Parents’ Perspectives on Using Computerized Cognitive Training to Manage Cognitive Late Effects in Children With Cancer: Qualitative Descriptive Study

BACKGROUND: Cognitive late effects affect 35%-60% of patients with pediatric cancer. Computerized cognitive training (CCT) is promising for cognitive training. Parents play a key role in children's CCT participation, particularly by providing guidance and practical support during training. Yet, little is known about parents' views on integrating CCT into the management of cognitive late effects in these patients. OBJECTIVE: This study aimed to explore parents' perspectives on the use of CCT for managing cognitive late effects in children with cancer, including perceived facilitators, barriers, and suggestions for improvement. METHODS: We conducted semistructured interviews with parents of children with cancer aged 3-6 years who had used or were currently using CCT for cognitive training. Interviews were audio-recorded and transcribed verbatim in Chinese and analyzed using inductive thematic analysis. Selected anonymized quotations were translated into English by the first author and reviewed against the original Chinese transcripts to ensure accuracy and preserve contextual meaning. RESULTS: We recruited 20 parents and identified 3 main themes and 12 subthemes regarding the use of CCT for cognitive management in children with cancer: (1) Perceptions of Integrating CCT into Cognitive Management, including Narrowing the Gap with Peers, Brief Yet Persistent Participation, It Freed Up My Time, Perceived Changes in Cognitive Functioning, and It Brings Fun; (2) Challenges, including Sometimes It's a Bit Hard for the Child, Sometimes We Forget to Do the Training, Fear of the "Retard" Label, and Can We Afford to Keep Doing This?; and (3) Opportunities for Improvement, including Need for Tailored Training, Information Needs, and Don't Leave Us Hanging. CONCLUSIONS: This study suggests that parents generally perceived CCT as a practical, engaging, and convenient approach to supporting cognitive management in children with cancer, particularly for home-based training. However, several challenges remain to be addressed to facilitate sustained engagement with CCT. Although some parents perceived improvements in their children's cognitive functioning following CCT, these perceptions do not establish the effectiveness of the intervention. Overall, this study highlights the potential value of CCT from parents' perspectives and provides practical insights for developing more flexible, individualized, and family-centered CCT interventions. Future research should incorporate children's perspectives, recruit more diverse samples, consider potential concerns related to prolonged screen use, and use objective cognitive outcomes to evaluate CCT effectiveness.