Cognitive changes after breast cancer: a scoping review to identify problems encountered by women when returning to work.

PURPOSE A scoping review of international literature was conducted to identify the various problems encountered by women with breast cancer associated with cognitive deficits, and the relationship to work roles and tasks. METHOD This scoping review was conducted using the structure recommended by Arksey & O'Malley in consideration of the PRISMA extension for Scoping Reviews checklist and reviewed for quality, inclusion criteria and key findings related to cognitive changes after breast and impact on work. Searches were conducted in five databases from January 2000 to December 2020. RESULTS A total of 34 studies met the inclusion criteria. There were 20 quantitative studies, 11 qualitative studies, one mixed method and two case study reports. Findings related to the type of cognitive changes that impact work performance and participation, how these are measured in a work context and the types of interventions directed towards improving cognitive function at work after breast cancer. An absence of ecologically valid assessments and interventions with a coherent approach to early identification and management of cognitive changes after breast cancer was apparent. CONCLUSION Breast cancer survivors can experience challenges in their employment due to cognitive deficits, which may lead to the loss of their employment. Health professionals need to explore breast cancer survivors work role and consider appropriate referrals to ensure women receive the necessary support and rehabilitation to address cognitive problems impacting work performance. Further research is needed to develop workplace-based cognitive assessments and interventions to improve the work performance and participation of women with breast cancer experiencing cognitive deficits.Implications for RehabilitationWork participation can be negatively impacted by unacknowledged cognitive changes that are not assessed and managed throughout the cancer survivorship journey.Health professionals in health care systems, particularly occupational therapists need to consider appropriate referrals to workplace rehabilitation providers to ensure necessary support and rehabilitation to address cognitive problems impacting on work performance.Occupational therapists performing workplace assessments for women with breast cancer, should assesses cognitive function in accordance with the cognitive demands of the job and work environment, and involve the employer and client in workplace based cognitive interventions.