer 15-52 months prior and identified themselves as having cognitive impairment were interviewed twice about their experiences. Three themes were identified in the analysis; "I just don't fell like me," "trying my best to live with it" and "I am alive." Participants described problems with memory, learning, concentration, language and multitasking abilities. Incidents of "chemo brain" could occur at any time and affected the ability to perform usual activities at work and at home Coping mechanisms were practical and attitudinal. Self esteem was sometimes negatively affected. Relationships were changed with some participants describing more isolation from friends and family and other describer greater support. The final theme speaks to the bigger experience of breast cancer and within that, the experience of chemo brain. The women believed that chemo brain was something that developed because of the necessary treatment for breast cancer. Often the women spoke about how they had survived breast cancer and that surviving was above all else the most important thing. Future implications for nursing and research include recognizing that cognitive impairment is experienced in a subgroup of breast cancer survivors. While it is important to inform breast cancer patients of this potential problem, it is also important to assess for other underlying factors that can play a role in cognitive impairment. The results of this study showed that social support is important to successful coping with cognitive impairment. More research is warranted to access this relationship. In addition, the participants provided concrete coping skills that can be easily used by cancer survivors struggling with cognitive impairment.