Development of an education package for men with prostate cancer on hormonal manipulation therapy

Experiences of patient education among people affected by cardiovascular disease: a qualitative study based on Andragogy model

BACKGROUND

Patient education is a key component of patient care, positively affecting health promotion and self-care ability. In this regard, an extensive body of research supports the use of the andragogy model in patient education. The study aimed to explore the experiences of people with cardiovascular disease in patient education.

METHODS

This qualitative study involved 30 adult patients with cardiovascular disease who were hospitalized or had a history of hospitalization. They were purposively recruited with maximum variation from two large hospitals in Tehran, Iran. Data were gathered by conducting semi-structured interviews. Data collection was done by conducting semi-structured interviews. Then, the data were analyzed using directed content analysis and a preliminary framework based on six constructs of the andragogy model.

RESULTS

Data analysis resulted in the development of 850 primary codes, which were reduced to 660 during data reduction. These codes were grouped into nineteen subcategories under the six primary constructs of the andragogy model, i.e., need-to-know, self-concept, prior experience, readiness for learning, orientation to learning, and motivation for learning. The most common problems in patient education were associated with self-concept, previous experience, and readiness for learning components.

CONCLUSION

This study provides valuable information about the problems of patient education for adults with cardiovascular disease. Correction of the issues identified can improve care quality and patient outcomes.

Androgen Deprivation Therapy in Pedophilic Disorder: Exploring the Physical, Psychological, and Sexual Effects From a Patient's Perspective

BACKGROUND

The use of androgen deprivation therapy (ADT) shows promising results in the treatment of paraphilic disorders. Although the side effects of ADT can be intrusive, there is no research into the experiences of patients with pedophilic disorder themselves.

AIM

This research aims to explore the psychological, physical, and sexual experiences of ADT from the perspective of sex offenders diagnosed with pedophilic disorder.

METHODS

Twelve semistructured in-depth interviews with male adults diagnosed with pedophilic disorder were conducted using a phenomenological approach. Six of the 12 respondents were on luteinizing hormone-releasing hormone agonists and the remaining on anti-androgens. Half of each group were inpatients, and the other half outpatients. The respondents were recruited in collaboration with one psychiatric hospital. The data were analyzed with help of a qualitative software application NVivo.

OUTCOMES

The respondents described experiences on the use of ADT on a physical, psychological, and sexual level.

RESULTS

The most prominent physical side effects mentioned were bone loss, weight gain, and breast formation. The respondents generally described a positive influence of the medication on their well-being. They felt more relaxed and experienced a reduction in frequency and intensity of sexual fantasies, anger, and aggressive feelings in general. In addition, all the respondents noticed a lower frequency of sexual contact and masturbation. Most of the participants experienced the use of ADT as a mandatory decision made by the treating psychiatrist.

CLINICAL IMPLICATIONS

This study recommends informing patients and their loved ones on the potential side effects of ADT. Furthermore, training forensic counselors on potential side effects of ADT and methods to alleviate them can promote the dissemination of information and will encourage the informed consent procedure.

STRENGTHS & LIMITATIONS

This is the first qualitative study about the experiences of ADT in men diagnosed with pedophilic disorder in Belgium. Future studies should include more than one treatment center.

CONCLUSION

The majority of the participants had a positive attitude towards ADT in general. Boons L, Jeandarme I, Vervaeke G. Androgen Deprivation Therapy in Pedophilic Disorder: Exploring the Physical, Psychological, and Sexual Effects From a Patient's Perspective. J Sex Med 2021;18:353-362.

Self-management program for chronic low back pain: A systematic review and meta-analysis

OBJECTIVE

To determine the effectiveness of self-management programs (SMPs) on chronic low back pain (CLBP).

METHODS

A search of randomized controlled trials (RCTs) was performed in Pubmed, Cochrane Library, Web of Science, Elsevier, and CINAHL through June, 2015. Two reviewers selected trials, conducted critical appraisal, and extracted data. Meta analyses were performed.

RESULTS

Thirteen moderate-quality RCTs were included. There were 9 RCTs for immediate post intervention on pain intensity and disability, 5 RCTs for short term, 3 RCTs for intermediate and 4 RCTs for long term. Specifically, the effect sizes (ESs) of SMP on pain intensity were -0.29, -0.20, -0.23, and -0.25 at immediate post-intervention, short-term, intermediate-term, and long-term follow-ups, respectively. The ESs on disability were -0.28, -0.23, -0.19, and -0.19 at immediate post-intervention, short-term, intermediate-term, and long-term follow-ups, respectively.

CONCLUSION

For CLBP patients, there is moderate-quality evidence that SMP has a moderate effect on pain intensity, and small to moderate effect on disability.

PRACTICE IMPLICATIONS

SMP can be regarded as an effective approach for CLBP management. In addition to face-to-face mode, internet-based strategy can also be considered as a useful option to deliver SMP. Theoretically driven programs are preferred.

Evaluation of an evidence-based education package for men with prostate cancer on hormonal manipulation therapy

Prostate cancer has become a public health problem worldwide with considerable social and economic consequences. Many men have extraprostatic spread at diagnosis, and treatment usually involves hormonal manipulation therapy, which can challenge the stereotypical male image. It is often assumed that merely the provision of educational material for patients in an accessible form is sufficient to address informational needs. However, with the increasing emphasis on evidence-based practice, an essential element of the patient education process is evaluation of the impact of educational interventions. In this study, a randomised controlled trial was used to evaluate the effect of an evidence-based education package on the knowledge of disease and treatment, quality of life, coping and satisfaction of a sample (n=55) of men with prostate cancer on hormonal manipulation therapy in the UK. The men were randomly assigned to experimental (n=28) and control group (n=27). Established instruments with satisfactory reliability and validity were used to measure the dependent variables. The independent variable, namely the education package, had been developed following the results of a previous study, which assessed the informational needs of this client group. This package consisted of an information booklet supplemented by the verbal teaching of a urology nurse. Results demonstrated that delivery of the education package had a significant effect on knowledge, quality of life and satisfaction with care, but not on coping. This study has contributed to the evidence-base for practice in urological nursing. This education package should become a routine, and not merely incidental aspect of care for this client group.