Les difficultés cognitives
Authors:
Dr. Christine Maheu, RN, PhD ,
Ms. Rosemary Cashman ,
Kyla Johnson, Occupational Therapist, Segal Cancer Centre, Jewish General Hospital ,
Ms. Maureen Parkinson, Vocational Rehabilitation Counsellor, M.Ed. C.C.R.C, BC CancerDr. Christine Maheu, RN, PhD
Dr. Christine Maheu is an Associate Professor in the Ingram School of Nursing, Faculty of Medicine, McGill University. Dr. Maheu is also an Affiliate Scientist at the University Health Network and the University of Toronto. At McGill University, she teaches research methods, supervises graduate students (masters, doctoral, post-doctoral), mentors practicing nurses and students in research, and conducts research in English and French. She has held research awards with the Canadian Institutes of Health Research, the Canadian Cancer Society, and the Canadian Partnership Against Cancer. These awards funded her research in psychosocial oncology, which focuses on developing and testing psychosocial interventions or measurements tools for various cancer populations. Additionally, in partnership with Ipsos Canada and funded by the Canadian Partnership Against Cancer, she is co-leading a nationwide survey of the needs of cancer patients for transition care from the end of their treatment to three years after their diagnosis. Dr. Maheu received awards for excellence in nursing research (2013, 2015, 2016) from Ovarian Cancer Canada, the Canadian Association of Nurses in Oncology, and the Quebec Association of Nurses in Oncology.
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Ms. Rosemary Cashman
Ms. Rosemary Cashman is a nurse practitioner at the BC Cancer Agency and an Adjunct Professor in the Faculty of Nursing at the University of British Columbia. Her professional experience includes the care of lymphoma, lung cancer and brain cancer patients. She co-chairs the Patient and Family Advisory Council, which guides the brain tumour care program at the BC Cancer Agency. She has authored book chapters and articles related to the care of brain tumour patients and their families. Ms. Cashman was involved in developing and implementing a rapid-access radiotherapy clinic for the palliative treatment of lung cancer and she continues to work in this clinic.
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Kyla Johnson, Occupational Therapist, Segal Cancer Centre, Jewish General Hospital
Ms. Kyla Johnson, M.Sc.A., originally from Edmonton, Alberta, Kyla Johnson works as an Occupational Therapist at the Segal Cancer Center of the Jewish General Hospital. She holds a Master of Science in Occupational Therapy from McGill University. Her goal as a rehabilitation professional in Oncology is to enable people with cancer to be able to do what they want and need to do, in all stages of their cancer experience. Kyla helps develop strategies and accommodations to facilitate a return to meaningful life roles, including work. She is specialized in cancer-related cognitive dysfunction and runs a weekly group teaching strategies to improve daily cognitive functioning. Kyla also leads a volunteer yoga class for young adults with cancer. She lives in Montreal, Quebec.
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Ms. Maureen Parkinson, Vocational Rehabilitation Counsellor, M.Ed. C.C.R.C, BC Cancer
Ms. Maureen Parkinson is the province-wide vocational rehabilitation counsellor at the BC Cancer Agency. She has also been vocational rehabilitation counsellor at a public rehabilitation hospital and vocational rehabilitation consultant to insurance companies and the court system. She has instructed and facilitated Service-Canada-funded programs on job searching and career exploration. Ms. Parkinson has a Masters in Counselling Psychology, is a Canadian Certified Rehabilitation Counsellor, and completed the Certified Return to Work Coordinator Program through the National Institute for Disability Management and Research. She has developed return-to-work and job-search seminars for cancer patients and created the guidebook “Cancer and Returning to Work: A Practical Guide for Cancer Patients” as well as on-line articles about returning to work and school. She also co-authored a paper commissioned by the Canadian Association of Psychosocial Oncology, “Cancer and Work: A Canadian Perspective”.
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Révisé par Lori Bernstein, membre de l’équipe principale, neuropsychologue
Nombreux sont les patients qui déclarent souffrir de difficultés cognitives pendant et après un traitement contre le cancer. Ces difficultés peuvent dépendre du type et de l’emplacement du cancer, du type et de la durée du traitement, de la présence d’autres maladies et affections médicales, ainsi que de problèmes de santé mentale comme la dépression, l’anxiété et le stress.
Il arrive que des personnes traitées pour un cancer constatent un changement dans leurs capacités cognitives, notamment leur concentration et leur aptitude à mener plusieurs tâches de front. Elles pourront aussi avoir plus de mal à apprendre ou à se rappeler des choses, et peineront à trouver les mots à l’oral comme à l’écrit. Si, en général, le rétablissement survient graduellement une fois le traitement terminé, il varie beaucoup d’une personne à l’autre. Certains symptômes sont insignifiants, tandis que d’autres sont nettement plus gênants. Les symptômes sont plus souvent persistants chez les personnes ayant suivi une chimiothérapie. Les termes « cerveau chimio » et « brouillard de la chimio » sont donc largement employés, même lorsqu’il n’y a pas eu de chimiothérapie. Les causes des difficultés cognitives restent floues, mais on pense que les facteurs en sont nombreux. Le problème est encore plus prononcé dans les milieux stressants.
Les difficultés cognitives persistantes se manifestent également en cas de tumeur cérébrale. À chaque région du cerveau correspondent des fonctions précises. Par conséquent, l’emplacement et la taille de la tumeur détermineront le type de défaillance. Parallèlement, les traitements associés, la physiologie propre à chacun et la nature des médicaments sont eux aussi susceptibles de compromettre le fonctionnement cognitif.
Conséquences sur le travail
Les employés devront estimer leur durée maximale de concentration sur chaque activité pour savoir s’ils ont besoin d’aide ou de formation. À certains moments de la journée, leur vivacité pourrait faiblir. En ayant conscience de ces schémas, ils seront à même de recenser les tâches et les heures pour lesquelles il leur faudra des stratégies visant à augmenter leur rendement.
Ladaptation du lieu de travail en fonction des difficultés cognitives
