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Vassão FV, Barbosa LR, Moraes GMD, Domenico EBLD. Abordagem da sexualidade no cuidado ao paciente oncológico: barreiras e estratégias. ACTA PAUL ENFERM 2018. [DOI: 10.1590/1982-0194201800078] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
Resumo Objetivo: Identificar os fatores intervenientes para a abordagem da sexualidade, pelo paciente e profissional, e descrever as estratégias empenhadas para a abordagem da sexualidade no cuidado ao paciente com câncer. Métodos: Revisão integrativa de literatura, baseada em etapas sistemáticas, nas bases de dados e ou bibliotecas eletrônicas: LILACS, PUbMed, MEDLINE, IBECS, ScIELO, UpToDate, BDEnf. As buscas ocorreram entre dezembro de 2016 a julho de 2017. Criterios de inclusão: estudos com pacientes oncológicos, idade acima de 18 anos; publicados nos últimos dez anos (2007-2017); disponíveis na íntegra; nos idiomas português, espanhol e inglês. Excluídos: teses, dissertações, revisões (sistemática, narrativa e integrativa), artigos de opinião e editoriais. Resultados: Incluídos 18 artigos, seis artigos referentes a fatores intervenientes e 12 artigos referentes a estratégias adotadas para abordagem da sexualidade. A maioria dos artigos evidenciou a dificuldade com a qual o tema é tratado na prática profissional, nas perspectivas da comunicação e das relações interpessoais entre pacientes e profissionais, reiterando a premissa que a saúde sexual do paciente é, normalmente, negligenciada. Os estudos que versavam sobre as intervenções empreendidas para sanarem as lacunas, demonstraram diferentes graus de positividade e demonstraram que é necessária a capacitação dos profissionais com estratégias de orientação e aconselhamento. Há modelos de intervenção disponíveis na literatura. Conclusão: A sexualidade é negligenciada no cuidado ao paciente com câncer. A atenção multidisciplinar em oncologia precisa reconhecer esta realidade e empreender, numa ação conjunta, atividades de educação e apoio psicossocial, para que esta necessidade humana básica seja satisfeita pelos pacientes.
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Elliott S, Matthew A. Sexual Recovery Following Prostate Cancer: Recommendations From 2 Established Canadian Sexual Rehabilitation Clinics. Sex Med Rev 2017; 6:279-294. [PMID: 29199096 DOI: 10.1016/j.sxmr.2017.09.001] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2017] [Revised: 09/12/2017] [Accepted: 09/23/2017] [Indexed: 12/25/2022]
Abstract
INTRODUCTION Supportive sexual health care is much-needed adjuvant care to oncologic management for men with prostate cancer (PCa). AIM To inspire the initiation of biopsychosocial sexual health programming where it does not exist and to inform program enhancement in existing sexual rehabilitation clinics (SRCs). METHODS This article reviews the combined 30-year experience of 2 well-established Canadian SRCs for men and their partners after PCa treatments, interwoven with empirical evidence. MAIN OUTCOME MEASURE To comprehensively review the biopsychosocial approach to sexual health assessment of men with PCa and their partners to direct the practicalities of running a successful and sustainable SRC. RESULTS A full description of the biomedical and psychosocial approaches, inclusive of comprehensive sexual function, the penile rehabilitation controversy, and other medical and relationship issues affecting sexual adjustment, is provided to highlight the relevance of proper assessment and follow-through for sexual adaptation and adjustment. 10 recommendations for a successful SRC are discussed, including the principles behind developing a sustainable business plan, staff acquisition and training, budget, integration of treatment and research priorities, respectful and multidisciplinary approaches to care, and suggestions of visit formats, protocols, and questionnaires. We recommend a phased approach of an SRC into usual care with the option to provide accessible and equitable care to patients not within proximal access of treating institutions. CONCLUSION Sexual rehabilitation after treatment for PCa requires a complex treatment process. Providing sustainable sexual rehabilitation programming under the financially strained environment of the Canadian medical system is a challenge; therefore, to provide Canadian patients and their partners with comprehensive cancer care, they deserve a biopsychosocial approach combined with a creative and systematic implementation strategy. Elliott S, Matthew A. Sexual Recovery Following Prostate Cancer: Recommendations From 2 Established Canadian Sexual Rehabilitation Clinics. Sex Med Rev 2018;6:279-294.
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Affiliation(s)
- Stacy Elliott
- Prostate Cancer Supportive Care Program, Prostate Center, Vancouver Hospital, Department of Urological Sciences, University of British Columbia, Vancouver, BC, Canada; BC Center for Sexual Medicine, Vancouver Coastal Health Authority, Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada.
| | - Andrew Matthew
- Cancer Clinical Research Unit, Princess Margaret Cancer Centre, University Health Network, Department of Surgery (Division of Urology) and Psychiatry, University of Toronto, Toronto, ON, Canada
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Abstract
BACKGROUND Although sexual health is a common concern for oncology patients, no practical guidelines to sexual intervention exist, perhaps because of a lack of systematic reviews or meta-analyses. OBJECTIVES The objectives of this study were to determine the effect size for psychoeducational intervention focused on sexuality and to compare effect sizes according to intervention outcomes and characteristic. METHODS We explored quantitative evidence for the effects of sexual intervention for cancer patients or partners by using the electronic databases. Among them, we considered 15 eligible articles. RESULTS The meta-analysis provided 133 effect sizes from 15 primary studies. The analysis revealed significant improvements after intervention, with a random-effects standardized mean difference of 0.75. Psychoeducational interventions focused on sexuality after cancer diagnosis were effective for compliance (2.40), cognitive aspect (1.29), and psychological aspect (0.83). Individual-based interventions (0.85) were more effective in improving outcomes than group approach and group combined with individual intervention. With regard to intervention providers, registered nurse only (2.22) and team approach including the registered nurse (2.38) had the highest effect size. Face-to-face intervention combined with telephone or the Internet (1.04) demonstrated a higher effect size than face-to-face (0.62) and telephone (0.58) independently. CONCLUSION We conducted an analysis of data from various subgroups of preexisting studies, obtained an overall estimate of the effectiveness of the intervention, and compared its effectiveness across variables that affect intervention outcomes. IMPLICATIONS FOR PRACTICE These results provide empirical data for evidence-based practice and inform the development of useful intervention programs through a comprehensive review and meta-analysis of the results.
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Schofield P, Gough K, Lotfi-Jam K, Bergin R, Ugalde A, Dudgeon P, Crellin W, Schubach K, Foroudi F, Tai KH, Duchesne G, Sanson-Fisher R, Aranda S. Nurse-led group consultation intervention reduces depressive symptoms in men with localised prostate cancer: a cluster randomised controlled trial. BMC Cancer 2016; 16:637. [PMID: 27530156 PMCID: PMC4986252 DOI: 10.1186/s12885-016-2687-1] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2015] [Accepted: 08/08/2016] [Indexed: 02/02/2023] Open
Abstract
Background Radiotherapy for localised prostate cancer has many known and distressing side effects. The efficacy of group interventions for reducing psychological morbidity is lacking. This study investigated the relative benefits of a group nurse-led intervention on psychological morbidity, unmet needs, treatment-related concerns and prostate cancer-specific quality of life in men receiving curative intent radiotherapy for prostate cancer. Methods This phase III, two-arm cluster randomised controlled trial included 331 men (consent rate: 72 %; attrition: 5 %) randomised to the intervention (n = 166) or usual care (n = 165). The intervention comprised four group and one individual consultation all delivered by specialist uro-oncology nurses. Primary outcomes were anxious and depressive symptoms as assessed by the Hospital Anxiety and Depression Scale. Unmet needs were assessed with the Supportive Care Needs Survey-SF34 Revised, treatment-related concerns with the Cancer Treatment Scale and quality of life with the Expanded Prostate Cancer Index −26. Assessments occurred before, at the end of and 6 months post-radiotherapy. Primary outcome analysis was by intention-to-treat and performed by fitting a linear mixed model to each outcome separately using all observed data. Results Mixed models analysis indicated that group consultations had a significant beneficial effect on one of two primary endpoints, depressive symptoms (p = 0.009), and one of twelve secondary endpoints, procedural concerns related to cancer treatment (p = 0.049). Group consultations did not have a significant beneficial effect on generalised anxiety, unmet needs and prostate cancer-specific quality of life. Conclusions Compared with individual consultations offered as part of usual care, the intervention provides a means of delivering patient education and is associated with modest reductions in depressive symptoms and procedural concerns. Future work should seek to confirm the clinical feasibility and cost-effectiveness of group interventions. Trial registration Australian and New Zealand Clinical Trials Registry ANZCTRN012606000184572. 1 March 2006.
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Affiliation(s)
- Penelope Schofield
- Department of Psychology, Swinburne University of Technology, Hawthorn, Australia. .,Department of Cancer Experiences Research, Peter MacCallum Cancer Centre, 2 St Andrews Place, East Melbourne, Australia. .,Sir Peter MacCallum Department of Oncology, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Parkville, Australia. .,School of Health Sciences, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Parkville, Australia.
| | - Karla Gough
- Department of Cancer Experiences Research, Peter MacCallum Cancer Centre, 2 St Andrews Place, East Melbourne, Australia.,School of Health Sciences, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Parkville, Australia
| | - Kerryann Lotfi-Jam
- School of Health Sciences, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Parkville, Australia
| | - Rebecca Bergin
- Department of Cancer Experiences Research, Peter MacCallum Cancer Centre, 2 St Andrews Place, East Melbourne, Australia
| | - Anna Ugalde
- Deakin University, Faculty of Health, 221 Burwood Highway, Burwood, Australia.,Cancer Council Victoria, Cancer Information and Support Services, 615 St Kilda Rd, Melbourne, Australia
| | - Paul Dudgeon
- School of Behavioural Science, University of Melbourne, Parkville, Australia
| | - Wallace Crellin
- Department of Cancer Experiences Research, Peter MacCallum Cancer Centre, 2 St Andrews Place, East Melbourne, Australia
| | - Kathryn Schubach
- Radiation Oncology and Cancer Imaging, Peter MacCallum Cancer Centre, 2 St Andrews Place, East Melbourne, Australia
| | - Farshard Foroudi
- Sir Peter MacCallum Department of Oncology, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Parkville, Australia.,Radiation Oncology and Cancer Imaging, Peter MacCallum Cancer Centre, 2 St Andrews Place, East Melbourne, Australia
| | - Keen Hun Tai
- Sir Peter MacCallum Department of Oncology, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Parkville, Australia.,Radiation Oncology and Cancer Imaging, Peter MacCallum Cancer Centre, 2 St Andrews Place, East Melbourne, Australia
| | - Gillian Duchesne
- Sir Peter MacCallum Department of Oncology, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Parkville, Australia.,Radiation Oncology and Cancer Imaging, Peter MacCallum Cancer Centre, 2 St Andrews Place, East Melbourne, Australia
| | - Rob Sanson-Fisher
- School of Medicine and Public Health, The University of Newcastle, University Drive, Callaghan, Australia
| | - Sanchia Aranda
- Department of Cancer Experiences Research, Peter MacCallum Cancer Centre, 2 St Andrews Place, East Melbourne, Australia.,Sir Peter MacCallum Department of Oncology, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Parkville, Australia.,Cancer Council Australia, Sydney, NSW, Australia
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Abstract
BACKGROUND Prostate cancer support groups (PCSGs) are community-based organizations that offer information and psychosocial support to men who experience prostate cancer and their families. Nurses are well positioned to refer men to a range of psychosocial resources to help them adjust to prostate cancer; however, little is known about nurses' perspectives on PCSGs. OBJECTIVE The aim of this study was to describe nurses' views about PCSGs as a means to making recommendations for advancing the effectiveness of PCSGs. METHODS A convenience sample of 101 Canadian nurses completed a 43-item Likert-scale questionnaire with the additional option of providing comments in response to an open-ended question. Univariate descriptive statistics and content analysis were used to analyze the quantitative and qualitative data, respectively. RESULTS Participants held positive views about the roles and potential impact of PCSGs. Participants strongly endorsed the benefits of support groups in disseminating information and providing support to help decrease patient anxiety. Online support groups were endorsed as a practical alternative for men who are reluctant to participate in face-to-face groups. CONCLUSIONS Findings suggest that nurses support the value of Canadian face-to-face and online PCSGs. This is important, given that nurses can help connect individual patients to community-based sources providing psychosocial support. IMPLICATIONS FOR PRACTICE Many men benefit from participating in PCSGs. Aside from positively endorsing the work of PCSGs, nurses are important partners for raising awareness of these groups among potential attendees and can directly contribute to information sharing in face-to-face and online PCSGs.
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Schofield P, Chambers S. Effective, clinically feasible and sustainable: Key design features of psycho-educational and supportive care interventions to promote individualised self-management in cancer care. Acta Oncol 2015; 54:805-12. [PMID: 25813474 DOI: 10.3109/0284186x.2015.1010016] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
UNLABELLED As the global burden of cancer increases healthcare services will face increasing challenges in meet the complex needs of these patients, their families and the communities in which they live. This raises the question of how to meet patient need where direct clinical contact may be constrained or not readily available. Patients and families require resources and skills to manage their illness outside of the hospital setting within their own communities. AIM To propose a framework for the development and delivery of psycho-educational and supportive care interventions drawing on theoretical principles of behaviour change and evidence-based interventions, and based on extensive experience in developing and testing complex interventions in oncology. APPROACH At the core of this intervention framework are considerations of efficiency: interventions are designed to cater for individuals' unique needs; to place minimal demands on the health system infrastructure and to be rapidly disseminated into usual care if successful. There are seven key features: 1) Targeting cancer type and stage; 2) Tailoring to unique individual needs; 3) Promotion of patient self-management of their disease and treatment side effects; 4) Efficient delivery of the intervention; 5) Training and adherence to protocol; 6) Ensuring the intervention is evidence-based; 7) Confirming stakeholder acceptability of the intervention. APPLICATION A case study of a randomised controlled trial which tested psycho-educational oncology interventions using this framework is presented. These interventions were designed to cater for individuals' unique needs and promote self-management while placing minimal demands on the acute health care setting. DISCUSSION Innovative ways to realise the potentially major impact that psycho-educational and supportive care interventions can have on psychological morbidity, coping, symptoms and quality of life in serious and chronic illness are needed. This framework, which is driven by theory, evidence, and experience, is designed to ensure that interventions are effective, clinically feasible and sustainable.
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Affiliation(s)
- Penelope Schofield
- Department of Psychology, Swinburne University of Technology , Melbourne, Victoria , Australia
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Wenger LM, Oliffe JL, Bottorff JL. Psychosocial Oncology Supports for Men: A Scoping Review and Recommendations. Am J Mens Health 2014; 10:39-58. [PMID: 25389212 DOI: 10.1177/1557988314555361] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
Although men's cancer experiences have received limited attention within the field of psychosocial oncology, increasing attention is being devoted to the development and evaluation of men-centered programs. This scoping review describes this emergent body of literature, detailing the focus, participation, and impact of interventions designed to help men with cancer build illness-specific knowledge, adapt to illness, manage side effects, distress, and uncertainty, sustain relationships, and more. Striving to build on existing knowledge, research gaps and opportunities are discussed, including a need for stronger methodologies, more tailored and targeted supports, attention to the experiences of men with nonprostate cancers, and the explicit integration of gender analyses in the research process.
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Affiliation(s)
- Lisa M Wenger
- University of British Columbia, Vancouver, British Columbia, Canada
| | - John L Oliffe
- University of British Columbia, Vancouver, British Columbia, Canada
| | - Joan L Bottorff
- University of British Columbia, Okanagan Campus, Kelowna, British Columbia; Australian Catholic University, Melbourne, Australia
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Oliffe JL, Han CS, Lohan M, Bottorff JL. Repackaging prostate cancer support group research findings: an e-KT case study. Am J Mens Health 2014; 9:53-63. [PMID: 24713522 DOI: 10.1177/1557988314528238] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
In the context of psychosocial oncology research, disseminating study findings to a range of knowledge "end-users" can advance the well-being of diverse patient subgroups and their families. This article details how findings drawn from a study of prostate cancer support groups were repackaged in a knowledge translation website--www.prostatecancerhelpyourself.ubc.ca--using Web 2.0 features. Detailed are five lessons learned from developing the website: the importance of pitching a winning but feasible idea, keeping a focus on interactivity and minimizing text, negotiating with the supplier, building in formal pretests or a pilot test with end-users, and completing formative evaluations based on data collected through Google™ and YouTube™ Analytics. The details are shared to guide the e-knowledge translation efforts of other psychosocial oncology researchers and clinicians.
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Affiliation(s)
- John L Oliffe
- University of British Columbia, Vancouver, British Columbia, Canada
| | - Christina S Han
- University of British Columbia, Vancouver, British Columbia, Canada
| | | | - Joan L Bottorff
- University of British Columbia Okanagan, Kelowna, British Columbia, Canada
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Siddons HM, Wootten AC, Costello AJ. A randomised, wait-list controlled trial: evaluation of a cognitive-behavioural group intervention on psycho-sexual adjustment for men with localised prostate cancer. Psychooncology 2013; 22:2186-92. [PMID: 23576518 DOI: 10.1002/pon.3273] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2012] [Revised: 01/31/2013] [Accepted: 02/04/2013] [Indexed: 01/02/2023]
Abstract
OBJECTIVE To examine the effectiveness of a cognitive-behavioural therapy (CBT) group intervention to facilitate improved psycho-sexual adjustment to treatment side effects in prostate cancer survivors post-radical prostatectomy. METHODS A randomised, wait-list controlled trial was conducted with a total of 60 men who participated in a manualised 8-week cognitive-behavioural group intervention 6 months to 5 years post-radical prostatectomy for localised prostate cancer. Participants completed standardised questionnaires pre-intervention and post-intervention, which assessed mood state, stress, general and prostate cancer anxiety, quality of life and areas of sexual functioning. RESULTS Paired samples t-tests identified a significant improvement in sexual confidence, masculine self-esteem, sexual drive/relationship and a significant decline in sexual behaviour from pre-intervention to post-intervention. Hierarchical regression analyses revealed that after controlling for covariates, participation in the group intervention significantly improved sexual confidence, sexual intimacy, masculine self-esteem and satisfaction with orgasm. CONCLUSIONS This group-based CBT intervention for men post-radical prostatectomy for localised prostate cancer shows promising results in terms of improving quality of life.
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Affiliation(s)
- Heather M Siddons
- Department of Urology, Royal Melbourne Hospital, Parkville, Vic., Australia
| | - Addie C Wootten
- Department of Urology, Royal Melbourne Hospital, Parkville, Vic., Australia.,Australian Prostate Cancer Research Centre Epworth, Richmond, Vic., Australia
| | - Anthony J Costello
- Department of Urology, Royal Melbourne Hospital, Parkville, Vic., Australia.,Australian Prostate Cancer Research Centre Epworth, Richmond, Vic., Australia
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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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Cleary V, McCarthy G, Hegarty J. Development of an Educational Intervention Focused on Sexuality for Women with Gynecological Cancer. J Psychosoc Oncol 2012; 30:535-55. [DOI: 10.1080/07347332.2012.703767] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Lebret T, Coloby P, Descotes JL, Droupy S, Geraud M, Tombal B. Educational tool-kit on diet and exercise: survey of prostate cancer patients about to receive androgen deprivation therapy. Urology 2011; 76:1434-9. [PMID: 21130255 DOI: 10.1016/j.urology.2010.07.483] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2010] [Revised: 06/14/2010] [Accepted: 07/02/2010] [Indexed: 12/31/2022]
Abstract
OBJECTIVES To test a tool-kit designed to improve well-being in patients with prostate cancer. Lifestyle changes might lessen the metabolic, cardiovascular, and osseous side effects of androgen deprivation therapy (ADT) in prostate cancer patients. METHODS Urologists supplied 10 consecutive patients initiating ADT with a tool-kit (information brochure, practical guidance on diet and exercise, recipe booklet, and lifestyle diary). The urologists completed a total 4 questionnaires, at study initiation, one at the patients' first and second visits, and one at study completion. RESULTS Overall, 91 urologists completed all questionnaires; 585 patients (median age, 75 years) were seen at the first visit, and 511 patients at the second. Patient response rate to the first questionnaire was 62% and 56% to the second. After the first visit, 82% of respondents reported being very glad or glad to receive the kit; among those having read the practical guidance (301/362), 57% had started implementation and 36% intended to do so. After the second visit, 76% were satisfied with the tool-kit and 84% were implementing guidance. Clinician satisfaction rate was 82%: benefits were improved patient dialogue (62%), follow-up (55%), and better explanation of side effects (51%). Only 14 clinicians were not pleased by the tool kit. Their main criticisms (too long, tedious, not tailored to individual needs) matched those of patients. CONCLUSIONS Written detailed guidance on diet and physical exercise for patients about to receive ADT met a genuine need and was well perceived by both clinicians and patients. Implementation rate was high. However, content should be adapted to patient age and disease stage.
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Affiliation(s)
- Thierry Lebret
- Urology and Renal Transplantation Department, FOCH Hospital, University of Versailles Saint-Quentin-en-Yvelines, Suresnes, France.
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