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Röscher P, Naidoo K, Milios JE, van Wyk JM. A modified Delphi study to identify screening items to assess neglected sexual side-effects following prostate cancer treatment. BMC Urol 2022; 22:34. [PMID: 35277157 PMCID: PMC8915514 DOI: 10.1186/s12894-022-00982-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Accepted: 02/22/2022] [Indexed: 11/10/2022] Open
Abstract
Background Neglected sexual side effects (NSSE) are a group of less common sexual side effects that may present after Prostate Cancer (PCa) treatment. There is currently no valid and reliable tool to identify these side effects. A modified Delphi study is an effective way of developing the content of such a screening tool. Methods A modified Delphi study was used to obtain consensus from a multi-disciplinary group of experts over 3 rounds during a 12 week period. Ten statements were presented containing 8 closed-ended statements on individual NSSEs, and 2 open-ended statements on psychosocial impact related to NSSE. Consensus was defined as a 75% strongly agree achievement on each statement, or the final statement evolution at the end of 3 rounds. Statement support in each round was determined by mean, standard deviation and range, after a numerical value was allocated to each statement during specific rounds. All three rounds were structured and suggestions and additions were incorporated in the statement evolution of the three rounds. Results Thirty-five participants were invited, and 27 completed Round 1 (RD 1), 23 participants completed RD2, and 20 participants completed RD3. All 3 rounds were completed in 12 weeks. Statement 1 (sexual arousal incontinence), statement 2 (climacturia) and statement 3 (orgasm intensity) reached consensus after RD2, and statement 9 (sexual dysfunction impact) and statement 10 (experiences) were removed after RD3. Statement 4 (orgasmic pain), statement 5 (anejaculation), statement 6 (sensory disturbances), statement 7 (penile length shortening) and statement 8 (penile curvature) were finalised after the conclusion of RD3. Statements 1–3 were the most stable statements with the most support and least amount of disagreement. Statements 4–8 were less stable, but support for them improved over the 3 rounds. Statements 9–10 both had good stability, but the support indicated that they needed to be removed from the set of statements. Statement 5 had the poorest range due to an outlier opinion. Conclusions Consensus was reached on the items making up the NSSE screening tool. Health care practitioners will be able to use this tool to identify the evidence of NSSE after PCa treatment. Further testing will be undertaken to confirm the reliability and validly of the tool. Supplementary Information The online version contains supplementary material available at 10.1186/s12894-022-00982-0.
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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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3
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Ussher JM, Perz J, Rose D, Dowsett GW, Chambers S, Williams S, Davis I, Latini D. Threat of Sexual Disqualification: The Consequences of Erectile Dysfunction and Other Sexual Changes for Gay and Bisexual Men With Prostate Cancer. ARCHIVES OF SEXUAL BEHAVIOR 2017; 46:2043-2057. [PMID: 27102603 PMCID: PMC5547193 DOI: 10.1007/s10508-016-0728-0] [Citation(s) in RCA: 61] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/01/2015] [Revised: 12/21/2015] [Accepted: 02/25/2016] [Indexed: 05/31/2023]
Abstract
Gay and bisexual (GB) men with prostate cancer (PCa) have been described as an "invisible diversity" in PCa research due to their lack of visibility, and absence of identification of their needs. This study examined the meaning and consequences of erectile dysfunction (ED) and other sexual changes in 124 GB men with PCa and 21 male partners, through an on-line survey. A sub-sample of 46 men with PCa and seven partners also took part in a one-to-one interview. ED was reported by 72 % of survey respondents, associated with reports of emotional distress, negative impact on gay identities, and feelings of sexual disqualification. Other sexual concerns included loss of libido, climacturia, loss of sensitivity or pain during anal sex, non-ejaculatory orgasms, and reduced penis size. Many of these changes have particular significance in the context of gay sex and gay identities, and can result in feelings of exclusion from a sexual community central to GB men's lives. However, a number of men were reconciled to sexual changes, did not experience a challenge to identity, and engaged in sexual re-negotiation. The nature of GB relationships, wherein many men are single, engage in casual sex, or have concurrent partners, influenced experiences of distress, identity, and renegotiation. It is concluded that researchers and clinicians need to be aware of the meaning and consequences of sexual changes for GB men when designing studies to examine the impact of PCa on men's sexuality, advising GB men of the sexual consequences of PCa, and providing information and support to ameliorate sexual changes.
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Affiliation(s)
- Jane M Ussher
- Centre for Health Research, School of Medicine, Western Sydney University, Sydney, NSW, 2751, Australia.
| | - Janette Perz
- Centre for Health Research, School of Medicine, Western Sydney University, Sydney, NSW, 2751, Australia
| | - Duncan Rose
- Centre for Health Research, School of Medicine, Western Sydney University, Sydney, NSW, 2751, Australia
| | - Gary W Dowsett
- Australian Research Centre in Sex Health and Society, La Trobe University, Melbourne, VIC, Australia
| | - Suzanne Chambers
- Menzies Health Institute, Griffith University, Nathan, QLD, Australia
- Australian and New Zealand Urogenital and Prostate Cancer Trials Group, Camperdown, NSW, Australia
| | - Scott Williams
- Peter MacCallum Cancer Centre, Melbourne, VIC, Australia
- Australian and New Zealand Urogenital and Prostate Cancer Trials Group, Camperdown, NSW, Australia
| | - Ian Davis
- Eastern Health Clinical School, Monash University, Melbourne, VIC, Australia
- Australian and New Zealand Urogenital and Prostate Cancer Trials Group, Camperdown, NSW, Australia
| | - David Latini
- Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA
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4
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Chien CH, Chuang CK, Liu KL, Wu CT, Pang ST, Tsay PK, Chang YH, Huang XY, Liu HE. Effects of individual and partner factors on anxiety and depression in Taiwanese prostate cancer patients: A longitudinal study. Eur J Cancer Care (Engl) 2017; 27:e12753. [DOI: 10.1111/ecc.12753] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/19/2017] [Indexed: 02/04/2023]
Affiliation(s)
- C. H. Chien
- College of Nursing; National Taipei University of Nursing and Health Sciences; Taipei Taiwan
| | - C. K. Chuang
- Division of Urology; Department of Surgery; Chang Gung Memorial Hospital; Tao-Yuan Taiwan
- College of Medicine; Chang Gung University; Tao-Yuan Taiwan
| | - K. L. Liu
- Division of Urology; Department of Surgery; Chang Gung Memorial Hospital; Tao-Yuan Taiwan
- College of Medicine; Chang Gung University; Tao-Yuan Taiwan
| | - C. T. Wu
- College of Medicine; Chang Gung University; Tao-Yuan Taiwan
- Division of Urology; Department of Surgery; Chang Gung Memorial Hospital; Keelung Taiwan
| | - S. T. Pang
- Division of Urology; Department of Surgery; Chang Gung Memorial Hospital; Tao-Yuan Taiwan
- College of Medicine; Chang Gung University; Tao-Yuan Taiwan
| | - P. K. Tsay
- College of Medicine; School of Nursing; Chang Gung University; Tao-Yuan Taiwan
| | - Y. H. Chang
- College of Medicine; Chang Gung University; Tao-Yuan Taiwan
- Department of Surgery; Chang Gung Memorial Hospital; Tao-Yuan Taiwan
| | - X. Y. Huang
- College of Nursing; National Taipei University of Nursing and Health Sciences; Taipei Taiwan
| | - H. E. Liu
- School of Nursing; College of Medicine; Chang Gung University; Tao-Yuan Taiwan
- Department of Rheumatology; Chang Gung Memorial Hospital; Tao-Yuan Taiwan
- Department of Nursing; College of Nursing; Chang Gung University of Science and Technology; Tao-Yuan Taiwan
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5
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Matheson L, Watson EK, Nayoan J, Wagland R, Glaser A, Gavin A, Wright P, Rivas C. A qualitative metasynthesis exploring the impact of prostate cancer and its management on younger, unpartnered and gay men. Eur J Cancer Care (Engl) 2017; 26. [PMID: 28382745 DOI: 10.1111/ecc.12676] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/10/2017] [Indexed: 11/29/2022]
Abstract
Prostate cancer (PCa) can negatively impact on men's sexual, urinary and emotional functioning, affecting quality of life. Most men with PCa are older (≥65 years), married and heterosexual and little is known about the impact on men who are younger, unpartnered or gay. We aimed to synthesise existing qualitative research on these three groups of men. A systematic metasynthesis was undertaken that included data on the unique impacts of PCa on younger (<65 years) (n = 7 papers), unpartnered (n = 17 papers) or gay or bisexual men (n = 11 papers) using a modified meta-ethnographic approach. The three overarching constructs illustrated the magnified disruption to men's biographies, that included: marginalisation, isolation and stigma-relating to men's sense of being "out of sync"; the burden of emotional and embodied vulnerabilities and the assault on identity-illustrating the multiple threats to men's work, sexual and social identities; shifting into different communities of practice-such as the shift from being part of a sexually active community to celibacy. These findings suggest that PCa can have a particular impact on the quality of life of younger, unpartnered and gay men. This has implications for the provision of tailored support and information to these potentially marginalised groups.
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Affiliation(s)
- L Matheson
- Department of Applied Health and Professional Development, Oxford Brookes University, Oxford, UK
| | - E K Watson
- Department of Applied Health and Professional Development, Oxford Brookes University, Oxford, UK
| | - J Nayoan
- Faculty of Health Sciences, University of Southampton, Southampton, UK
| | - R Wagland
- Faculty of Health Sciences, University of Southampton, Southampton, UK
| | - A Glaser
- Leeds Institute of Cancer and Pathology, Faculty of Medicine and Health, University of Leeds, Leeds, UK
| | - A Gavin
- School of Medicine, Dentistry and Biomedical Sciences, Centre for Public Health, Queen's University Belfast, Belfast, UK
| | - P Wright
- Leeds Institute of Cancer and Pathology, Faculty of Medicine and Health, University of Leeds, Leeds, UK
| | - C Rivas
- Faculty of Health Sciences, University of Southampton, Southampton, UK
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6
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Ussher JM, Perz J, Kellett A, Chambers S, Latini D, Davis ID, Rose D, Dowsett GW, Williams S. Health-Related Quality of Life, Psychological Distress, and Sexual Changes Following Prostate Cancer: A Comparison of Gay and Bisexual Men with Heterosexual Men. J Sex Med 2016; 13:425-34. [PMID: 26853048 DOI: 10.1016/j.jsxm.2015.12.026] [Citation(s) in RCA: 87] [Impact Index Per Article: 10.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2015] [Revised: 12/14/2015] [Accepted: 12/18/2015] [Indexed: 12/27/2022]
Abstract
INTRODUCTION Decrements in health-related quality of life (HRQOL) and sexual difficulties are a recognized consequence of prostate cancer (PCa) treatment. However little is known about the experience of gay and bisexual (GB) men. AIM HRQOL and psychosexual predictors of HRQOL were examined in GB and heterosexual men with PCa to inform targeted health information and support. METHOD One hundred twenty-four GB and 225 heterosexual men with PCa completed a range of validated psychosexual instruments. MAIN OUTCOME MEASURE Functional Assessment of Cancer Therapy-Prostate (FACT-P) was used to measure HRQOL, with validated psychosexual measures, and demographic and treatment variables used as predictors. RESULTS GB men were significantly younger (64.25 years) than heterosexual men (71.54 years), less likely to be in an ongoing relationship, and more likely to have casual sexual partners. Compared with age-matched population norms, participants in both groups reported significantly lower sexual functioning and HRQOL, increased psychological distress, disruptions to dyadic sexual communication, and lower masculine self-esteem, sexual confidence, and sexual intimacy. In comparison with heterosexual men, GB men reported significantly lower HRQOL (P = .046), masculine self-esteem (P < .001), and satisfaction with treatment (P = .013); higher psychological distress (P = .005), cancer related distress (P < .001) and ejaculatory concern (P < .001); and higher sexual functioning (P < .001) and sexual confidence (P = .001). In regression analysis, psychological distress, cancer-related distress, masculine self-esteem, and satisfaction with treatment were predictors of HRQOL for GB men (R2Adj = .804); psychological distress and sexual confidence were predictors for heterosexual men (R2Adj = .690). CONCLUSION These findings confirm differences between GB and heterosexual men in the impact of PCa on HRQOL across a range of domains, suggesting there is a need for GB targeted PCa information and support, to address the concerns of this "hidden population" in PCa care.
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Affiliation(s)
- Jane M Ussher
- Centre for Health Research, School of Medicine, Western Sydney University, Sydney, New South Wales, Australia.
| | - Janette Perz
- Centre for Health Research, School of Medicine, Western Sydney University, Sydney, New South Wales, Australia
| | - Andrew Kellett
- Centre for Health Research, School of Medicine, Western Sydney University, Sydney, New South Wales, Australia
| | - Suzanne Chambers
- Menzies Health Institute, Griffith University, Queensland, Australia; Australian and New Zealand Urogenital and Prostate Cancer Trials Group (ANZUP)
| | - David Latini
- Baylor College of Medicine, Houston, Texas, United States
| | - Ian D Davis
- Monash University, Melbourne, Victoria, Australia; Australian and New Zealand Urogenital and Prostate Cancer Trials Group (ANZUP); Eastern Health, Melbourne, Victoria, Australia
| | - Duncan Rose
- Centre for Health Research, School of Medicine, Western Sydney University, Sydney, New South Wales, Australia
| | - Gary W Dowsett
- Australian Research Centre in Sex, Health and Society, La Trobe University, Melbourne, Victoria, Australia
| | - Scott Williams
- Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia; Australian and New Zealand Urogenital and Prostate Cancer Trials Group (ANZUP)
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7
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Couper J, Collins A, Bloch S, Street A, Duchesne G, Jones T, Olver J, Love A. Cognitive existential couple therapy (CECT) in men and partners facing localised prostate cancer: a randomised controlled trial. BJU Int 2015; 115 Suppl 5:35-45. [DOI: 10.1111/bju.12991] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Affiliation(s)
- Jeremy Couper
- Psycho-oncology Research Unit; Peter MacCallum Cancer Centre; Melbourne Australia
- Department of Psychiatry; St Vincent's Hospital; Melbourne Australia
| | - Anna Collins
- Psycho-oncology Research Unit; Peter MacCallum Cancer Centre; Melbourne Australia
- Centre for Palliative Care; St Vincent's Hospital; Melbourne Australia
| | - Sidney Bloch
- Department of Psychiatry; St Vincent's Hospital; Melbourne Australia
| | - Annette Street
- Department of Public Health, Faculty of Health Sciences; LaTrobe University; Melbourne Australia
| | - Gillian Duchesne
- Department of Radiation Oncology; Peter MacCallum Cancer Centre; Melbourne Australia
| | - Tessa Jones
- Department of Clinical Psychology and Psychiatry; Peter MacCallum Cancer Centre; Melbourne Australia
| | - James Olver
- Department of Psychiatry, Austin Health; University of Melbourne; Melbourne Australia
| | - Anthony Love
- Centre for Cultural Diversity and Wellbeing, College of Arts; Victoria University; Melbourne Australia
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Chambers SK, Lowe A, Hyde MK, Zajdlewicz L, Gardiner RA, Sandoe D, Dunn J. Defining young in the context of prostate cancer. Am J Mens Health 2015; 9:103-14. [PMID: 24780936 PMCID: PMC4361457 DOI: 10.1177/1557988314529991] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
The experience of prostate cancer is for most men a major life stress with the psychological burden of this disease falling more heavily on those who are younger. Despite this, being young as it applies to prostate cancer is not yet clearly defined with varied chronological approaches applied. However, men's responses to health crises are closely bound to life course and masculinities from which social roles emerge. This paper applied qualitative methodology (structured focus groups and semistructured interviews with expert informants) using interpretative phenomenological analysis to define what it means to be young and have prostate cancer. Structured focus groups were held with 26 consumer advisors (men diagnosed with prostate cancer who provide support to other men with prostate cancer or raise community awareness) and health professionals. As well, 15 men diagnosed with prostate cancer and in their 40s, 50s, or 60s participated in semi-structured interviews. Participants discussed the attributes that describe a young man with prostate cancer and the experience of being young and diagnosed with prostate cancer. Chronological definitions of a young man were absent or inconsistent. Masculine constructions of what it means to be a young man and life course characteristics appear more relevant to defining young as it applies to prostate cancer compared with chronological age. These findings have implications for better understanding the morbidities associated with this illness, and in designing interventions that are oriented to life course and helping young men reconstruct their identities after prostate cancer.
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Affiliation(s)
- Suzanne K Chambers
- Griffith Health Institute, Griffith University, Gold Coast Campus, Queensland, Australia Cancer Council Queensland, Brisbane, Queensland, Australia Prostate Cancer Foundation of Australia, Sydney, New South Wales, Australia Health and Wellness Institute, Edith Cowan University, Joondalup, Perth, Queensland, Australia Centre for Clinical Research, University of Queensland, Brisbane, Queensland, Australia
| | - Anthony Lowe
- Griffith Health Institute, Griffith University, Gold Coast Campus, Queensland, Australia Prostate Cancer Foundation of Australia, Sydney, New South Wales, Australia
| | - Melissa K Hyde
- Griffith Health Institute, Griffith University, Gold Coast Campus, Queensland, Australia
| | | | - Robert A Gardiner
- Health and Wellness Institute, Edith Cowan University, Joondalup, Perth, Queensland, Australia Centre for Clinical Research, University of Queensland, Brisbane, Queensland, Australia Department of Urology, Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia
| | - David Sandoe
- Prostate Cancer Foundation of Australia, Sydney, New South Wales, Australia
| | - Jeff Dunn
- Griffith Health Institute, Griffith University, Gold Coast Campus, Queensland, Australia Cancer Council Queensland, Brisbane, Queensland, Australia School of Social Science, University of Queensland, Brisbane, Queensland, Australia
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9
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Lepore SJ, Buzaglo JS, Lieberman MA, Golant M, Greener JR, Davey A. Comparing standard versus prosocial internet support groups for patients with breast cancer: a randomized controlled trial of the helper therapy principle. J Clin Oncol 2014; 32:4081-6. [PMID: 25403218 DOI: 10.1200/jco.2014.57.0093] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
PURPOSE Internet support group (ISG) members benefit from receiving social support and, according to the helper therapy principle, by providing support to others. To test the mental health benefits of providing support to others, this trial compared the efficacy of a standard ISG (S-ISG) and an enhanced prosocial ISG (P-ISG). METHODS A two-armed randomized controlled trial with 1-month pretest and post-test assessments was conducted with women (N = 184) diagnosed in the past 36 months with nonmetastatic breast cancer who reported elevated anxiety or depression. Women were randomly assigned to either the S-ISG or P-ISG condition. Both conditions included six professionally facilitated live chat sessions (90-minute weekly sessions) and access to an asynchronous discussion board; P-ISG also included structured opportunities to help and encourage others. RESULTS Relative to the S-ISG, participants in the P-ISG condition exhibited more supportive behaviors (emotional, informational, and companionate support), posted more messages that were other-focused and fewer that were self-focused, and expressed less negative emotion (P < .05). Relative to the S-ISG, participants in the P-ISG condition had a higher level of depression and anxiety symptoms after the intervention (P < .05). CONCLUSION Despite the successful manipulation of supportive behaviors, the P-ISG did not produce better mental health outcomes in distressed survivors of breast cancer relative to an S-ISG. The prosocial manipulation may have inadvertently constrained women from expressing their needs openly, and thus, they may not have had their needs fully met in the group. Helping others may not be beneficial as a treatment for distressed survivors of breast cancer.
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Affiliation(s)
- Stephen J Lepore
- Stephen J. Lepore, Judith R. Greener, and Adam Davey, Temple University; Joanne S. Buzaglo and Mitch Golant, Cancer Support Community, Philadelphia, PA; and Morton A. Lieberman, University of California, San Francisco, San Francisco, CA.
| | - Joanne S Buzaglo
- Stephen J. Lepore, Judith R. Greener, and Adam Davey, Temple University; Joanne S. Buzaglo and Mitch Golant, Cancer Support Community, Philadelphia, PA; and Morton A. Lieberman, University of California, San Francisco, San Francisco, CA
| | - Morton A Lieberman
- Stephen J. Lepore, Judith R. Greener, and Adam Davey, Temple University; Joanne S. Buzaglo and Mitch Golant, Cancer Support Community, Philadelphia, PA; and Morton A. Lieberman, University of California, San Francisco, San Francisco, CA
| | - Mitch Golant
- Stephen J. Lepore, Judith R. Greener, and Adam Davey, Temple University; Joanne S. Buzaglo and Mitch Golant, Cancer Support Community, Philadelphia, PA; and Morton A. Lieberman, University of California, San Francisco, San Francisco, CA
| | - Judith R Greener
- Stephen J. Lepore, Judith R. Greener, and Adam Davey, Temple University; Joanne S. Buzaglo and Mitch Golant, Cancer Support Community, Philadelphia, PA; and Morton A. Lieberman, University of California, San Francisco, San Francisco, CA
| | - Adam Davey
- Stephen J. Lepore, Judith R. Greener, and Adam Davey, Temple University; Joanne S. Buzaglo and Mitch Golant, Cancer Support Community, Philadelphia, PA; and Morton A. Lieberman, University of California, San Francisco, San Francisco, CA
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10
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Teloken PE, Mulhall JP. Erectile Function Following Prostate Cancer Treatment: Factors Predicting Recovery. Sex Med Rev 2013; 1:91-103. [PMID: 27784588 DOI: 10.1002/smrj.11] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Prostate cancer represents the most common nonskin malignancy encountered in men, and the excellent long-term survival achieved in the majority of patients has allowed more attention to be given to the side effects associated with its treatment. Erectile function is one of the main concerns of patients when considering treatment options for prostate cancer. Not surprisingly, post-treatment sexual function is closely related to outcome satisfaction and has long-lasting effects on quality of life. Radical prostatectomy is currently the most commonly employed therapy for prostate cancer. Conflicting rates of erectile dysfunction have been reported after surgery, owing not only to different surgical techniques but also because of dissimilar patient populations and definitions. Providing accurate information to individual patients in regards to their chances of recuperating the ability to have intercourse after treatment is important not only because it allows patients to make informed decisions but also because it has the potential to reduce treatment dissatisfaction. This article mainly focuses on discussing predictors of erectile function after radical prostatectomy. Patient factors, surgical aspects, including comparisons between open, laparoscopic, and robotic approaches, and postoperative management issues that impact sexual outcomes are evaluated. Prediction models combining multiple factors are described. The definition and chronology of erectile function recovery and impact of sexual function on quality of life after surgery are also discussed. Teloken PE and Mulhall JP. Erectile function following prostate cancer treatment: Factors predicting recovery. Sex Med Rev 2013;1:91-103.
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Affiliation(s)
- Patrick E Teloken
- Department of Urology, Sir Charles Gaidner Hospital, Perth, Australia
| | - John P Mulhall
- Department of Urology, Memorial Sloan-Kettering Cancer Center, New York, NY, USA.
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11
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Chambers SK, Schover L, Nielsen L, Halford K, Clutton S, Gardiner RA, Dunn J, Occhipinti S. Couple distress after localised prostate cancer. Support Care Cancer 2013; 21:2967-76. [PMID: 23756617 DOI: 10.1007/s00520-013-1868-6] [Citation(s) in RCA: 56] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2013] [Accepted: 05/21/2013] [Indexed: 12/22/2022]
Abstract
BACKGROUND The experience of the diagnosis of prostate cancer is distressing for both men and their partners. The present study describes the prevalence of psychological distress in men with prostate cancer and their partners, and the predictors of adjustment outcomes. METHODS/DESIGN A cross-sectional survey of 189 prostate cancer patients who were scheduled for or had undergone surgery for localised prostate cancer and their partners assessed socio-demographic variables, masculine self-esteem and social intimacy, psychological adjustment and quality of life. RESULTS Overall, patients and partners reported low distress; however, female partners were more anxious with 36 % reporting mild to severe anxiety. For men, masculine self-esteem and time since diagnosis were most strongly related to mental health status; urinary bother most influenced physical quality of life. For female partners, the man's psychological distress and his sexual bother were most strongly related to her mental health status; higher social intimacy was most strongly associated with physical quality of life. CONCLUSION The correlates of distress after the diagnosis of prostate cancer differ between patients and female partners. For men, masculine self-esteem may be most crucial, whereas for women, her partner's level of distress may matter most. Research to better understand these interactions is needed.
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12
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Zaider T, Manne S, Nelson C, Mulhall J, Kissane D. Loss of masculine identity, marital affection, and sexual bother in men with localized prostate cancer. J Sex Med 2012; 9:2724-32. [PMID: 22989267 PMCID: PMC5180593 DOI: 10.1111/j.1743-6109.2012.02897.x] [Citation(s) in RCA: 72] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
INTRODUCTION Erectile dysfunction (ED) is one of the most frequent sources of distress after treatment for prostate cancer (PCa), yet evidence suggests that men do not easily adjust to loss of sexual function over time. A hypothesized determinant of men's adaptation to ED is the degree to which they experience a loss of masculine identity in the aftermath of PCa treatment. AIMS The aims of this study were (i) to describe the prevalence of concerns related to diminished masculinity among men treated for localized PCa; (ii) to determine whether diminished masculinity is associated with sexual bother, after controlling for sexual functioning status; and (iii) to determine whether men's marital quality moderates the association between diminished masculinity and sexual bother. METHODS We analyzed cross-sectional data provided by 75 men with localized PCa who were treated at one of two cancer centers. Data for this study were provided at a baseline assessment as part of their enrollment in a pilot trial of a couple-based intervention. MAIN OUTCOME MEASURES The sexual bother subscale from the Prostate Health-Related Quality-of-Life Questionnaire and the Masculine Self-Esteem and Marital Affection subscales from Clark et al's PCa-related quality-of-life scale. RESULTS Approximately one-third of men felt they had lost a dimension of their masculinity following treatment. Diminished masculinity was the only significant, independent predictor of sexual bother, even after accounting for sexual functioning status. The association between diminished masculinity and sexual bother was strongest for men whose spouses perceived low marital affection. CONCLUSIONS Diminished masculinity is a prominent, yet understudied concern for PCa survivors. Regardless of functional status, men who perceive a loss of masculinity following treatment may be more likely to be distressed by their ED. Furthermore, its impact on adjustment in survivorship may rely on the quality of their intimate relationships.
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Affiliation(s)
- Talia Zaider
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan-Kettering Cancer Center, New York, NY, USA
| | - Sharon Manne
- Section of Population Science, Cancer Institute of New Jersey, New Brunswick, NJ, USA
| | - Christian Nelson
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan-Kettering Cancer Center, New York, NY, USA
| | - John Mulhall
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan-Kettering Cancer Center, New York, NY, USA
| | - David Kissane
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan-Kettering Cancer Center, New York, NY, USA
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Ryu E, West SG, Sousa KH. Distinguishing between-person and within-person relationships in longitudinal health research: arthritis and quality of life. Ann Behav Med 2012; 43:330-42. [PMID: 22270265 DOI: 10.1007/s12160-011-9341-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Many health measures (e.g., blood pressure, quality of life) have meaningful fluctuation over time around a relatively stable mean level for each person. PURPOSE This didactic paper describes two closely related statistical models for examining between-person and within-person relationships between two or more sets of measures collected over time: the latent intercept model with correlated residuals (LI) in structural equation modeling framework and the multivariate multilevel model (MVML) in multilevel modeling framework. RESULTS We illustrated that the basic LI model and the MVML model are equivalent. We presented an illustrative example using a national arthritis data resource to examine between-person and within-person relationships of symptom status, functional health, and quality of life in arthritis patients. DISCUSSION Additional design and modeling issues for the treatment of missing data are considered. We discuss contexts in which one of the two models may be preferred. Mplus and SAS syntax are available.
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Affiliation(s)
- Ehri Ryu
- Department of Psychology, Boston College, Chestnut Hill, MA 02467, USA.
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Chambers SK, Ferguson M, Gardiner RA, Aitken J, Occhipinti S. Intervening to improve psychological outcomes for men with prostate cancer. Psychooncology 2012; 22:1025-34. [PMID: 22549800 DOI: 10.1002/pon.3095] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2011] [Revised: 01/25/2012] [Accepted: 04/03/2012] [Indexed: 11/11/2022]
Abstract
BACKGROUND Prostate cancer is the most common cancer in men in the Western world with well-described negative effects from treatments. However, outcomes are highly heterogeneous. A Phase 3 trial of a psycho-educational intervention was undertaken, aiming to reduce cancer-specific and decision-related distress and improve quality of life for men newly diagnosed with localised prostate cancer. METHODS Seven hundred forty (81.7%) men were recruited after diagnosis and before treatment and randomised to a tele-based nurse-delivered five-session psycho-educational intervention (N = 372) or usual care (N = 368). Participants were assessed before treatment and 2, 6, 12 and 24 months post-treatment. Outcome measures included cancer-specific and decision-related distress, cognitive judgmental adjustment, subjective well-being, and domain-specific and health-related quality of life. Social support was assessed as a potential moderator. RESULTS No unconditioned effects were found. Classification analyses on pre-randomisation measures distinguished three subgroups: younger, higher education and income men (N = 90); younger, lower education and income men (N = 106); and older men (N = 344). Younger, higher education and income men showed positive intervention effects for cancer-specific distress (p = 0.008) and mental health (p = 0.042). By contrast, for younger, lower education men, participation in the intervention was associated with decreases in cognitive judgmental adjustment over time (p = 0.006). CONCLUSIONS Response to intervention and adjustment over time varied according to previous sexual functioning, age, educational level and income. How to best intervene with younger, low education, low income men with prostate cancer is a critical future research question.
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