Nurse’s Perceptions of Best Practices to Assess Pediatric Patients and Educate Their Families Experiencing Delayed Effects of Cancer Therapy: “Chemo Brain:” A Pilot Study

With more advanced and more aggressive chemotherapy cancer treatment leading to higher survival rates, complications with quality of life are becoming more prominent. Of these complications, delayed cognitive processing, commonly known as “chemo brain,” is becoming a topic of interest. Cognitive changes are some of the most common as well as most challenging complications associated with central nervous system (CNS) directed treatment, such as intrathecal chemotherapy, for acute lymphoblastic leukemia (ALL) and brain tumors. The term “chemo brain” is often used to describe self-reported or observed cognitive processing delays in patients who receive chemotherapy as a form of cancer treatment (Raffa, 2009). Although these cognitive delays have the potential to be serious side effects, little education is given to the patients and families regarding these possibilities prior to the initiation of cancer treatment. The purpose of this paper is three fold: 1) to define and discuss the etiology of “chemo brain,” 2) discuss the best assessment and evaluation of severity of “chemo brain,” and 3) to explore pediatric oncology nurses reports of practice implications for teaching and supporting pediatric patients and their families experiencing “chemo brain.” A theoretical framework that will guide the research is Erikson’s Theory of Psychosocial Development with a focus on the school age stage of industry versus inferiority. With the possible gap in knowledge and skill that may be present in these children who have undergone chemotherapy, there is a significantly higher chance of them developing a sense of inferiority rather than the preferred sense of industry. Convenience and snowball sampling will be used to locate pediatric oncology registered nurses to complete the research instrument. This pilot study has a qualitative/descriptive design with a goal of 30 subjects. Research data will be collected through a short survey created by the primary investigator that has construct and content validity from two advanced practice pediatric oncology nurses