Early Cognitive Interventions in Digital Format for Cancer Survivors

Functional Assessment of Cancer Therapy-Cognition, FACT-Cog v3

Self-report questionnaire for cancer patients with cognitive problems consisting of 37 items divided in 4 subscales: Perceived Cognitive Impairment (PCI), Perceived Cognitive Abilities (PCA), Comments From Others (OTH), and Impact on Quality of Life (QoL). The items asked for the past 7 days and are rated on a 5-point Likert scale. Higher scores are indicative of a better cognitive function and QoL.

Sufficient adherence is defined by completing at least 70% of the required exercise levels

MoCA: screening tool aiming to detect cognitive impairment. Total score ranges from 0 to 30, with higher scores indicating better cognitive function.

The HVLT-R assesses learning and immediate and delayed verbal memory. The number of words remembered ranges from 0 to 36 (immediate memory) and from 0 to 12 (delayed memory). Higher scores, words remembered, are indicative of better memory.

Consists of two parts, to connect numbers in ascending order and to alternate connecting numbers and letters in ascending order. The final score is the time taken to complete the task. The longer it takes, the poorer the cognitive performance.

Consists of phonological fluency (P-M-R) and semantic fluency (animals, fruits and vegetables). Each word correctly given in each category counts as a point. Higher scores mean better verbal fluency.

Measures attention (Digits Forward) and working memory (Digits Backward). The participant must repeat a number sequence. Higher scores, total number sequences correctly repeated, indicate better performance.

Measures processing speed. Higher scores, number of correctly correct answers, indicate better processing speed.

Cognitive test (higher score indicating better outcome).

Cognitive test (higher score indicating better outcome)

Cognitive test (higher score indicating better outcome)

Cognitive test (higher score indicating better outcome)

Cognitive test (higher score indicating better outcome)

Cognitive test (higher score indicating better outcome)

Assesses learning and immediate and delayed verbal memory. The number of words remembered ranges from 0 to 36 (immediate memory) and from 0 to 12 (delayed memory). Higher scores, words remembered, are indicative of better memory.

EORTC - QCL - FA-12, is a 12-item Likert scale. It evaluates the physical, emotional, and cognitive aspects of fatigue and the interference of it with daily activities and social life in the last 7 days. The items range from 1 to 4 with higher values representing higher symptomatology.

Insomnia Severity Index - ISI. It consists of 7 questions asking for difficulties of falling asleep, staying asleep, and problems with waking up too early, current sleep patterns and the effects of sleep on quality of life. Higher scores indicate more sleep problems.

Hospital Anxiety and Depression Scale (HADS). It is used to assess anxiety and depression in a hospital setting. This scale consisted of 14 questions, where half of the questions are related to anxiety and the other half to depression. Each item ranges from 0 to 3. Higher scores indicate the presence of anxiety and/or depression.

EORTC QLQ-C-30. This assessment consisted of 30 questions addressing several aspects of quality of life in cancer patients (Functioning scales: physical, emotional, social, cognitive and role; Symptoms scales: fatigue, nausea/vomiting, pain, dyspnea, insomnia, appetite loss, constipation and diarrhea symptoms, plus financial difficulties and global health status / quality of life scale). For each scale, scores range from 0 to 100, with higher scores indicating good functioning in the functioning scales and more symptoms burden in the symptoms scales.

The first two items of the WAI scale rated the current work ability on a Likert scale from 1 to 10 and the current work ability with respect to the physical and the mental demands of the work. On both items higher scores reflect better work ability.

Morisky Medication Adherence Scale (MMAS-8) (MMAS-8). The scale consists of 8 items. Response choices are "yes" or "no" for items 1-7 and Item 8 has a five-point Likert response scale. Total scores on the MMAS-8 range from 0 to 8, with higher scores meaning higher adherence.

Net Promoter Score (NPS), assesses satisfaction with a specific product or service by asking how likely that person is to recommend it to someone else on a scale of 0 (not at all likely) to 10 (extremely likely). The final score is calculated by dividing the percentage of promoters (those who score 9-10) by the percentage of detractors (those who score 0-6). The NPS range varies between -100 and +100, with a positive score being considered acceptable and the higher the score, the more acceptable it is considered to be. Client Satisfaction Questionnaire (CSQ-8). Likert-based 8-item questionnaire rating overall satisfaction and acceptability. The 8 items are scored on a 4-point scale (total range from 8-32) with higher scores indicating greater acceptability and satisfaction.

Game Experience Questionnaire (GEQ). The Core Module consists of 33 items which assess game experience on seven components: Immersion, Flow, Competence, Positive and Negative Affect, Tension, and Challenge. Each item is rated from 0 (Not at all) to 4 (Extremely). High score in a concrete dimension means intense experience on that dimension.

System Usability Scale (SUS), is a 10-item self-report measure designed for usability assessment. Items are rated on a 5- 8 point Likert scale (1 = strongly disagree, 5 = strongly agree). Total SUS scores have a range of 0 to 100, being higher scores in the SUS indicative of greater usability.