Behavior Change Wheel-Based Music Listening for Chemotherapy-Related Cognitive Impairment in Breast Cancer Patients

Effect of a Behavior Change Wheel-Based Music Listening Intervention on Chemotherapy-Related Cognitive Impairment in Breast Cancer Patients: An Assessor-Blinded Randomized Controlled Trial

Breast cancer patients frequently experience chemotherapy-related cognitive impairment (CRCI), which can negatively affect memory, attention, executive function, daily activities, and quality of life. Effective non-pharmacological interventions for CRCI remain limited.

This randomized controlled trial aims to evaluate the effectiveness of a Behavior Change Wheel (BCW)-based music listening intervention in improving cognitive function among breast cancer patients receiving chemotherapy. A total of 90 eligible participants will be randomly assigned in a 1:1 ratio to either a BCW-based music listening intervention group or a routine care control group. Participants in the intervention group will receive a 12-week music listening program in addition to routine care, while participants in the control group will receive routine care alone.

The primary outcome is the change in Functional Assessment of Cancer Therapy-Cognitive Function (FACT-Cog) total score from baseline to the end of the intervention. Secondary outcomes include FACT-Cog subscale scores and PROMIS anxiety and depression scores. This study aims to provide evidence regarding the effectiveness of a theory-based music listening intervention for managing chemotherapy-related cognitive impairment in breast cancer patients.

This study was registered retrospectively after completion of participant enrollment and follow-up.

This is a single-center, assessor-blinded, parallel-group randomized controlled trial designed to evaluate the effectiveness of a Behavior Change Wheel-based music listening intervention for chemotherapy-related cognitive impairment in breast cancer patients. Eligible participants were adult female patients with histopathologically confirmed breast cancer who received chemotherapy. A total of 90 participants were randomly assigned in a 1:1 ratio to either the intervention group or the control group. Participants in the intervention group received routine nursing care plus a 12-week BCW-based music listening intervention, which included relationship building, health education, family involvement, individualized planning, self-training, behavioral reinforcement, and regular feedback. Participants were instructed to listen to self-selected music for at least 20 minutes per day. Participants in the control group received routine nursing care, including health education, educational materials, online support, and regular follow-up. The primary outcome was the change in Functional Assessment of Cancer Therapy-Cognitive Function total score from baseline to Week 12. Secondary outcomes included FACT-Cog subscale scores and PROMIS anxiety and depression scores. Primary analyses followed the intention-to-treat principle, and analysis of covariance was used to compare post-intervention outcomes between groups while adjusting for baseline values. The study was approved by the Ethics Committee of The First Affiliated Hospital of Nanjing Medical University. Written informed consent was obtained from all participants before enrollment. This study was registered retrospectively after completion of participant enrollment and follow-up.

Inclusion Criteria:

1. Histopathologically confirmed breast cancer.
2. Female patients aged 18 years or older.
3. Patients receiving chemotherapy with at least six planned cycles.
4. Able to understand the study procedures and complete the required questionnaires.
5. Provided written informed consent and voluntarily agreed to participate.

Exclusion Criteria:

1. Visual, hearing, or speech impairment that may affect participation in the intervention or outcome assessment.
2. Cognitive impairment caused by other diseases.
3. Metastatic breast cancer or cachexia.
4. Receiving other interventions specifically targeting cognitive impairment.