"Om å holde på øyeblikket når minnene er borte...": Kognitiv svekkelse hos kreftoverlevere - En metasyntese over utførte studier 2007-2011
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My aim with this writing is to give a review of what science has done the last five years with the topic of cognitive impairment, both national and international. What do we know, and what do we not know in this area? Many patients who have completed initial cancer treatment with chemotherapy, experience cognitive changes. This mild cognitive impairment evinced in form of short-term memory loss, and attention and concentration problems. Side-effects can be both physical and/or psychological of nature and we know quite a lot of how to deal with them. We know much less about cognitive impairment and the underlying mechanisms of progressing cognitive dysfunction. Cancer comes in many variations and so doe’s cancer treatment too. A lot of people survive the illness and the treatment and becomes a cancer survivor for at least five to ten years after initial diagnosis and treatment. Better diagnosis and treatment has given more cancer survivors. But what do we know about cognitive impairment? It is impairment in higher brain functions and it is still unknown what causes it. The cancer survivors reports that this comes when they get their chemotherapy, but the scientist don`t necessarily agreed. They struggle with finding tests that can measure the cognitive impairment better. Until now, neuropsychological tests are not good enough to measure this subtle condition. Both oncology and psychology agreed that it is need for a multi factorial approach to the topic. How long the patients will have this problem are varying from those who get better when the chemotherapy is over, to those who struggle with it for more than ten years. This condition can make it problematic to get back to job and hard to deal with daily life because of their lack of concentration and memory. Scientist in both oncology and psychology are aware of certain methodological problems in studies, and it is still more review than original articles in this topic. The quality of the evidence is often poor, and we urgently need data on the natural evolution and scale of the problems and cancer survivors obtained from welldesigned, large-scale cohort studies and testing of interventions in clinical trials. My scientifically and theoretically approach is hermeneutic and the method I use is a metasyntese of three perspectives. First from the medicine, second from the patient’s perspective and third from the psychological point of view.