Systematic review of self-management programs for prostate cancer patients, a quality of life and self-efficacy meta-analysis

Effectiveness of proactive health interventions in reducing symptoms and enhancing self-efficacy and self-management in prostate cancer survivors: a randomized controlled trial

PURPOSE

To evaluate the effectiveness of a proactive health intervention in reducing symptoms, enhancing self-efficacy, and improving self-management capabilities in prostate cancer survivors.

METHODS

A single-blind randomized controlled trial was conducted with 200 prostate cancer survivors at a tertiary hospital in Zhejiang Province. Participants were randomly assigned to either the intervention group (n = 95), which received a 3-month proactive health management program based on five health modules with online and telephone follow-up, or the control group (n = 97), which received routine telephone follow-up care. Outcomes were assessed at baseline, 1 month, and 3 months post-discharge, focusing on prostate cancer symptoms, self-care ability, self-efficacy, and psychological well-being.

RESULTS

Compared to the control group, the intervention group showed significant improvements in prostate cancer symptoms (95% CI = [- 5.898, - 1.756], p < 0.001), self-care ability (95% CI = [14.427, 20.878], p < 0.001), and self-efficacy (95% CI = [0.078, 0.408], p = 0.004) after the intervention. Anxiety and depression (95% CI = [- 2.408, - 1.404], p < 0.001) were significantly reduced at the 3-month follow-up compared to baseline, although no significant difference was observed between the groups.

CONCLUSIONS

The 3-month proactive health management intervention significantly reduced symptoms, anxiety, and depression in prostate cancer survivors, while improving self-care ability and self-efficacy. Further studies with larger samples and longer follow-up periods are needed to confirm these findings.

IMPLICATIONS FOR CANCER SURVIVORS

Rehabilitation for prostate cancer survivors should integrate both physical and psychological recovery to address comprehensive health needs. Enhancing survivors' proactive health management skills supports sustained recovery.

CLINICAL TRIALS REGISTRATION

ClinicalTrial.gov Identifier: ChiCTR2300076594.

The Effect of Self-Management on Patients with Chronic Diseases: A Systematic Review and Meta-Analysis

BACKGROUND

Chronic diseases significantly impact global morbidity and mortality, affecting millions. Self-management interventions are crucial for improving patient health outcomes. This study explores the effects of self-management interventions on the quality of life (QOL), self-efficacy, depression, and anxiety of patients with chronic diseases.

METHODS

Relevant studies were searched from PubMed, EMBASE, and Web of Science. Two reviewers independently screened the literature, evaluated the risk of bias assessment, and extracted characteristics and outcomes among patients with chronic diseases. For each included study, we calculated the standardized mean difference (SMD) and 95% confidence interval (CI) of the main outcomes. When deemed feasible, the heterogeneity of the study was explored by meta-analysis and subgroup analysis.

RESULTS

Thirty-four studies involving a total of 7603 patients with chronic diseases were included. Self-management interventions significantly improved quality of life (Higher-better QOL and Lower-better QOL), self-efficacy, and reduced depression symptoms compared to usual care (95%CI 0.01 to 0.15, p = 0.03; 95%CI -0.49 to -0.08, p = 0.006; 95%CI 0.19 to 0.62, p < 0.001; 95%CI -0.23 to -0.07, p < 0.001). However, no significant effect was found for anxiety (95%CI -0.18 to 0.03, p = 0.18). In the heterogeneity analysis, Lower-better QOL and self-efficacy were all higher than 50% (I2 = 80%, 87%). After the subgroup analysis, the heterogeneity of Lower-better QOL and self-efficacy was less than 50% (I2 = 0%, 16.1%). Subgroup analyses revealed that studies with mean age greater than 60 years old and follow-up times greater than 6 months were more effective in improving patients' Lower-better QOL (p = 0.03, p = 0.004), whereas follow-up times less than 6 months were better at reducing patients' anxiety symptoms (p = 0.03).

CONCLUSIONS

Self-management interventions are more effective than routine care in managing chronic diseases, significantly improving patients' quality of life, self-efficacy, and reducing depressive symptoms, but they did not show significant improvements in anxiety symptoms. Overall, self-management interventions for chronic diseases can help patients adapt to the changes brought about by the disease and self-manage diseases to prevent disease progression.

Effect of cognitive-behavioral program on quality of life in men with post-prostatectomy incontinence: a randomized trial

OBJECTIVE

To explore the effects of a cognitive-behavioral program addressing urinary incontinence on the quality of life of men who have undergone radical prostatectomy.

METHOD

Randomized controlled clinical trial with patients undergoing radical prostatectomy in an institution for cancer treatment in Brazil. The 34 participants were randomized into two groups: 17 in the control group who received the institution's standard care and 17 in the intervention group who received the cognitive-behavioral program. Quality of life was assessed using the King's Health Questionnaire and the International Consultation on Incontinence Questionnaire-Short Form.

RESULTS

Participants from intervention group showed better results regarding the reduction of the impact of urinary incontinence on quality of life (p ≤ 0.001), with emphasis on limitations in daily activities, general health perception, physical and social limitations, emotions, and sleep and mood.

CONCLUSION

The cognitive-behavioral program was effective in reducing the impact of urinary incontinence on quality of life. This study contributes to clinical practice by providing an effective, low-cost, and easily applicable therapy. Brazilian Registry of Clinical Trials: RBR-3sstqg.

Effects of three-dimensional quality assessment nursing intervention on efficacy and disease management of patients undergoing esophageal cancer surgery

BACKGROUND

Esophageal cancer is one of the most common malignant tumors. The three-dimensional quality structure model is a quality assessment theory that includes three dimensions: Structure, process, and results.

AIM

To investigate the effects of nursing interventions with three-dimensional quality assessment on the efficacy and disease management ability of patients undergoing esophageal cancer surgery.

METHODS

In this prospective study, the control group received routine nursing, and the intervention group additionally received a three-dimensional quality assessment intervention based on the above routine care. Self-efficacy and patient disease management abilities were evaluated using the General Self-Efficacy Scale (GSES) and Exercise of Self-Care Agency scale, respectively. IBM SPSS Statistics for Windows, version 17.0, was used for the data processing.

RESULTS

This study recruited 112 patients who were assigned to the control and experimental groups (n = 56 per group). Before the intervention, there was no significant difference in GSES scores between the two groups (P > 0.05). After the intervention, the GSES scores of both groups increased, with the experimental group showing higher values (P < 0.05). At the time of discharge and three months after discharge, the scores for positive attitudes, self-stress reduction, and total score of health promotion in the experimental group were higher than those in the control group (P < 0.05).

CONCLUSION

The implementation of a three-dimensional quality structure model for postoperative patients with esophageal cancer can effectively improve their self-management ability and self-efficacy of postoperative patients.

Survivorship Care for People Affected by Advanced or Metastatic Cancer: MASCC-ASCO Standards and Practice Recommendations

PURPOSE

People with advanced or metastatic cancer and their caregivers may have different care goals and face unique challenges compared with those with early-stage disease or those nearing the end of life. These Multinational Association for Supportive Care in Cancer (MASCC)-ASCO standards and practice recommendations seek to establish consistent provision of quality survivorship care for people affected by advanced or metastatic cancer.

METHODS

A MASCC-ASCO expert panel was formed. Standards and recommendations relevant to the provision of quality survivorship care for people affected by advanced or metastatic cancer were developed through conducting (1) a systematic review of unmet supportive care needs; (2) a scoping review of cancer survivorship, supportive care, and palliative care frameworks and guidelines; and (3) an international modified Delphi consensus process.

RESULTS

A systematic review involving 81 studies and a scoping review of 17 guidelines and frameworks informed the initial standards and recommendations. Subsequently, 77 experts (including eight people with lived experience) across 33 countries (33% were low- to middle-resource countries) participated in the Delphi study and achieved ≥94.8% agreement for seven standards, (1) Person-Centered Care; (2) Coordinated and Integrated Care; (3) Evidence-Based and Comprehensive Care; (4) Evaluated and Communicated Care; (5) Accessible and Equitable Care; (6) Sustainable and Resourced Care; and (7) Research and Data-Driven Care, and ≥84.2% agreement across 45 practice recommendations.

CONCLUSION

Standards of survivorship care for people affected by advanced or metastatic cancer are provided. These MASCC-ASCO standards support optimization of health outcomes and care experiences by providing guidance to stakeholders (health care professionals, leaders, and administrators; governments and health ministries; policymakers; advocacy agencies; cancer survivors and caregivers). Practice recommendations may be used to facilitate future research, practice, policy, and advocacy efforts.Additional information is available at www.mascc.org, www.asco.org/standards and www.asco.org/survivorship-guidelines.

A Non-Randomized Comparison of Online and In-Person Formats of the Canadian Androgen Deprivation Therapy Educational Program: Impacts on Side Effects, Bother, and Self-Efficacy

Although Androgen Deprivation Therapy (ADT) is effective in controlling prostate cancer (PCa) and increasing survival, it is associated with a myriad of side effects that cause significant morbidity. Previous research has shown that PCa patients starting on ADT are neither fully informed nor well-equipped to manage the breadth of ADT's side effects. The ADT Educational Program (a 1.5 h interactive class plus a book) was developed as an evidence-based resource for patients dealing with ADT. Our aim here was to compare the efficacy of an online version of the class with a previously assessed in-person version of the class. Using mixed MANOVAs within a non-randomized comparison design, we assessed: (1) changes in patients' experiences of self-efficacy to manage and bother associated with side effects approximately 10 weeks after attending a class, and (2) potential differences in these variables between online and in-person class formats. Side effect bother decreased from pre- to post-class but did not differ between in-person (n = 94) and online (n = 137) class cohorts. While self-efficacy to manage side effects was slightly higher post-class in both cohorts, the increase was not statistically significant. Average self-efficacy ratings were significantly higher among in-person versus online class participants (p < 0.05; ηp2 = 0.128). Both online and in-person classes are associated with a significant reduction in the severity of side effect bother reported by PCa patients, suggesting non-inferiority of online versus in-person formats. Online classes offer greater accessibility to the program for patients outside the reach of in-person classes, increasing the availability of the program to more PCa patients and family members across Canada.

Mediating Effects of Self-Efficacy and Illness Perceptions on Mental Health in Men with Localized Prostate Cancer: A Secondary Analysis of the Prostate Cancer Patient Empowerment Program (PC-PEP) Randomized Controlled Trial

Understanding how interventions reduce psychological distress in patients with prostate cancer is crucial for improving patient care. This study examined the roles of self-efficacy, illness perceptions, and heart rhythm coherence in mediating the effects of the Prostate Cancer Patient Empowerment Program (PC-PEP) on psychological distress compared to standard care. In a randomized controlled trial, 128 patients were assigned to either the PC-PEP intervention or standard care. The PC-PEP, a six-month program emphasizing daily healthy living habits, included relaxation and stress management, diet, exercise, pelvic floor muscle exercises, and strategies to improve relationships and intimacy, with daily activities supported by online resources and live sessions. Participants in the intervention group showed significant improvements in self-efficacy and specific illness perceptions, such as personal control and emotional response, compared to the control group. These factors mediated the relationship between the intervention and its psychological benefits, with self-efficacy accounting for 52% of the reduction in psychological distress. No significant differences in heart rhythm coherence were observed. This study highlights the critical role of self-efficacy and illness perceptions in enhancing psychological health in prostate cancer patients through the PC-PEP. The results underscore this program's effectiveness and the key mechanisms through which it operates. Given the high rates of distress among men undergoing prostate cancer treatments, these findings emphasize the importance of integrating the PC-PEP into clinical practice. The implementation of the PC-PEP in clinical settings can provide a structured approach to reducing psychological distress and improving overall patient well-being.

The Effect of Self-efficacy-Enhancing Interventions on Quality of Life of Cancer Survivors: A Systematic Review

BACKGROUND

The influence of self-efficacy-enhancing interventions on quality of life (QOL) is not clear with recent randomized controlled trials (RCTs) because current reviews only evaluated self-efficacy as an outcome.

OBJECTIVES

We conducted a systematic review to examine the effect of self-efficacy-enhancing interventions on QOL among patients with cancer and to summarize the effective determinants for designing self-efficacy-enhancing interventions.

METHODS

A systematic search was performed on studies published from January 2003 to May 2023 using PubMed, CINAHL, PsycINFO, and Web of Science. Included studies were RCTs, adults diagnosed with cancer, interventions with explicit self-efficacy components, and QOL as the outcome.

RESULTS

Nineteen RCTs were included. Risk-of-bias assessment revealed 12 studies with some concerns and 7 with high risk of bias. The mean intervention adherence rate was 88.2%; the most frequently listed reason for dropout was medical conditions and mortality. Self-efficacy interventions were shown to significantly improve at least 1 subscale of QOL in 9 of 19 studies, of which 7 studies used Bandura's 4 sources of self-efficacy. The interventions with between-session intervals shorter than 2 weeks, of 12-week duration, and with an in-person delivery approach were the most effective.

CONCLUSIONS

Self-efficacy-enhancing interventions show potential beneficial effects on QOL among cancer survivors. Interventions that use Bandura's 4 sources of self-efficacy strategies and have between-session intervals shorter than 2 weeks, an in-person approach, and 12-week intervention duration are recommended.

IMPLICATIONS FOR PRACTICE

Properly designed self-efficacy-enhancing interventions can facilitate behavioral change and improve QOL in cancer survivors.

Integrative model for self-perception of well-being in cancer

PURPOSE

Continual illness uncertainty can affect how people perceive and interpret their well-being. Some cognitive and spiritual factors may be involved in the management of disruptive thoughts and emotions that can emerge during the experience of cancer.

MATERIAL AND METHODS

An evidence-based integrative model was developed to evaluate and show the role that mindfulness, acceptance, self-efficacy, uncertainty, meaning, and purpose in life play in the self-perception of well-being in individuals with cancer. This evidence-based integrative model was conducted using relevant and selected studies.

RESULTS

An integrative model for self-perception of well-being has been proposed. This model integrates evidence-based findings and provides clear principles for clinicians and researchers. This integrative model proposes that mindfulness, acceptance, self-efficacy perception, and uncertainty can predict how people with cancer perceive their well-being. The model also posits that meaning and purpose in life can act as mediators or moderators of this prediction.

CONCLUSIONS

This integrative model involves the multidimensionality of human beings and facilitates the understanding of some key factors for the design of therapeutic approaches such as Acceptance & Commitment Therapy or Meaning-Centered Psychotherapy.IMPLICATIONS FOR REHABILITATIONMindfulness, acceptance, self-efficacy, uncertainty, meaning, and purpose in life can be highly relevant for clinical oncology.An integrative model is proposed to understand the combined influence of these factors on patients with cancer.This model may favor a better integration of well-known interventions, such as Mindfulness-based approaches, Acceptance and Commitment Therapy (ACT), and Meaning-Centered Psychotherapy (MCP).

Survivorship care for people affected by advanced or metastatic cancer: MASCC-ASCO standards and practice recommendations

PURPOSE

People with advanced or metastatic cancer and their caregivers may have different care goals and face unique challenges compared to those with early-stage disease or those nearing the end-of-life. These MASCC-ASCO standards and practice recommendations seek to establish consistent provision of quality survivorship care for people affected by advanced or metastatic cancer.

METHODS

An expert panel comprising MASCC and ASCO members was formed. Standards and recommendations relevant to the provision of quality survivorship care for people affected by advanced or metastatic cancer were developed through conducting: (1) a systematic review of unmet supportive care needs; (2) a scoping review of cancer survivorship, supportive care, and palliative care frameworks and guidelines; and (3) an international modified Delphi consensus process.

RESULTS

A systematic review involving 81 studies and a scoping review of 17 guidelines and frameworks informed the initial standards and recommendations. Subsequently, 77 experts (including 8 people with lived experience) across 33 countries (33% were low-to-middle resource countries) participated in the Delphi study and achieved ≥ 94.8% agreement for seven standards (1. Person-Centred Care; 2. Coordinated and Integrated Care; 3. Evidence-Based and Comprehensive Care; 4. Evaluated and Communicated Care; 5. Accessible and Equitable Care; 6. Sustainable and Resourced Care; 7. Research and Data-Driven Care) and ≥ 84.2% agreement across 45 practice recommendations.

CONCLUSION

Standards of survivorship care for people affected by advanced or metastatic cancer are provided. These MASCC-ASCO standards will support optimization of health outcomes and care experiences by providing guidance to stakeholders in cancer care (healthcare professionals, leaders, and administrators; governments and health ministries; policymakers; advocacy agencies; cancer survivors and caregivers. Practice recommendations may be used to facilitate future research, practice, policy, and advocacy efforts.

Development and assessment of a self-management intervention for urinary incontinence among patients with prostate cancer: protocol for a randomized feasibility study

BACKGROUND

Urinary incontinence is a common complication among patients with prostate cancer who have undergone radical prostatectomy. Guided by social cognitive theory and a framework for the recovery of health and well-being, we propose to develop and test a self-management intervention for patients with prostate cancer who experience urinary incontinence after undergoing radical prostatectomy.

METHODS

In this study, a self-management intervention for urinary incontinence (SMI-UI) is developed, comprising a mobile self-management application, a self-management handbook, and professional support. The feasibility, acceptability, and effectiveness of this intervention will be assessed. Patient data from the urology departments of two hospitals will be collected through convenience sampling by adopting an experimental, parallel, and random assignment research design. Patients experiencing urinary incontinence after undergoing radical prostatectomy will be invited to participate. After completing the pretest questionnaire, patients will be randomly divided into the experimental and attention control groups. The experimental group will undergo a 12-week SMI-UI, whereas the attention control group will receive an intervention consisting of a single dietetic education information package. The two groups will be tested 12 and 16 weeks after the pretest. In this study, we recorded the sociodemographic and clinical variables; recruitment rate; retention rate; satisfaction with the intervention; cancer-related self-efficacy; urination symptoms and disturbance; social participation and satisfaction; resilience; and demoralization.

TRIAL REGISTRATION

ClinicalTrials.gov ID: NCT05335967 [date of registration 04-04-2022].

Making "Joy Pie" to Stay Joyful: Self-Care Interventions Alleviate College Students' Mental Health Challenges

As more college students are facing mental health challenges, it is imperative to explore innovative ways of improving their mental health, including developing self-care interventions that help mitigate their stressors. Based on the Response Styles Theory and self-care conceptions, this study creates the "Joy Pie" project that consists of five self-care strategies, aiming to regulate negative emotions and increase self-care efficacy. Using an experimental design and two-wave data collected from a representative sample of Beijing college students (n₁ = 316, n₂ = 127), this study assesses the effects of the five proposed interventions on the students' self-care efficacy and mental health management. The results show that self-care efficacy helped improve mental health through emotion regulation, which is mediated by age, gender, and family income. The promising results support the effectiveness of the "Joy Pie" interventions in strengthening self-care efficacy and improving mental health. This study offers insights into building back better mental health security among college students at this critical time when the world is recovering from the COVID-19 pandemic.