Characterizing changes in executive functions and performance in daily activities after chemotherapy: A pre-post mixed-methods study protocol.

Background: Impairments in higher cognitive abilities (termed executive functions (EF) are common among individuals with cancer following chemotherapy and may impact their performance of daily activities. Our aim is to better understand the changes in EF and the impact on performance in daily activities of individuals with cancer pre- and post-chemotherapy.

Methods: A convergent parallel mixed-method pre-post experimental design. Qualitative and quantitative data will be collected pre- and post-chemotherapy (12 weeks following chemotherapy commencement). Participants will be adult candidates for chemotherapy who are newly diagnosed with non-central nervous system malignancy, stages I-III. The Canadian Occupational Performance Measure will assess the performance of daily activities; secondary measures include EF, cognitive functioning, fatigue, and emotional well-being. Qualitative data will be collected via open-ended questions. Pre- and post-chemotherapy, quantitative and qualitative data will be analyzed separately and merged into an overall interpretation. It is expected that, pre-chemotherapy, no difficulties in performing daily activities will be revealed. Post-chemotherapy EF impairments will be apparent and their impact on the performance of daily activities will be identified.

Conclusions: Integrating quantitative and qualitative measures will contribute to a comprehensive understanding of the individuals' cognitive needs and may enable the development of effective interventions to minimize deterioration in daily activities after chemotherapy.