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Victorson D, Morgan T, Kutikov A, Novakovic K, Kundu S, Horowitz B, Jackson K, Addington E, Murphy K, Sauer C, Brendler C. Mindfulness-based stress reduction for men on active surveillance for prostate cancer and their spouses: Design and methodology of a randomized controlled trial. Contemp Clin Trials 2023; 125:107059. [PMID: 36563902 PMCID: PMC9918709 DOI: 10.1016/j.cct.2022.107059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2022] [Revised: 12/18/2022] [Accepted: 12/19/2022] [Indexed: 12/24/2022]
Abstract
BACKGROUND Although active surveillance (AS) is an increasingly adopted treatment paradigm for management of very low risk prostate cancer, many men and their partners face a variety of AS-related psychosocial stressors. Stressors may include anxiety and fear of progression, which may negatively affect short- and long-term psychosocial adjustment and influence early withdrawal from AS in order to seek definitive therapies such as surgery or radiation. Here we describe the protocol for an NCI-funded trial, which seeks to examine the efficacy of mindfulness training compared with a time/attention-matched health promotion control condition in a geographically generalizable sample of men on AS and their spouses. METHODS Using a randomized, controlled, partially double-blinded study design, this study involves the delivery of 8 weeks of standardized mindfulness training (MBSR; mindfulness-based stress reduction) and patient reported outcomes over a 12-month period (proposed enrollment of 80 men on AS and spouses), compared with a health promotion control (proposed enrollment of 80 men on AS and spouses) that has been matched for time and attention. Baseline (T1) measures (e.g., anxiety, fear of progression, quality of life) are administered just prior to randomization to the two study arms, followed by repeated assessments at 2 months (T2), 6 months (T3) and 12 months (T4). CONCLUSION This study has the potential to offer men and their partners on AS with important educational and self-regulatory skills to better cope and adjust with known stressors related to being placed on this protocol.
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Affiliation(s)
- David Victorson
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
| | - Todd Morgan
- University of Michigan, Department of Urology, Ann Arbor, MI, USA
| | | | - Kristian Novakovic
- John and Carol Walter Center for Urological Health, NorthShore University Health System, Evanston, IL, USA
| | - Shilajit Kundu
- Department of Urology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Bruriah Horowitz
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Kathryn Jackson
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Elizabeth Addington
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Karly Murphy
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Christina Sauer
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Charles Brendler
- John and Carol Walter Center for Urological Health, NorthShore University Health System, Evanston, IL, USA
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Wood AW, Martin JL, Bruns K. An Integrative Counseling Approach for African American Couples With Prostate Cancer. ADULTSPAN JOURNAL 2021. [DOI: 10.1002/adsp.12113] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
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Cho D, Basen-Engquist K, Acquati C, Ma H, Pettaway C, Li Y, Diep CS, McNeill LH. Study protocol: a lifestyle intervention for African American and Hispanic prostate cancer survivors on active surveillance and their partners. Pilot Feasibility Stud 2020; 6:111. [PMID: 32782817 PMCID: PMC7414583 DOI: 10.1186/s40814-020-00653-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2018] [Accepted: 07/30/2020] [Indexed: 11/17/2022] Open
Abstract
Background Prostate cancer is the most commonly diagnosed cancer in both African American and Hispanic men. Active surveillance is a treatment option for low- or very low-risk prostate cancer survivors, and lifestyle interventions have been found to reduce the disease progression and improve the quality of life for both survivors and their partners. To date, no lifestyle interventions that specifically target African American or Hispanic men and their partners exist. This protocol describes a study that tests the feasibility of a randomized controlled trial, a lifestyle intervention developed to enhance healthy lifestyle and quality of life among African American and Hispanic men on active surveillance and their partners. Methods A mixed-method study, including a two-arm randomized controlled trial (n = 30 dyads in the intervention arm and n = 10 dyads in the control arm) and in-depth interviews, will be conducted. Intervention arm participants will receive bi-weekly health coaching calls (a total of 12 calls based on Motivational Interviewing), as well as physical activity-specific (e.g., power point slides, print materials about physical activity, and activity trackers for self-monitoring) and nutrition-specific education (e.g., two nutrition counseling sessions from a registered dietitian, print materials about nutrition, and food intake recording for self-monitoring) over 6 months. All participants will be assessed at baseline, month 3, and month 6. Blood will be collected at baseline and month 6 from the prostate cancer survivors. Finally, in-depth interviews will be conducted with subsamples (up to n = 15 dyads in the intervention arm and up to n = 5 dyads in the control arm) at baseline and months 3 and 6 to conduct a process evaluation and further refine the intervention. Discussion If effective, the intervention may have a higher health impact compared with a typical lifestyle intervention targeting only survivors (or partners), as it improves both survivors’ (tertiary prevention) and partners’ health (primary prevention). Results from this study will provide important information regarding recruiting racial/ethnic minority cancer survivors and their partners. Lessons learned from this study will be used to apply for a large-scale grant to test the impact of the dyadic intervention in a fully powered sample. Trial registration ClinicalTrials.gov (NCT No. 03575832) registered on 3 July 2018.
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Affiliation(s)
- Dalnim Cho
- Department of Health Disparities Research, UT Texas MD Anderson Cancer Center, 1400 Pressler St, 9th floor, Houston, TX 77030 USA
| | - Karen Basen-Engquist
- Department of Behavioral Science, UT Texas MD Anderson Cancer Center, Houston, TX USA
| | - Chiara Acquati
- Graduate College of Social Work, University of Houston, Houston, TX USA
| | - Hilary Ma
- Department of General Oncology, UT Texas MD Anderson Cancer Center, Houston, TX USA
| | - Curtis Pettaway
- Department of Urology, UT Texas MD Anderson Cancer Center, Houston, TX USA
| | - Yisheng Li
- Department of Biostatistics, UT Texas MD Anderson Cancer Center, Houston, TX USA
| | | | - Lorna H McNeill
- Department of Health Disparities Research, UT Texas MD Anderson Cancer Center, 1400 Pressler St, 9th floor, Houston, TX 77030 USA
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Hansen HP, Tjørnhøj-Thomsen T. Men with cancer and their experiences of marital relationships: a struggle for control and balance. Anthropol Med 2020; 27:315-329. [DOI: 10.1080/13648470.2019.1688611] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- Helle Ploug Hansen
- Department of Public Health, The Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark
| | - Tine Tjørnhøj-Thomsen
- National Institute of Public Health, The Faculty of Health Sciences, University of Southern Denmark, Copenhagen, Denmark
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Martinez YC, Ellington L, Vadaparampil ST, Heyman RE, Reblin M. Concordance of cancer related concerns among advanced cancer patient–spouse caregiver dyads. J Psychosoc Oncol 2019; 38:143-155. [DOI: 10.1080/07347332.2019.1642285] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Affiliation(s)
- Yessica C. Martinez
- Department of Cancer Epidemiology, Moffitt Cancer Center, Tampa, Florida, USA
| | - Lee Ellington
- University of Utah College of Nursing, Salt Lake City, Utah, USA
| | - Susan T. Vadaparampil
- Department of Health Outcomes & Behavior, Moffitt Cancer Center, Tampa, Florida, USA
| | | | - Maija Reblin
- Department of Health Outcomes & Behavior, Moffitt Cancer Center, Tampa, Florida, USA
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Abstract
So much has happened since the original publication of this chapter. In some ways, the progress made in appreciating the full spectrum of sexual and gender expression has been uneven and in some nations, there has been serious regression and resulting repression. But overall, especially in the industrialized countries, there is much greater awareness of sex and gender and its importance in health and well being. In this updated chapter, we put sex and gender into a historical context that is relevant to psycho-oncology and that openly accepts that society overall, is highly conflicted when it comes to how women and men get the best out of each other, never mind how to best integrate lesbian, gay, bisexual, and transgender (LGBT) communities. With the advent of more tailored treatments and strategic medicine, sex becomes much more important as a variable and this has led to greater scientific requirements to create protocols that integrate sex into all aspects of health from prevention, diagnosis, treatment, survivorship, and death. But we still have a very far way to go. There is a serious dearth of data on sex and gender in science overall and in cancer medicine specifically. Avoidance of discussions of sex and gender in medicine reflects the larger lingering societal discomfort with any discussion that links potential sex and gender differences with superiority. The data shows that there is more intrasexual than intersexual variation in men and women. When speaking about sex and gender the literature reflects that, on average, there are many differences, and although they are small, that when taken together, the impact may be quite robust. Sex and gender differences are relevant to how individuals, couples, and families experience and cope with serious illness; however these important and obvious variables are seldom taken into account when counseling seriously ill patients and their families. Cancer is a complex disease that brings into sharp relief the potential alignments and misalignments in the sexes. In this chapter we have attempted to communicate the imperative for and importance of understanding people under stress within the context of sex and gender. Gender-specific medicine is a very young movement for scientific study but one that has great potential to maximize adaptation and mutual respect at a time when men and women are redefining themselves and adapting to new social realities and challenges.
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Affiliation(s)
- Matthew Loscalzo
- City of Hope, 1500 East Duarte Road, Main Medical Bldg Suite Y-1, Duarte, CA, 91010-3000, USA.
| | - Karen Clark
- City of Hope, 1500 East Duarte Road, Main Medical Bldg Suite Y-8, Duarte, CA, 91010-3000, USA
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Kim Y, Mitchell HR, Ting A. Application of psychological theories on the role of gender in caregiving to psycho-oncology research. Psychooncology 2018; 28:228-254. [PMID: 30488661 DOI: 10.1002/pon.4953] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2018] [Revised: 11/21/2018] [Accepted: 11/23/2018] [Indexed: 12/29/2022]
Abstract
BACKGROUND Cancer affects both men and women, yet systematic understanding of the role of gender in caregiving and dyadic caregiver-patient interactions is lacking. Thus, it may be useful to review how gender theories apply to cancer caregiving and to evaluate the adequacy of current cancer caregiving studies to the gender theories. METHODS Several databases, including MEDLINE (Ovid), PsychINFO, PubMed, and CINAHL, were used for searching articles published in English between 2000 and 2016. The search was restricted by age (≥18) and yielded 602 articles, which were subject to further screen and review based on selection criteria. Of 108 full texts reviewed to determine inclusion eligibility for this review, 55 met the criteria and included for review. RESULTS The reviewed studies supported the "gender role" and "doing gender" perspectives for caregiver selection. The role identity, role strain, and transactional stress theories were supported for predicting caregiving outcomes at the individual level. Furthermore, attachment, self-determination, and interdependence theories incorporated caregiver factors that predicted the patients' outcomes, and vice versa. CONCLUSION Despite limited gender theory-driven research in cancer caregiving and psycho-oncology in general, the utility of gender theories in (a) identifying subgroups of caregiver-patient dyads who are vulnerable to the adverse effects of cancer in the family and (b) developing evidence-based interventions is promising. Integrating broader issues of medical trajectory, lifespan, sociocultural, and biological factors in gender-oriented research and practice in psycho-oncology is encouraged.
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Affiliation(s)
- Youngmee Kim
- Department of Psychology, University of Miami, Coral Gables, FL, USA
| | | | - Amanda Ting
- Department of Psychology, University of Miami, Coral Gables, FL, USA
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8
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Harju E, Rantanen A, Kaunonen M, Helminen M, Isotalo T, Åstedt-Kurki P. Changes in the health-related quality of life of patients with prostate cancer and their spouses. INTERNATIONAL JOURNAL OF UROLOGICAL NURSING 2018. [DOI: 10.1111/ijun.12157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Eeva Harju
- Doctoral Researcher, Doctoral Researcher Faculty of Social Sciences, Nursing Science; University of Tampere; Tampere Finland
| | - Anja Rantanen
- Docent, University Teacher Faculty of Social Sciences, Nursing Science; University of Tampere; Tampere Finland
| | - Marja Kaunonen
- Professor, Doctoral Researcher Faculty of Social Sciences, Nursing Science; University of Tampere; Tampere Finland
- Department of General Administration; Pirkanmaa Hospital District; Tampere Finland
| | - Mika Helminen
- Biostatistician, Faculty of Social Sciences; University of Tampere; Tampere Finland
- Science Centre; Pirkanmaa Hospital District; Tampere Finland
| | - Taina Isotalo
- Chief Urologist, Department of Surgery; Päijät-Häme Central Hospital; Lahti Finland
| | - Päivi Åstedt-Kurki
- Professor, Department of General Administration; Pirkanmaa Hospital District; Tampere Finland
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Song L, Dunlap KL, Tan X, Chen RC, Nielsen ME, Rabenberg RL, Asafu-Adjei JK, Koontz BF, Birken SA, Northouse LL, Mayer DK. Enhancing Survivorship Care Planning for Patients With Localized Prostate Cancer Using a Couple-Focused mHealth Symptom Self-Management Program: Protocol for a Feasibility Study. JMIR Res Protoc 2018; 7:e51. [PMID: 29483070 PMCID: PMC5847815 DOI: 10.2196/resprot.9118] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2017] [Revised: 11/22/2017] [Accepted: 11/22/2017] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND This project explores a new model of care that enhances survivorship care planning and promotes health for men with localized prostate cancer transitioning to posttreatment self-management. Survivorship care planning is important for patients with prostate cancer because of its high incidence rate in the United States, the frequent occurrence of treatment-related side effects, and reduced quality of life (QOL) for both men and their partners. A key component of comprehensive survivorship care planning is survivorship care plans (SCPs), documents that summarize cancer diagnosis, treatment, and plans for follow-up care. However, research concerning the effectiveness of SCPs on patient outcomes or health service use has thus far been inconclusive. SCPs that are tailored to individual patients' needs for information and care may improve effectiveness. OBJECTIVE This study aims to examine the feasibility of an enhanced survivorship care plan (ESCP) that integrates a symptom self-management mHealth program called Prostate Cancer Education and Resources for Couples (PERC) into the existing standardized SCP. The specific aims are to (1) examine the feasibility of delivering ESCPs and (2) to estimate the magnitude of benefit of ESCPs. METHODS We will use a two-group randomized controlled pretest-posttest design and collect data at baseline (T1) and 4 months later (T2) among 50 patients completing initial treatment for localized prostate cancer and their partners. First, we will assess the feasibility of ESCP by recruitment, enrollment, and retention rates; program satisfaction with the ESCP; and perceived ease of use of the ESCP. To achieve the secondary aim, we will compare the ESCP users with the standardized SCP users and assess their primary outcomes of QOL (overall, physical, emotional, and social QOL); secondary outcomes (reduction in negative appraisals and improvement in self-efficacy, social support, and health behaviors to manage symptoms); and number of visits to posttreatment care services between T1 and T2. We will assess the primary and secondary outcomes using measurements with sound psychometrical properties. We will use a qualitative and quantitative mixed methods approach to achieve the research aims. RESULTS This project is ongoing and will be completed by the end of 2018. CONCLUSIONS The results from this study will help design a definitive randomized trial to test the efficacy of the ESCPs, a potentially scalable program, to enhance supportive care for prostate cancer patients and their families.
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Affiliation(s)
- Lixin Song
- School of Nursing, University of North Carolina, Chapel Hill, NC, United States
- Lineberger Comprehensive Cancer Center, School of Medicine, University of North Carolina, Chapel Hill, NC, United States
| | - Kaitlyn L Dunlap
- School of Nursing, University of North Carolina, Chapel Hill, NC, United States
| | - Xianming Tan
- Lineberger Comprehensive Cancer Center, School of Medicine, University of North Carolina, Chapel Hill, NC, United States
| | - Ronald C Chen
- Lineberger Comprehensive Cancer Center, School of Medicine, University of North Carolina, Chapel Hill, NC, United States
| | - Matthew E Nielsen
- Lineberger Comprehensive Cancer Center, School of Medicine, University of North Carolina, Chapel Hill, NC, United States
| | | | | | | | - Sarah A Birken
- University of North Carolina, Chapel Hill, NC, United States
| | | | - Deborah K Mayer
- School of Nursing, University of North Carolina, Chapel Hill, NC, United States
- Lineberger Comprehensive Cancer Center, School of Medicine, University of North Carolina, Chapel Hill, NC, United States
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McCaughan E, Curran C, Northouse L, Parahoo K. Evaluating a psychosocial intervention for men with prostate cancer and their partners: Outcomes and lessons learned from a randomized controlled trial. Appl Nurs Res 2018; 40:143-151. [PMID: 29579490 DOI: 10.1016/j.apnr.2018.01.008] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2017] [Revised: 01/08/2018] [Accepted: 01/19/2018] [Indexed: 10/18/2022]
Abstract
AIM This study evaluated the process and outcome of a psychosocial intervention for men with prostate cancer and their partners. As more men survive prostate cancer, they and their partners need help and support to help them cope with the physical and psychosocial effects of the disease and treatment. There is a lack of psychosocial interventions for men with prostate cancer and their partners. METHODS A randomized controlled trial was conducted with 34 participants to measure the effects of the intervention on selected psychosocial outcomes, post-intervention and at one month' follow-up. The nine-week program (CONNECT) consisted of three group and two telephone sessions. It focused on symptom management, sexual dysfunction, uncertainty management, positive thinking and couple communication. The outcomes, measured by validated tools were: self-efficacy, quality of life, symptom distress, communication, uncertainty and illness benefits. RESULTS The men in the intervention group did better on two outcomes (communication and support) than controls. Partners in the intervention group did better than controls on most outcomes. Less participants than expected participated in the trial. The reasons for non-participation included partners not wishing to participate, men not interested in group work, and not understanding the core purpose of the intervention. The cost of training facilitators and for delivering the intervention appeared to be low. CONCLUSION The knowledge generated from this study will be beneficial for all those grappling with the challenges of developing, implementing and evaluating complex psychosocial interventions. This study has also highlighted the difficulties in recruiting men and their partners in clinical trials.
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Affiliation(s)
- Eilis McCaughan
- Institute of Nursing and Health Research, University of Ulster, Newtownabbey, UK.
| | - Carol Curran
- Faculty of Life Sciences, Ulster University, Newtownabbey, UK.
| | | | - Kader Parahoo
- Institute of Nursing and Health Research, University of Ulster, Newtownabbey, UK.
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11
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Hyde MK, Legg M, Occhipinti S, Lepore SJ, Ugalde A, Zajdlewicz L, Laurie K, Dunn J, Chambers SK. Predictors of long-term distress in female partners of men diagnosed with prostate cancer. Psychooncology 2018; 27:946-954. [PMID: 29268006 DOI: 10.1002/pon.4617] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2017] [Revised: 12/07/2017] [Accepted: 12/15/2017] [Indexed: 11/09/2022]
Abstract
OBJECTIVE Female partners of men with prostate cancer (PCa) experience heightened psychological distress; however, long-term distress for this group is not well described. We examined partner's psychological and cancer-specific distress over 2 years and predictors of change. METHODS A cohort of 427 female partners (63% response; mean age 62.6 y) of PCa survivors completed baseline (2-4 y post-PCa treatment) assessments of anxiety, depression, and cancer-specific distress and were followed up at 6, 12, 18, and 24 months. Caregiver burden, threat and challenge appraisal, self-efficacy, and dyadic adjustment were assessed as potential predictors of distress. RESULTS Over time, 23% to 25% of women reported anxiety; 8% to 11% depression; 5% to 6% high cancer-specific distress. Higher caregiver burden and more threat appraisals were associated with increased distress, anxiety, depression, and cancer-specific distress over time. Higher dyadic adjustment over time and more challenge appraisals at 24 months were associated with less distress, anxiety, and depression. Increased partner self-efficacy was associated with lower distress and depression at baseline. CONCLUSIONS A substantial subgroup of partners experience ongoing anxiety, with depression less prevalent but also persistent. Caregiver burden, partner self-efficacy, threat, and challenge appraisals present as potential supportive care targets.
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Affiliation(s)
- Melissa K Hyde
- Menzies Health Institute Queensland, Griffith University, Southport, QLD, Australia.,Cancer Research Centre, Cancer Council Queensland, Brisbane, QLD, Australia
| | - Melissa Legg
- Menzies Health Institute Queensland, Griffith University, Southport, QLD, Australia.,Cancer Research Centre, Cancer Council Queensland, Brisbane, QLD, Australia
| | - Stefano Occhipinti
- Menzies Health Institute Queensland, Griffith University, Southport, QLD, Australia
| | - Stephen J Lepore
- Department of Social and Behavioral Sciences, College of Public Health, Temple University, Philadelphia, PA, USA
| | - Anna Ugalde
- School of Nursing and Midwifery, Deakin University, Geelong, VIC, Australia
| | - Leah Zajdlewicz
- Cancer Research Centre, Cancer Council Queensland, Brisbane, QLD, Australia
| | - Kirstyn Laurie
- Menzies Health Institute Queensland, Griffith University, Southport, QLD, Australia.,Cancer Research Centre, Cancer Council Queensland, Brisbane, QLD, Australia
| | - Jeff Dunn
- Menzies Health Institute Queensland, Griffith University, Southport, QLD, Australia.,Cancer Research Centre, Cancer Council Queensland, Brisbane, QLD, Australia.,Institute for Resilient Regions, University of Southern Queensland, Toowoomba, QLD, Australia
| | - Suzanne K Chambers
- Menzies Health Institute Queensland, Griffith University, Southport, QLD, Australia.,Cancer Research Centre, Cancer Council Queensland, Brisbane, QLD, Australia.,Institute for Resilient Regions, University of Southern Queensland, Toowoomba, QLD, Australia.,Prostate Cancer Foundation of Australia, Sydney, NSW, Australia.,Health & Wellness Institute, Edith Cowan University, Perth, WA, Australia
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eHealth Literacy and Partner Involvement in Treatment Decision Making for Men With Newly Diagnosed Localized Prostate Cancer. Oncol Nurs Forum 2018; 44:225-233. [PMID: 28222090 DOI: 10.1011/17.onf.225-233] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
PURPOSE/OBJECTIVES To examine how the eHealth literacy of partners of patients with newly diagnosed prostate cancer affects their involvement in decision making, and to identify the factors that influence their eHealth literacy.
. DESIGN Cross-sectional exploratory study.
. SETTING North Carolina.
. SAMPLE 142 partners of men with newly diagnosed localized prostate cancer.
. METHODS A telephone survey and descriptive and multiple linear regression analyses were used.
. MAIN RESEARCH VARIABLES The partners' eHealth literacy, involvement in treatment decision making, and demographics, and the health statuses of the patients and their partners.
. FINDINGS Higher levels of eHealth literacy among partners were significantly associated with their involvement in getting a second opinion, their awareness of treatment options, and the size of the social network they relied on for additional information and support for treatment decision making for prostate cancer. The factor influencing eHealth literacy was the partners' access to the Internet for personal use, which explained some of the variance in eHealth literacy.
. CONCLUSIONS This study described how partners' eHealth literacy influenced their involvement in treatment decision making for prostate cancer and highlighted the influencing factors (i.e., partners' access to the Internet for personal use).
. IMPLICATIONS FOR NURSING When helping men with prostate cancer and their partners with treatment decision making, nurses need to assess eHealth literacy levels to determine whether nonelectronically based education materials are needed and to provide clear instructions on how to use eHealth resources.
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Hoeck B, Ledderer L, Ploug Hansen H. Dealing with cancer: a meta-synthesis of patients' and relatives' experiences of participating in psychosocial interventions. Eur J Cancer Care (Engl) 2017; 26:e12652. [PMID: 28169475 DOI: 10.1111/ecc.12652] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/07/2016] [Indexed: 11/28/2022]
Abstract
The aim was to synthesise patients' and relatives' experiences of participating in a psychosocial intervention related to having cancer. The study was a meta-synthesis inspired by Noblit & Hare's 'meta-ethnography' approach. We systematically searched six databases and included 33 studies in the meta-synthesis. Inclusion criteria were qualitative studies with relevance to the synthesis topic. The meta-synthesis conceptualised the way in which participants develop their way of living with cancer, and the role psychosocial interventions play in helping them to live through the illness. Five themes symbolising the participants' core experiences were identified: (1) Emotional relief and a sense of well-being, (2) normalisation of experiences and a sense of control, (3) shared experience and a sense of community, (4) a safe place and (5) transformation and adaptability. The findings indicated that psychosocial interventions were used to try to deal with the changes in the human conditions caused by cancer. Sharing their experiences and forming social relationships helped the participants adapt to cancer. An existential perspective may provide a nuanced understanding of patients' and relatives' experiences of participating in psychosocial interventions.
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Affiliation(s)
- B Hoeck
- Research Unit of User Perspectives, Department of Public Health, University of Southern Denmark, Odense, Denmark
| | - L Ledderer
- Section for Health Promotion and Health Services, Department of Public Health, Aarhus University, Aarhus, Denmark
| | - H Ploug Hansen
- Research Unit of General Practice, Department of Public Health, University of Southern Denmark, Odense, Denmark
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The Impact of Husbands' Prostate Cancer Diagnosis and Participation in a Behavioral Lifestyle Intervention on Spouses' Lives and Relationships With Their Partners. Cancer Nurs 2017; 39:E1-9. [PMID: 25881805 DOI: 10.1097/ncc.0000000000000259] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND A prostate cancer diagnosis affects the patient and his spouse. Partners of cancer patients are often the first to respond to the demands related to their husband's illness and thus are likely to be the most supportive individuals available to the patients. It is therefore important to examine how spouses react and handle their husband's prostate cancer diagnosis. OBJECTIVE The aim of this study was to explore how the prostate cancer diagnosis and the participation in their partners' behavioral lifestyle intervention program influenced the spouses' life, their relationship with their partner, and how they handle the situation. METHODS Interviews were recorded with 8 spouses of potential low-risk prostate cancer patients on active surveillance as part of a clinical self-management lifestyle trial. RESULTS We identified 3 phases that the spouses went through: feeling insecure about their situation, coping strategies to deal with these insecurities, and feeling reassured. CONCLUSIONS The framework of a clinical trial should include mobilizing spousal empowerment so that they can take on an active and meaningful role in relation to their husband's disease. The observations here substantiate that the framework of active surveillance in combination with a lifestyle intervention in 1 specific prostate cancer clinical trial can mobilize spousal empowerment. IMPLICATIONS FOR PRACTICE Creating well-designed clinical patient programs that actively involve the spouse appears to promote empowerment (meaning, self-efficacy, positive impact, and self-determination) in spouses. Spousal participation in clinical patient programs can give spouses relief from anxieties while recognizing them as a vital support for their husband.
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Kim HS, Ahn HJ. Effects of stress, dyadic communication and adaptation on prostatectomy patients' quality of life. INTERNATIONAL JOURNAL OF UROLOGICAL NURSING 2017. [DOI: 10.1111/ijun.12115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Hae Sook Kim
- Department of Nursing; Cheong Ju University; Cheong Ju Korea
| | - Han Jong Ahn
- Department of Urology, Asan Medical Center; University of Ulsan College of Medicine; Seoul Korea
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Clark K, Bergerot CD, Philip EJ, Buga S, Obenchain R, Loscalzo MJ. Biopsychosocial problem-related distress in cancer: examining the role of sex and age. Psychooncology 2016; 26:1562-1568. [DOI: 10.1002/pon.4172] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2015] [Revised: 04/13/2016] [Accepted: 05/08/2016] [Indexed: 11/11/2022]
Affiliation(s)
- Karen Clark
- Sheri & Les Biller Patient and Family Resource Center, Department of Supportive Medicine; City of Hope; Duarte CA USA
| | | | - Errol J. Philip
- The Notre Dame Laboratory for Psycho-Oncology Research; Notre Dame; Notre Dame IN USA
| | - Sorin Buga
- Sheri & Les Biller Patient and Family Resource Center, Department of Supportive Medicine; City of Hope; Duarte CA USA
| | - Richard Obenchain
- Sheri & Les Biller Patient and Family Resource Center, Department of Supportive Medicine; City of Hope; Duarte CA USA
| | - Matthew J. Loscalzo
- Sheri & Les Biller Patient and Family Resource Center, Department of Supportive Medicine; City of Hope; Duarte CA USA
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Appraisals, perceived dyadic communication, and quality of life over time among couples coping with prostate cancer. Support Care Cancer 2016; 24:3757-65. [PMID: 27039207 DOI: 10.1007/s00520-016-3188-0] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2015] [Accepted: 03/21/2016] [Indexed: 10/22/2022]
Abstract
PURPOSE Little research has examined how prostate cancer patients' and their spouses' appraisals of illness and quality of life (QOL) interact with one another. This study examined the interdependent relationships between their appraisals of illness and QOL and if their perceived dyadic communication mediated these relationships. METHODS We used the Actor-Partner Interdependence Mediation Model (APIMeM) approach to conduct a secondary analysis of longitudinal data from 124 prostate cancer patient-spouse dyads. We examined actor effects (each person's influence on his/her own outcomes) and partner effects (each person's influence on his/her partner's outcomes). Appraisals of illness, perceived dyadic communication, and QOL were measured using Appraisal of Illness Scale, Lewis Mutuality and Interpersonal Sensitivity Scale, and Functional Assessment of Chronic Illness Therapy General Scale, respectively. Analyses controlled for effects of prostate cancer symptoms and demographic factors. RESULTS Among actor effects, spouses with more negative appraisals at baseline perceived worse dyadic communication 4 months later (p < .05) and worse QOL 8 months later (p < .001). Patients and spouses who perceived more dyadic communication at 4 months had better QOL at 8 months (p < .01). Among partner effects, there was only weak evidence for an association between patient perceived dyadic communication at 4 months and better spouse QOL at 8 months of follow-up (p = .05). No mediation effects were found. CONCLUSIONS Patients' and spouses' appraisals of the illness and their dyadic communication were associated with their long-term QOL. Interventions that reduce negative appraisals of illness and promote dyadic communication may improve QOL for both patients with prostate cancer and their spouses.
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Heyes SM, Bond MJ, Harrington A, Belan I. The relative contributions of function, perceived psychological burden and partner support to cognitive distress in bladder cancer. Psychooncology 2015; 25:1043-9. [PMID: 26639622 DOI: 10.1002/pon.4054] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2015] [Revised: 10/13/2015] [Accepted: 11/13/2015] [Indexed: 11/08/2022]
Abstract
OBJECTIVE Bladder cancer is a genitourinary disease of increasing incidence. Despite improvements in treatment, outcomes remain equivocal with high recurrence rates. It is associated with poor psychosocial outcomes due to reduced functioning of the genitourinary system. The objective of these analyses was to query whether reported loss of function or the perception of psychological burden caused by this functional impedance was the key to understanding psychosocial outcomes. METHODS The sample comprised 119 participants with a confirmed diagnosis of bladder cancer. They completed a self-report questionnaire comprising the Bladder Cancer Index, Mini-mental Adjustment to Cancer Scale, Psychosocial Adjustment to Illness Scale and standard sociodemographic details. Simple mediation and serial mediation were used to explore the potential for psychological burden to mediate associations between loss of function and cognitive distress, and the potential additional contribution of positive partner support on these relationships. Age and duration of cancer were considered as covariates. RESULTS Simple mediation demonstrated that the association between function and cognitive distress was fully mediated by perceived psychological burden. Serial mediation, which allowed for the addition of partner support, again demonstrated full mediation, with partner support being the key predictive variable. CONCLUSIONS These analyses emphasise the importance of an appreciation of individuals' interpretation of the burden occasioned by bladder cancer and the role of a supportive partner. The implications for management discussions and support services in alleviating negative psychological outcomes in bladder cancer are highlighted. Copyright © 2015 John Wiley & Sons, Ltd.
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Affiliation(s)
- Susan M Heyes
- School of Nursing and Midwifery, Flinders University, Adelaide, Australia
| | - Malcolm J Bond
- School of Medicine, Flinders University, Adelaide, Australia
| | - Ann Harrington
- School of Nursing and Midwifery, Flinders University, Adelaide, Australia
| | - Ingrid Belan
- School of Nursing and Midwifery, Flinders University, Adelaide, Australia
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Huber J, Streuli JC, Lozankovski N, Stredele RJF, Moll P, Hohenfellner M, Huber CG, Ihrig A, Peters T. The complex interplay of physician, patient, and spouse in preoperative counseling for radical prostatectomy: a comparative mixed-method analysis of 30 videotaped consultations. Psychooncology 2015; 25:949-56. [DOI: 10.1002/pon.4041] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2015] [Revised: 09/26/2015] [Accepted: 11/05/2015] [Indexed: 11/10/2022]
Affiliation(s)
- Johannes Huber
- Department of Urology; University of Heidelberg; Heidelberg Germany
| | - Jürg C. Streuli
- Department of Biomedical Ethics; University of Zürich; Zürich Switzerland
| | | | | | - Peter Moll
- Department of Urology; University of Heidelberg; Heidelberg Germany
| | | | | | - Andreas Ihrig
- Division of Psychooncology, Department for Psychosomatic and General Clinical Medicine; University of Heidelberg; Heidelberg Germany
| | - Tim Peters
- Center for Medical Education; Ruhr-University Bochum; Bochum Germany
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21
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Impact of Gender Infertility Diagnosis on Marital Relationship in Infertile Couples: A Couple Based Study. SEXUALITY AND DISABILITY 2015. [DOI: 10.1007/s11195-015-9417-5] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Ross KM, Ranby KW, Wooldridge JS, Robertson C, Lipkus IM. Effects of physical and mental health on relationship satisfaction: a dyadic, longitudinal examination of couples facing prostate cancer. Psychooncology 2015; 25:898-904. [DOI: 10.1002/pon.3931] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2015] [Revised: 06/05/2015] [Accepted: 07/15/2015] [Indexed: 11/09/2022]
Affiliation(s)
- Kaile M. Ross
- Department of Psychology; University of Colorado Denver; USA
| | - Krista W. Ranby
- Department of Psychology; University of Colorado Denver; USA
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McCaughan E, McKenna S, McSorley O, Parahoo K. The experience and perceptions of men with prostate cancer and their partners of the CONNECT psychosocial intervention: a qualitative exploration. J Adv Nurs 2015; 71:1871-82. [PMID: 25818026 DOI: 10.1111/jan.12648] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/27/2015] [Indexed: 11/30/2022]
Abstract
AIM To explore the experience of prostate cancer survivors and their partners of the CONNECT psychosocial intervention. BACKGROUND There is a scarcity of evidence relating to interventions to help men and their partners cope with the after affects of prostate cancer treatment. DESIGN This study employed a qualitative design for in depth exploration through couple interviews. The addition of a short process evaluation questionnaire was used to supplement the qualitative data. METHODS Semi-structured interviews were conducted between January 2012-October 2012 with a purposive sample of 11 couple dyads who had participated in the CONNECT intervention. Data were analysed using inductive content analysis. Simple descriptive statistics were used to analyse the findings from the questionnaire data. RESULTS Couples perceived benefits of participating in the intervention to include: opportunities to share experiences, gain validation, obtain information and engage in couple care. The expertise of the professional facilitator and group dynamics were highlighted as factors influencing the success of the intervention. Potential areas for improvement of the intervention were identified as being: further development of the sexual dysfunction component; incorporation of a partner specific session to better address their needs; determination of optimal delivery format and timing; and further tailoring of the components of the intervention. CONCLUSION Although there were areas that could be further improved, this psychosocial intervention was valued by the participants. The insight gained from this qualitative exploration can be used to make the necessary changes before the intervention can be tested in a large randomised controlled trial.
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Affiliation(s)
- Eilis McCaughan
- Institute of Nursing and Health Research, University of Ulster, Coleraine, UK
| | - Suzanne McKenna
- Institute of Nursing and Health Research, University of Ulster, Coleraine, UK
| | - Oonagh McSorley
- Institute of Nursing and Health Research, University of Ulster, Coleraine, UK
| | - Kader Parahoo
- Institute of Nursing and Health Research, University of Ulster, Coleraine, UK
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Abstract
Many therapies for erectile dysfunction (ED) after prostate cancer treatment improve erectile firmness, yet, most couples stop using aids within 1-2 years. Patients and partners who expect immediate and complete success with their first ED treatment can be demoralized when they experience treatment failure, which contributes to reticence to explore other ED aids. Comprehensive patient education should improve sustainability and satisfaction with ED treatments. Pre-emptive and realistic information should be provided to couples about the probability of recovering natural erections. Beginning intervention early and using a couple-based approach is ideal. Recommendations are provided about the timing of ED treatment, the order of aid introduction, and combination therapies. Renegotiation of sexual activity is an essential part of sexual adaptation. From the outset of therapy, couples should be encouraged to broaden their sexual repertoire, incorporate erection-independent sexual activities, and continue to be sexual despite ED and reduced libido.
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Reed SC, Partridge AH, Nekhlyudov L. Shared Medical Appointments in Cancer Survivorship Care: A Review of the Literature. J Oncol Pract 2014; 11:6-11. [PMID: 25424650 DOI: 10.1200/jop.2014.001411] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
PURPOSE The physical and psychological effects of a cancer diagnosis and treatment on an individual may be significant and require appropriate monitoring and management. Furthermore, attention to preventive care and comorbid medical conditions is critical. Innovative approaches are needed to provide quality care to this growing population. METHODS We reviewed the literature evaluating shared medical appointments (SMAs) in noncancer and cancer care settings. Supported by a conceptual framework and adhering to the goals of patient-centered communication, we propose how SMAs may be used in clinical practice to enhance survivorship care. RESULTS The literature suggests that SMAs are an effective model in noncancer settings, showing improved blood pressure and health-related quality of life, among others. Although evidence for SMAs in cancer care is limited, there is significant potential for improved patient outcomes and costs. In particular, SMAs may provide an opportunity to address medical and psychological needs while creating a structure for enhanced communication. CONCLUSION SMAs may offer an innovative care model for cancer survivors and their providers. Implementation and evaluation of SMAs in the care of cancer survivors is warranted.
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Affiliation(s)
- Sarah C Reed
- Betty Irene Moore School of Nursing, University of California Davis, Davis, CA; Dana-Farber Cancer Institute-Harvard Medical School; and Harvard Vanguard Medical Associates, Boston, MA
| | - Ann H Partridge
- Betty Irene Moore School of Nursing, University of California Davis, Davis, CA; Dana-Farber Cancer Institute-Harvard Medical School; and Harvard Vanguard Medical Associates, Boston, MA
| | - Larissa Nekhlyudov
- Betty Irene Moore School of Nursing, University of California Davis, Davis, CA; Dana-Farber Cancer Institute-Harvard Medical School; and Harvard Vanguard Medical Associates, Boston, MA
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"An arena for sharing": exploring the joint involvement of patients and their relatives in a cancer rehabilitation intervention study. Cancer Nurs 2014; 38:E1-9. [PMID: 24831040 DOI: 10.1097/ncc.0000000000000149] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Despite an increasing focus on cancer rehabilitation programs, there is limited knowledge about the experiences of residential rehabilitation focusing on both the patients and their relatives. OBJECTIVE The aim of this study was to explore the experienced benefits of the joint involvement of patients and their relatives in a 5-day residential cancer rehabilitation course, provided as part of a larger intervention study in Denmark. METHODS Ethnographic fieldwork, consisting of participant observations and informal conversations, was conducted with 20 individuals (10 patients and 10 relatives). In-depth interviews were conducted in the participants' homes 1 month after the rehabilitation course. Data were analyzed by a constant comparative method. RESULTS Residential rehabilitation course was identified to serve as an "arena for sharing," underpinned by 3 dimensions of sharing: sharing cancer experiences, sharing strategies, and sharing mutual care. CONCLUSION Sharing in residential rehabilitation is experienced as useful for cancer patients and their relatives, to validate cancer-related strategies and strengthen mutual understanding within relationships. IMPLICATIONS FOR PRACTICE The results can guide the development of cancer rehabilitation to involve patients and their relatives and provide opportunity for sharing and empowerment on individual as well as couple and group levels.
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Loscalzo M, Clark K. Gender opportunities in psychosocial oncology. Recent Results Cancer Res 2013; 197:31-47. [PMID: 24305767 DOI: 10.1007/978-3-642-40187-9_3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/21/2023]
Abstract
Avoidance of discussions of sex and gender in medicine reflects the larger lingering societal discomfort with any discussion that links potential sex and gender differences with superiority. The data show that there is more intra-sexual then intersexual variation in men and women. When speaking about sex and gender the literature reflects that, on average, there are many differences, and although they are small, that when taken together, the impact may be quite robust. Sex and gender differences are relevant to how individuals, couples, and families experience and cope with serious illness; however, these important and obvious variables are seldom taken into account when counseling seriously ill patients and their families. Cancer is a complex disease that brings into sharp relief the potential alignments and misalignments in the sexes. In this chapter we have attempted to communicate the imperative for and importance of understanding people under stress within the context of sex and gender. Gender-specific medicine is a very young movement for scientific study but one that has great potential to maximize adaptation and mutual respect at a time when men and women are redefining themselves and adapting to new social realities and challenges.
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Affiliation(s)
- Matthew Loscalzo
- City of Hope, 1500 East Duarte Road Main Medical Bldg Suite Y-1, Duarte, CA, 91010-3000, USA,
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Paterson C, Jones M, Rattray J, Lauder W. Exploring the relationship between coping, social support and health-related quality of life for prostate cancer survivors: A review of the literature. Eur J Oncol Nurs 2013; 17:750-9. [DOI: 10.1016/j.ejon.2013.04.002] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2012] [Revised: 02/01/2013] [Accepted: 04/08/2013] [Indexed: 10/26/2022]
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Ramsey SD, Zeliadt SB, Blough DK, Moinpour CM, Hall IJ, Smith JL, Ekwueme DU, Fedorenko CR, Fairweather ME, Koepl LM, Thompson IM, Keane TE, Penson DF. Impact of prostate cancer on sexual relationships: a longitudinal perspective on intimate partners' experiences. J Sex Med 2013; 10:3135-43. [PMID: 24118980 DOI: 10.1111/jsm.12295] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
INTRODUCTION In this prospective study of localized prostate cancer patients and their partners, we analyzed how partner issues evolve over time, focusing on satisfaction with care, influence of cancer treatment, and its impact on relationship with patient, cancer worry, and personal activities. AIMS Our study aims were twofold: (i) to determine whether the impact of treatment on patients and partners moderate over time and (ii) if receiving surgery (i.e., radical prostatectomy) influences partner issues more than other treatments. METHODS Patients newly diagnosed with localized prostate cancer and their female partners were recruited from three states to complete surveys by mail at three time points over 12 months. MAIN OUTCOME MEASURES The four primary outcomes assessed in the partner analysis included satisfaction with treatment, cancer worry, and the influence of cancer and its treatment on their relationship (both general relationship and sexual relationship). RESULTS This analysis included 88 patient-partner pairs. At 6 months, partners reported that cancer had a negative impact on their sexual relationship (39%--somewhat negative and 12%--very negative). At 12 months, this proportion increased substantially (42%--somewhat negative and 29%--very negative). Partners were significantly more likely to report that their sexual relationship was worse when the patient reported having surgery (P = 0.0045, odds ratio = 9.8025, 95% confidence interval 2.076-46.296). A minority of partners reported significant negative impacts in other areas involving their personal activities (16% at 6 months and 25% at 12 months) or work life (6% at 6 months, which increased to 12% at 12 months). CONCLUSION From partners' perspectives, prostate cancer therapy has negative impact on sexual relationships and appears to worsen over time.
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Affiliation(s)
- Scott D Ramsey
- Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
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30
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Aarts JWM, Faber MJ, den Boogert AG, Cohlen BJ, van der Linden PJQ, Kremer JAM, Nelen WLDM. Barriers and facilitators for the implementation of an online clinical health community in addition to usual fertility care: a cross-sectional study. J Med Internet Res 2013; 15:e163. [PMID: 23996964 PMCID: PMC3815434 DOI: 10.2196/jmir.2098] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2012] [Revised: 10/21/2012] [Accepted: 04/07/2013] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Online health communities are becoming more popular in health care. Patients and professionals can communicate with one another online, patients can find peer support, and professionals can use it as an additional information channel to their patients. However, the implementation of online health communities into daily practice is challenging. These challenges relate to the fact that patients need to be activated to (1) become a member (ie, subscription) and (2) participate actively within the community before any effect can be expected. Therefore, we aimed at answering 2 research questions: (1) what factors are associated with subscription to an online health community, and (2) which are associated with becoming an active participant within an online health community. OBJECTIVE To identify barriers and facilitators as perceived by patients for the implementation of an online health community. METHODS We performed a cross-sectional study. Three Dutch fertility clinics (2 IVF-licensed) offered their patients a secure online clinical health community through which clinicians can provide online information and patients can ask questions to the medical team or share experiences and find support from peers. We randomly selected and invited 278 men and women suffering from infertility and attending 1 of the participating clinics. Participants filled out a questionnaire about their background characteristics and current use of the online community. Possible barriers and facilitators were divided into 2 parts: (1) those for subscription to the community, and (2) those for active participation in the community. We performed 2 multivariate logistic regression analyses to calculate determinants for both subscription and active participation. RESULTS Subscription appeared to be associated with patients' background characteristics (eg, gender, treatment phase), intervention-related facilitators (odds ratio [OR] 2.45, 95% CI 1.14-5.27), and patient-related barriers (OR 0.20, 95% CI 0.08-0.54), such as not feeling the need for such an online health community. After subscription, determinants for participation consisted of aspects related to participant's age (OR 0.86, 95% CI 0.76-0.97), length of infertility (OR 1.48, 05% CI 1.09-2.02), and to intervention-related facilitators (OR 5.79, 95% CI 2.40-13.98), such as its reliable character and possibility to interact with the medical team and peers. CONCLUSIONS Implementing an online health community in addition to usual fertility care should be performed stepwise. At least 2 strategies are needed to increase the proportion of patient subscribers and consequently make them active participants. First, the marketing strategy should contain information tailored to different subgroups of the patient population. Second, for a living online health community, incorporation of interactive elements, as well as frequent news and updates are needed. These results imply that involving patients and their needs into the promotion strategy, community's design, and implementation are crucial.
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Affiliation(s)
- Johanna W M Aarts
- Department of Obstetrics and Gynecology, Radboud University Nijmegen Medical Center, Radboud University, Nijmegen, Netherlands.
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McCaughan E, Prue G, McSorley O, Northouse L, Schafenacker A, Parahoo K. A randomized controlled trial of a self-management psychosocial intervention for men with prostate cancer and their partners: a study protocol. J Adv Nurs 2013; 69:2572-83. [PMID: 23528148 DOI: 10.1111/jan.12132] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/16/2013] [Indexed: 11/29/2022]
Abstract
BACKGROUND Little is known about interventions to help men and their partners cope with the after effects of prostate cancer treatment. The lack of in-depth descriptions of the intervention content is hindering the identification of which intervention (or component of an intervention) works. AIM To describe the development and evaluation of the content of a self-management psychosocial intervention for men with prostate cancer and their partners. DESIGN A feasibility randomized controlled trial including structure, process, and outcome analysis. METHODS This 9-week intervention commences on completion of treatment and consists of three group and two telephone sessions. The intervention focuses on symptom management, sexual dysfunction, uncertainty management, positive thinking and couple communication. Forty-eight couples will be assigned to either the intervention or a control group receiving usual care. Participants will be assessed at baseline, immediately postintervention and at 1 and 6 months postintervention. Outcome measures for patients and caregivers include self-efficacy, quality of life, symptom distress, uncertainty, benefits of illness, health behaviour, and measures of couple communication and support. An additional caregiver assessment will be completed by the partner. DISCUSSION The main purpose of this feasibility study is to investigate the acceptability of the CONNECT programme to men with prostate cancer and their partners and to gain feedback from the participants and facilitators to make changes to and enhance the programme. Reasons why men do not want to participate will be collated to enhance recruitment in the future. We will also test recruitment strategies, randomization procedures, and the acceptability of the questionnaires. Ethical approval granted December 2010.
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Affiliation(s)
- Eilis McCaughan
- Institute of Nursing and Health Research, University of Ulster, Newtownabbey, UK
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Seiler D, Randazzo M, Leupold U, Zeh N, Isbarn H, Chun FK, Ahyai SA, Baumgartner M, Huber A, Recker F, Kwiatkowski M. Protocol-based active surveillance for low-risk prostate cancer: anxiety levels in both men and their partners. Urology 2012; 80:564-9. [PMID: 22770614 DOI: 10.1016/j.urology.2012.04.053] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2011] [Revised: 04/24/2012] [Accepted: 04/27/2012] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To assess anxiety levels and health-related quality of life in partners of patients with prostate cancer (PCa) on active surveillance. METHODS For low-risk PCa, active surveillance is frequently chosen as a monitoring strategy. Active surveillance has been shown to be associated with low anxiety levels and a fair health-related quality of life in patients. However, little is known about the impact on their partners. We hypothesized that the latter suffer more from PCa diagnosis than the men themselves. Therefore, between February and August 2010, 133 couples-a response rate of 46.9%-completed a written questionnaire at their individual time lags from PCa diagnosis. A Wilcoxon test was performed to assess how distress levels affected the couples' quality of life. Binary logistic regression was used to determine factors affecting distress levels. RESULTS The mean age was 66.2 years in partners and 69.3 in men. At the time quartiles, partners had anxiety scores of 5.5, 4.6, 5.4, and 5.6. Scores in men were statistically significantly lower: 3.9 (P = .05), 2.0 (P < .001), 3.3 (P = .002), and 3.3 (P = .02), respectively. However, the partners' scores were still well below 7 (ie, normal). Prostate-specific anxiety scores were below the clinical threshold as well: 15.5, 9.5, 6.5, and 9.0, respectively. CONCLUSION Active surveillance preserves an encouragingly high health-related quality of life in both men on active surveillance and their partners. Fortunately, the more adverse values of the partners are well within the normal range and thus clinically not relevant.
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Affiliation(s)
- Daniel Seiler
- Department of Urology, Kantonsspital Aarau, Aarau, Switzerland.
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Li C, Zeliadt SB, Hall IJ, Smith JL, Ekwueme DU, Moinpour CM, Penson DF, Thompson IM, Keane TE, Ramsey SD. Willingness to pay for prostate cancer treatment among patients and their family members at 1 year after diagnosis. VALUE IN HEALTH : THE JOURNAL OF THE INTERNATIONAL SOCIETY FOR PHARMACOECONOMICS AND OUTCOMES RESEARCH 2012; 15:716-23. [PMID: 22867781 DOI: 10.1016/j.jval.2012.03.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/05/2011] [Revised: 02/06/2012] [Accepted: 03/01/2012] [Indexed: 05/12/2023]
Abstract
OBJECTIVES To explore an alternative approach to quantifying the burden of side effects at 1 year after treatment for prostate cancer among both patients and their partners. METHODS We analyzed data from 75 couples in the Family and Cancer Therapy Selection study. Paired patients and family members were independently asked about their willingness to pay (WTP) for a hypothetical new treatment that cures prostate cancer without side effects if they could reconsider their treatment decision by indicating the maximum amount they would be willing to pay given 11 separate "bids" ranging from $0 to $1500 per month. Descriptive and regression analyses were conducted for patients and family members controlling for sociodemographic characteristics and health status; Spearman correlations were also examined. RESULTS Among 75 couples analyzed, the income-adjusted mean WTP estimates per month were $400.8 (standard error [SE] $54.3) for patients and $650.2 (SE 72.2) for family members. The WTP between patients and family members was correlated (Pearson ρ 0.30; P = 0.01). After adjusting for covariates, the adjusted mean WTP per month was $588.1 (SE 65.77) for patients and $819.4 (SE 74.33) for family members. Wanting to avoid side effects at baseline predicted higher WTP for patients (P = 0.010). Experiencing sexual side effects was predictive of higher WTP for family members (P = 0.047). CONCLUSIONS Fairly high WTP amounts for a hypothetical treatment without side effects suggests that patients and their partners are experiencing important burdens 1 year after treatment. The higher amounts partners are willing to pay and the correlation with sexual side effects suggest that they are perceptive of significant treatment burdens.
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Affiliation(s)
- Chunyu Li
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA 30341, USA.
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