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Xu J, Ma C, Hirschey R, Liu J, Neidre DB, Nielsen ME, Keyserling TC, Tan X, Song L. Associations of role, area deprivation index, and race with health behaviors and body mass index among localized prostate cancer patients and their partners. J Cancer Surviv 2024:10.1007/s11764-024-01625-z. [PMID: 38888710 DOI: 10.1007/s11764-024-01625-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Accepted: 05/29/2024] [Indexed: 06/20/2024]
Abstract
PURPOSE To examine the associations of role (localized prostate cancer (PCa) patient vs. their intimate partner), area deprivation index (ADI-higher scores indicating higher neighborhood deprivation levels), and race (Black/African American (AA) vs. White) with health behaviors and body mass index (BMI) among PCa patients and partners. The behaviors include smoking, alcohol consumption, diet quality, sedentary behaviors, and physical activity (PA). METHODS This study used the baseline data collected in a clinical trial. Given the nested structure of the dyadic data, multi-level models were used. RESULTS Significant role-race interaction effects on smoking, ADI-race effects on alcohol consumption, and role-ADI effects on BMI were found. Meanwhile, patients smoked more cigarettes, decreased alcohol consumption, had less healthful diets, spent longer time watching TV, did fewer sedentary hobbies, had more confidence in PA, and had higher BMIs than their partners. High ADI was independently associated with lower odds of drinking alcohol, using computer/Internet, and doing non-walking PA, and higher BMI compared to low ADI controlling for role and race. Black/AA dyads had less smoking amount and alcohol consumption and higher sedentary time and BMI than White dyads when adjusted for role and ADI. CONCLUSIONS This study identified significant interaction and main effects of role, ADI, or race on health behaviors and BMI. IMPLICATIONS FOR CANCER SURVIVORS Future behavioral interventions should address divergent individual needs between patients and partners, social and neighborhood barriers, and cultural indicators of racial groups to promote healthful behaviors and improve the quality of survivorship for PCa patients and partners.
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Affiliation(s)
- Jingle Xu
- School of Nursing, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Chunxuan Ma
- School of Nursing, The University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
| | - Rachel Hirschey
- School of Nursing, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Jia Liu
- School of Nursing, The University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
| | - Daria B Neidre
- School of Nursing, The University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
| | - Matthew E Nielsen
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Thomas C Keyserling
- School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Xianming Tan
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Lixin Song
- School of Nursing, The University of Texas Health Science Center at San Antonio, San Antonio, TX, USA.
- Mays Cancer Center, The University of Texas Health Science Center at San Antonio, San Antonio, TX, USA.
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2
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Hughes S, Everitt H, Stuart B, Band R. The experiences of men on active surveillance for prostate cancer and their significant others: A qualitative synthesis. Psychooncology 2024; 33:e6324. [PMID: 38570198 DOI: 10.1002/pon.6324] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Revised: 02/26/2024] [Accepted: 03/03/2024] [Indexed: 04/05/2024]
Abstract
BACKGROUND Active surveillance (AS) for prostate cancer (PCa) is a monitoring pathway for men with low-grade, slow growing PCa and aims to delay or avoid active treatment by treating only in the case of disease progression. Experiences of this pathway vary but living with an untreated cancer can have a negative psychological impact on both the patient and their significant other (SO). Literature suggests partners are the primary source of support for men on AS, and therefore it is important to consider SO experiences alongside those of the patient. To the best of our knowledge this is the first UK-based qualitative review looking specifically at experiences of AS for both men with PCa and their SOs. METHODS MEDLINE (Ovid), EMBASE, PsychINFO, CINAHL and Cochrane Library were searched for literature reporting qualitative experiences of AS for PCa for either men on AS or SOs (or both). 2769 records were identified and screened, with 28 meeting the eligibility criteria. Qualitative data were synthesised and included men on AS (n = 428), and SOs (n = 51). RESULTS Experiences of the AS pathway vary but reports of uncertainty and anxiety were present in the accounts of both men on AS and SOs. SOs are intertwined throughout every part of the PCa journey, and couples presented as a unit that were on AS together. Both patients and SOs expressed a need for more support, and highly valued peer support. Despite this finding, men expressed a dislike towards 'support groups'. CONCLUSIONS Increased recognition in clinical practice of SO involvement in AS is needed. Further research is required to explore the specific types of support that would be most acceptable to this population to address the unmet support needs uncovered in this review.
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Affiliation(s)
- Stephanie Hughes
- Primary Care Research Centre, School of Primary Care, Population Sciences & Medical Education, University of Southampton, Southampton, Hants, UK
| | - Hazel Everitt
- Primary Care Research Centre, School of Primary Care, Population Sciences & Medical Education, University of Southampton, Southampton, Hants, UK
| | - Beth Stuart
- Wolfson Institute of Population Health, Queen Mary University of London, London, UK
| | - Rebecca Band
- Health Sciences, University of Southampton, Southampton, Hants, UK
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3
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Roberts C, Toohey K, Paterson C. The Experiences and Unmet Supportive Care Needs of Partners of Men Diagnosed With Prostate Cancer: A Meta-aggregation Systematic Review. Cancer Nurs 2024:00002820-990000000-00074. [PMID: 36480350 DOI: 10.1097/ncc.0000000000001172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND Partners of men diagnosed with prostate cancer face their own emotional struggles as they navigate additional caregiver responsibilities while concurrently adjusting to the diagnosis and coping with greater illness uncertainty for their loved one. OBJECTIVE This qualitative systematic review examined the unmet supportive care needs of partners affected by prostate cancer. INTERVENTIONS/METHODS A meta-aggregation was conducted. Four electronic databases were searched using key words. The methodology followed the Joanna Briggs Institute for qualitative evidence synthesis. The review process followed a registered priori review protocol and was reported using the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-analysis) guidelines. Data extraction and quality assessment were conducted in parallel. RESULTS Twenty-one publications were included. A total of 239 findings and 32 categories were synthesized into 7 domains of unmet needs as experienced by partners. The domains of needs expressed by the participants included interpersonal/intimacy, physical/daily living, healthcare service, family-related, psychological/emotional needs, and spiritual and social needs. CONCLUSIONS There are gaps in clinical service support, despite routine clinical consultation with healthcare professionals. Partners may diminish their social networks to protect their husband at the cost to their own self-preservation and well-being. IMPLICATIONS FOR PRACTICE Cancer organizations, policy makers, healthcare care professionals, and researchers are slowly making progress to acknowledge the unique support needs of partners affected by cancer. Healthcare professionals should encourage partners to be included in models of prehabilitation to access timely support to address informational, intimacy, spiritual, and daily living needs support.
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Affiliation(s)
- Cara Roberts
- Author Affiliations: Faculty of Health (Drs Paterson and Toohey and Ms Roberts) and Prehabilitation, Activity, Cancer, Exercise, and Survivorship (PACES) Research Group (Dr Paterson, Dr Toohey and Ms Roberts), University of Canberra, Bruce; and Canberra Health Services & ACT Health, SYNERGY Nursing and Midwifery Research Centre, ACT Health Directorate Level 3, Canberra Hospital, Garran (Dr Paterson), Australian Capital Territory, Australia; and Robert Gordon University, Aberdeen, Scotland, United Kingdom (Dr Paterson)
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4
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Victorson D, Morgan T, Kutikov A, Novakovic K, Kundu S, Horowitz B, Jackson K, Addington E, Murphy K, Sauer C, Brendler C. Mindfulness-based stress reduction for men on active surveillance for prostate cancer and their spouses: Design and methodology of a randomized controlled trial. Contemp Clin Trials 2023; 125:107059. [PMID: 36563902 PMCID: PMC9918709 DOI: 10.1016/j.cct.2022.107059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2022] [Revised: 12/18/2022] [Accepted: 12/19/2022] [Indexed: 12/24/2022]
Abstract
BACKGROUND Although active surveillance (AS) is an increasingly adopted treatment paradigm for management of very low risk prostate cancer, many men and their partners face a variety of AS-related psychosocial stressors. Stressors may include anxiety and fear of progression, which may negatively affect short- and long-term psychosocial adjustment and influence early withdrawal from AS in order to seek definitive therapies such as surgery or radiation. Here we describe the protocol for an NCI-funded trial, which seeks to examine the efficacy of mindfulness training compared with a time/attention-matched health promotion control condition in a geographically generalizable sample of men on AS and their spouses. METHODS Using a randomized, controlled, partially double-blinded study design, this study involves the delivery of 8 weeks of standardized mindfulness training (MBSR; mindfulness-based stress reduction) and patient reported outcomes over a 12-month period (proposed enrollment of 80 men on AS and spouses), compared with a health promotion control (proposed enrollment of 80 men on AS and spouses) that has been matched for time and attention. Baseline (T1) measures (e.g., anxiety, fear of progression, quality of life) are administered just prior to randomization to the two study arms, followed by repeated assessments at 2 months (T2), 6 months (T3) and 12 months (T4). CONCLUSION This study has the potential to offer men and their partners on AS with important educational and self-regulatory skills to better cope and adjust with known stressors related to being placed on this protocol.
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Affiliation(s)
- David Victorson
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
| | - Todd Morgan
- University of Michigan, Department of Urology, Ann Arbor, MI, USA
| | | | - Kristian Novakovic
- John and Carol Walter Center for Urological Health, NorthShore University Health System, Evanston, IL, USA
| | - Shilajit Kundu
- Department of Urology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Bruriah Horowitz
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Kathryn Jackson
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Elizabeth Addington
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Karly Murphy
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Christina Sauer
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Charles Brendler
- John and Carol Walter Center for Urological Health, NorthShore University Health System, Evanston, IL, USA
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5
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Green A, Winter N, DiGiacomo M, Oliffe JL, Ralph N, Dunn J, Chambers SK. Experiences of female partners of prostate cancer survivors: A systematic review and thematic synthesis. HEALTH & SOCIAL CARE IN THE COMMUNITY 2022; 30:1213-1232. [PMID: 34761456 DOI: 10.1111/hsc.13644] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/05/2021] [Revised: 10/26/2021] [Accepted: 10/27/2021] [Indexed: 06/13/2023]
Abstract
The purpose of this systematic review and synthesis of studies reporting qualitative data was to understand the gendered experiences of female partners of prostate cancer survivors to inform psychosocial support for women. We searched Medline, PsycINFO, EMBASE, AMED, CINAHL, Cochrane Database of Systematic Reviews, and Sociological Abstracts for articles on 15 and 16 April 2019, and again on 30 November 2020. English language articles published in peer-reviewed journals were included if they reported solely on findings describing the perspectives of the female partners. Extracted data were analysed using line-by-line coding, organisation of codes into descriptive themes, and development of analytical themes. A theoretical framework was then selected to organise the relationships between issues that were found to be central to the experiences of female partners. Of 4839 articles screened, 14 met inclusion criteria, reporting 13 studies with a total sample of 359 female partners. Ussher and Sandoval's theory to describe the gendered positionings of cancer caregivers accommodated the thematic findings. The overarching theme reflected the substantive psychosocial impact of prostate cancer on female partners. Women's experiences were influenced by self-positioning (as part of a couple; provider of support to their male partner; resilient; and guided by faith and spirituality), being positioned by their partners' response (manager of male partner's psychological distress or strengthened by male partner's positive response) and by their broader contexts (family members and social networks; clinicians and the health system; and cultural values and customs). Findings highlight the need to avoid reductionist approaches to gender. Greater consideration of 'contextualised femininities', or conceptualising the influence of gender roles, relations, and identities within the wider life course contexts of female partners is required in the design and delivery of psychosocial support services.
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Affiliation(s)
- Anna Green
- IMPACCT (Improving Palliative, Aged and Chronic Care through Clinical Research and Translation), Faculty of Health, University of Technology Sydney, Ultimo, New South Wales, Australia
| | - Natalie Winter
- School of Nursing and Midwifery, Faculty of Health, Deakin University, Burwood, Victoria, Australia
| | - Michelle DiGiacomo
- IMPACCT (Improving Palliative, Aged and Chronic Care through Clinical Research and Translation), Faculty of Health, University of Technology Sydney, Ultimo, New South Wales, Australia
| | - John L Oliffe
- School of Nursing, University of British Columbia, Vancouver, Canada
- Department of Nursing, University of Melbourne, Victoria, Australia
| | - Nicholas Ralph
- Faculty of Health, University of Technology Sydney, Ultimo, New South Wales, Australia
- Division of Research and Innovation, University of Southern Queensland, Springfield, Queensland, Australia
- School of Nursing and Midwifery, University of Southern Queensland, Toowoomba, Queensland, Australia
| | - Jeff Dunn
- Faculty of Health, University of Technology Sydney, Ultimo, New South Wales, Australia
- Division of Research and Innovation, University of Southern Queensland, Springfield, Queensland, Australia
- Cancer Council Queensland, Brisbane, Queensland, Australia
- Prostate Cancer Foundation of Australia, Sydney, New South Wales, Australia
| | - Suzanne K Chambers
- Faculty of Health, University of Technology Sydney, Ultimo, New South Wales, Australia
- Exercise Medicine Research Institute, Edith Cowan University, Perth, WA, Australia
- Faculty of Health Sciences, Australian Catholic University, Brisbane, Australia
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6
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Midtgaard J, Tjørnhøj-Thomsen T, Rørth M, Kronborg M, Bjerre ED, Oliffe JL. Female partner experiences of prostate cancer patients' engagement with a community-based football intervention: a qualitative study. BMC Public Health 2021; 21:1398. [PMID: 34266389 PMCID: PMC8281704 DOI: 10.1186/s12889-021-11448-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Accepted: 07/05/2021] [Indexed: 12/04/2022] Open
Abstract
Background Prostate cancer is often labelled a couple’s disease wherein the partner plays an important role in the man’s illness management and related health promotion activities. The aim of this study was to explore partner experiences of prostate cancer patients’ engagement with a community-based football program. Methods Eight audio-visual recorded semi-structured focus group interviews were conducted with a total of 39 female partners of men with prostate cancer who participated in a community-based football program as part of the nationwide FC Prostate Community Trial (NCT02430792). Data was managed with the software program Nvivo 11 and analysed inductively to derive thematic findings. Results The four thematic findings were: 1) ‘Hope of a new beginning’ which included stories of hope that football would mitigate the negative effects of men’s prostate cancer treatment [s]; 2) ‘My new partner’ was characterized by attributing connections between physical activity and elevated mood as a by-product of men’s involvement in the program; 3) ‘Football first’ included assertions of the couples mutual commitment to the football program; and 4) ‘Invisible needs’ contrasted insecurity, and unforeseen challenges for partners feeling somewhat neglected. Overall, the results confirm the need for cohesion and flexibility amongst couple-dyads to ensure partners and men with prostate cancer benefit from their involvement in football programs. Conclusions This study indicates that partners of prostate cancer survivors’ engaging with community-based football align to idealized gender relations, roles and identities. In many instances, these gendered dimensions aided positive dyadic coping and long-term exercise adherence. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-021-11448-7.
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Affiliation(s)
- Julie Midtgaard
- The University Hospitals Centre for Health Research, Copenhagen University Hospital, Rigshospitalet, Department 9701, Blegdamsvej 9, DK-2100, Copenhagen Ø, Denmark. .,Department of Clinical Medicine, University of Copenhagen, Blegdamsvej 3B, DK-2200, Copenhagen N, Denmark. .,Mental Health Centre Glostrup, University of Copenhagen, Nordstjernevej 41, DK-2600, Glostrup, Denmark.
| | - Tine Tjørnhøj-Thomsen
- National Institute of Public Health, Department of Health and Social Context, University of Southern Denmark, Studiestræde 6, DK-1455, Copenhagen K, Denmark
| | - Mette Rørth
- The University Hospitals Centre for Health Research, Copenhagen University Hospital, Rigshospitalet, Department 9701, Blegdamsvej 9, DK-2100, Copenhagen Ø, Denmark
| | - Malene Kronborg
- The University Hospitals Centre for Health Research, Copenhagen University Hospital, Rigshospitalet, Department 9701, Blegdamsvej 9, DK-2100, Copenhagen Ø, Denmark
| | - Eik D Bjerre
- The University Hospitals Centre for Health Research, Copenhagen University Hospital, Rigshospitalet, Department 9701, Blegdamsvej 9, DK-2100, Copenhagen Ø, Denmark
| | - John L Oliffe
- The University of British Columbia, School of Nursing, Health Sciences Mall, Vancouver, BC, V6T 1Z3, Canada.,The University of Melbourne, Department of Nursing, Parkville, Melbourne, Victoria, 3052, Australia
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Ge X, Tong H, Song Y, He H, Li S, Hong J, Wang W. The caring experience and supportive care needs of male partners for women with gynaecologic cancer: A qualitative literature review. J Clin Nurs 2020; 29:4469-4481. [PMID: 32949056 DOI: 10.1111/jocn.15501] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Revised: 08/25/2020] [Accepted: 09/06/2020] [Indexed: 12/15/2022]
Abstract
OBJECTIVE To systematically review male partners' caring experience and supportive care needs when caring for women with gynaecologic cancer. METHODS The PRISMA guidelines were used to conduct this systematic review. We performed a comprehensive literature search in nine databases and qualitative studies published in English or Chinese from inception to January 2020. The included papers were appraised, using the Critical Appraisal Skills Program tool for qualitative research. An inductive thematic analysis method was adopted to synthesise major findings to construct core concepts and themes. RESULTS Eight studies were included in this review, and four overarching themes emerged the following: the negative experience of disease, the need for supportive care to cope, adapting to a new life and post-traumatic growth. CONCLUSIONS This study shows that male partners had both negative and positive experiences in the caring process, and they could adjust themselves to some extent. Their perceived supportive care needs were often neglected. RELEVANCE TO CLINICAL PRACTICE Male partners of women with gynaecologic cancer are an under-recognised group. The couple-oriented or family-oriented supportive care programmes should be implemented to meet the supportive care needs of male partners to enhance their health and well-being.
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Affiliation(s)
- Xiaoling Ge
- School of Nursing, Anhui Medical University, Hefei City, China.,The First Affiliated Hospital of Anhui Medical University, Hefei City, China
| | - Huanhuan Tong
- School of Nursing, Anhui Medical University, Hefei City, China
| | - Yongxia Song
- School of Nursing, Anhui Medical University, Hefei City, China
| | - Hongye He
- School of Nursing, Anhui Medical University, Hefei City, China.,The First Affiliated Hospital of Anhui Medical University, Hefei City, China
| | - Shuwen Li
- School of Nursing, Anhui Medical University, Hefei City, China
| | - Jingfang Hong
- School of Nursing, Anhui Medical University, Hefei City, China.,Nursing International Collaboration Research Center of Anhui Province, Hefei, China
| | - Wenru Wang
- Alice Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
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Cho D, Basen-Engquist K, Acquati C, Ma H, Pettaway C, Li Y, Diep CS, McNeill LH. Study protocol: a lifestyle intervention for African American and Hispanic prostate cancer survivors on active surveillance and their partners. Pilot Feasibility Stud 2020; 6:111. [PMID: 32782817 PMCID: PMC7414583 DOI: 10.1186/s40814-020-00653-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2018] [Accepted: 07/30/2020] [Indexed: 11/17/2022] Open
Abstract
Background Prostate cancer is the most commonly diagnosed cancer in both African American and Hispanic men. Active surveillance is a treatment option for low- or very low-risk prostate cancer survivors, and lifestyle interventions have been found to reduce the disease progression and improve the quality of life for both survivors and their partners. To date, no lifestyle interventions that specifically target African American or Hispanic men and their partners exist. This protocol describes a study that tests the feasibility of a randomized controlled trial, a lifestyle intervention developed to enhance healthy lifestyle and quality of life among African American and Hispanic men on active surveillance and their partners. Methods A mixed-method study, including a two-arm randomized controlled trial (n = 30 dyads in the intervention arm and n = 10 dyads in the control arm) and in-depth interviews, will be conducted. Intervention arm participants will receive bi-weekly health coaching calls (a total of 12 calls based on Motivational Interviewing), as well as physical activity-specific (e.g., power point slides, print materials about physical activity, and activity trackers for self-monitoring) and nutrition-specific education (e.g., two nutrition counseling sessions from a registered dietitian, print materials about nutrition, and food intake recording for self-monitoring) over 6 months. All participants will be assessed at baseline, month 3, and month 6. Blood will be collected at baseline and month 6 from the prostate cancer survivors. Finally, in-depth interviews will be conducted with subsamples (up to n = 15 dyads in the intervention arm and up to n = 5 dyads in the control arm) at baseline and months 3 and 6 to conduct a process evaluation and further refine the intervention. Discussion If effective, the intervention may have a higher health impact compared with a typical lifestyle intervention targeting only survivors (or partners), as it improves both survivors’ (tertiary prevention) and partners’ health (primary prevention). Results from this study will provide important information regarding recruiting racial/ethnic minority cancer survivors and their partners. Lessons learned from this study will be used to apply for a large-scale grant to test the impact of the dyadic intervention in a fully powered sample. Trial registration ClinicalTrials.gov (NCT No. 03575832) registered on 3 July 2018.
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Affiliation(s)
- Dalnim Cho
- Department of Health Disparities Research, UT Texas MD Anderson Cancer Center, 1400 Pressler St, 9th floor, Houston, TX 77030 USA
| | - Karen Basen-Engquist
- Department of Behavioral Science, UT Texas MD Anderson Cancer Center, Houston, TX USA
| | - Chiara Acquati
- Graduate College of Social Work, University of Houston, Houston, TX USA
| | - Hilary Ma
- Department of General Oncology, UT Texas MD Anderson Cancer Center, Houston, TX USA
| | - Curtis Pettaway
- Department of Urology, UT Texas MD Anderson Cancer Center, Houston, TX USA
| | - Yisheng Li
- Department of Biostatistics, UT Texas MD Anderson Cancer Center, Houston, TX USA
| | | | - Lorna H McNeill
- Department of Health Disparities Research, UT Texas MD Anderson Cancer Center, 1400 Pressler St, 9th floor, Houston, TX 77030 USA
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Forslund M, Nygren P, Ottenblad A, Johansson B. Experiences of a nutrition intervention-A qualitative study within a randomised controlled trial in men undergoing radiotherapy for prostate cancer. Nutr Diet 2019; 77:223-230. [PMID: 31243870 DOI: 10.1111/1747-0080.12564] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2019] [Revised: 04/29/2019] [Accepted: 05/17/2019] [Indexed: 11/28/2022]
Abstract
AIM Men with prostate cancer undergoing radiotherapy may experience acute and late bowel symptoms. Nutrition interventions have shown some benefits, however, adherence tends to decline over time. Qualitative studies, carried out after an intervention, are important to help explain trial results. The aim of the present study was to explore patient experience of participating in a nutrition intervention in a randomised controlled trial, with a focus on facilitators and barriers to adherence. METHODS Semistructured interviews were conducted with 15 men with prostate cancer recruited from a randomised controlled trial on a nutrition intervention during radiotherapy. Interviews were analysed with content analysis with an inductive approach. RESULTS The informants were motivated to make dietary changes to avoid bowel symptoms. Social support, a feeling of contributing to the greater good, prior knowledge, dietary information and a small need for behaviour change facilitated adherence. Feeling limited, wanting to decide for themselves, the timing of the intervention, unmet expectations of dietary advice and loss of motivation, were described as barriers for adherence. CONCLUSIONS Future nutrition intervention trials may benefit from involving significant others to a greater degree, as well as offering pre-set recipes and strategies to manage social events, and more sessions with the dietitian for patients in need of more support. Tailored interventions based on the individual's preferences, context and prior knowledge about food may further facilitate adherence.
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Affiliation(s)
- Marina Forslund
- Department of Immunology, Genetics and Pathology, Uppsala University, Uppsala, Sweden
| | - Peter Nygren
- Department of Immunology, Genetics and Pathology, Uppsala University, Uppsala, Sweden
| | - Anna Ottenblad
- Department of Immunology, Genetics and Pathology, Uppsala University, Uppsala, Sweden.,Department of Nutrition and Dietetics, Karolinska University Hospital, Stockholm, Sweden
| | - Birgitta Johansson
- Department of Immunology, Genetics and Pathology, Uppsala University, Uppsala, Sweden
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10
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Mata LRFD, Azevedo C, Bernardes MFVG, Chianca TCM, Pereira MDG, Carvalho ECD. Effectiveness of a home care teaching program for prostatectomized patients: a randomized controlled clinical trial. Rev Esc Enferm USP 2019; 53:e03421. [DOI: 10.1590/s1980-220x2018012503421] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2018] [Accepted: 08/07/2018] [Indexed: 11/22/2022] Open
Abstract
ABSTRACT Objective: To evaluate the effectiveness of a teaching program for hospital discharge of patients submitted to radical prostatectomy based on the self-efficacy construct of the Cognitive Social Theory. Method: A controlled clinical trial carried out on a 2-month follow-up of 68 prostatectomized men randomized into intervention group (n = 34) and control (n = 34). The intervention group received routine guidance from the service plus the teaching program. The control group only received routine guidance from the service. The data collection instruments were: sociodemographic and clinical questionnaire, self-efficacy scale, hospital depression and anxiety scale, household care knowledge questionnaire, and an item on satisfaction with a score of 1 to 5. Results: There was a significant difference between the intragroups for satisfaction (p<0.001) and knowledge (p<0.001) of the pre-test to the post-test. In the intervention group, there were significant changes between the times for anxiety (p=0.011) and knowledge (p<0.001). Conclusion: The teaching program with a combination of oral guidance, written instruction and telephone follow-up was effective in improving knowledge about home care and personal satisfaction. Brazilian Registry of Clinical Trials: RBR-5n95rm.
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11
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Mader EM, Li HH, Lyons KD, Morley CP, Formica MK, Perrapato SD, Irwin BH, Seigne JD, Hyams ES, Mosher T, Hegel MT, Stewart TM. Qualitative insights into how men with low-risk prostate cancer choosing active surveillance negotiate stress and uncertainty. BMC Urol 2017; 17:35. [PMID: 28482875 PMCID: PMC5422871 DOI: 10.1186/s12894-017-0225-3] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2016] [Accepted: 05/01/2017] [Indexed: 11/25/2022] Open
Abstract
Background Active surveillance is a management strategy for men diagnosed with early-stage, low-risk prostate cancer in which their cancer is monitored and treatment is delayed. This study investigated the primary coping mechanisms for men following the active surveillance treatment plan, with a specific focus on how these men interact with their social network as they negotiate the stress and uncertainty of their diagnosis and treatment approach. Methods Thematic analysis of semi-structured interviews at two academic institutions located in the northeastern US. Participants include 15 men diagnosed with low-risk prostate cancer following active surveillance. Results The decision to follow active surveillance reflects the desire to avoid potentially life-altering side effects associated with active treatment options. Men on active surveillance cope with their prostate cancer diagnosis by both maintaining a sense of control over their daily lives, as well as relying on the support provided them by their social networks and the medical community. Social networks support men on active surveillance by encouraging lifestyle changes and serving as a resource to discuss and ease cancer-related stress. Conclusions Support systems for men with low-risk prostate cancer do not always interface directly with the medical community. Spousal and social support play important roles in helping men understand and accept their prostate cancer diagnosis and chosen care plan. It may be beneficial to highlight the role of social support in interventions targeting the psychosocial health of men on active surveillance.
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Affiliation(s)
- Emily M Mader
- Department of Family Medicine, SUNY Upstate Medical University, 475 Irving Ave., Suite 200, Syracuse, NY, 13210, USA
| | - Hsin H Li
- Department of Family Medicine, SUNY Upstate Medical University, 475 Irving Ave., Suite 200, Syracuse, NY, 13210, USA.,Department of Public Health and Preventive Medicine, SUNY Upstate Medical University, 766 Irving Ave., Rm. 2262, Syracuse, NY, 13210, USA
| | - Kathleen D Lyons
- Department of Psychiatry, Geisel School of Medicine at Dartmouth, Dartmouth-Hitchcock Medical Center, 1 Medical Center Dr., Lebanon, NH, 03756, USA
| | - Christopher P Morley
- Department of Family Medicine, SUNY Upstate Medical University, 475 Irving Ave., Suite 200, Syracuse, NY, 13210, USA.,Department of Public Health and Preventive Medicine, SUNY Upstate Medical University, 766 Irving Ave., Rm. 2262, Syracuse, NY, 13210, USA.,Department of Psychiatry and Behavioral Sciences, SUNY Upstate Medical University, 750 E Adams St., Syracuse, NY, 13210, USA
| | - Margaret K Formica
- Department of Public Health and Preventive Medicine, SUNY Upstate Medical University, 766 Irving Ave., Rm. 2262, Syracuse, NY, 13210, USA.
| | - Scott D Perrapato
- Division of Urology, Department of Surgery, University of Vermont College of Medicine, Fletcher House 301, 111 Colchester Ave., Burlington, VT, 05401, USA
| | - Brian H Irwin
- Division of Urology, Department of Surgery, University of Vermont College of Medicine, Fletcher House 301, 111 Colchester Ave., Burlington, VT, 05401, USA
| | - John D Seigne
- Urology Section, Geisel School of Medicine at Dartmouth College, Dartmouth-Hitchcock Medical Center, 1 Medical Center Dr., Lebanon, NH, 03756, USA
| | - Elias S Hyams
- Urology Section, Geisel School of Medicine at Dartmouth College, Dartmouth-Hitchcock Medical Center, 1 Medical Center Dr., Lebanon, NH, 03756, USA
| | - Terry Mosher
- Department of Psychiatry, Geisel School of Medicine at Dartmouth, Dartmouth-Hitchcock Medical Center, 1 Medical Center Dr., Lebanon, NH, 03756, USA
| | - Mark T Hegel
- Department of Psychiatry, Geisel School of Medicine at Dartmouth, Dartmouth-Hitchcock Medical Center, 1 Medical Center Dr., Lebanon, NH, 03756, USA.,Cancer Control Program, Norris Cotton Cancer Center, Dartmouth-Hitchcock Medical Center, 1 Medical Center Dr., Lebanon, NH, 03756, USA
| | - Telisa M Stewart
- Department of Public Health and Preventive Medicine, SUNY Upstate Medical University, 766 Irving Ave., Rm. 2262, Syracuse, NY, 13210, USA
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Eriksen AK, Hansen RD, Borre M, Larsen RG, Jensen JM, Overgaard K, Borre M, Kyrø C, Landberg R, Olsen A, Tjønneland A. A lifestyle intervention among elderly men on active surveillance for non-aggressive prostate cancer: a randomised feasibility study with whole-grain rye and exercise. Trials 2017; 18:20. [PMID: 28086943 PMCID: PMC5237258 DOI: 10.1186/s13063-016-1734-1] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2016] [Accepted: 11/28/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The prognosis for men with non-aggressive prostate cancer is good, and several studies have investigated the impact of lifestyle changes including physical activity and diet on the prognosis. Despite positive results in animal studies and a few human interventions with whole-grain rye on markers of prostate cancer progression, the feasibility of trials investigating such dietary changes in combination with physical activity remains largely unstudied. The primary aim was to investigate the feasibility of an intervention with high whole-grain rye intake and vigorous physical activity for 6 months in men diagnosed with prostate cancer. METHODS In total, 26 men (53-72 years) recently diagnosed with non-aggressive prostate cancer and on active surveillance, were enrolled in 2011-2012 and randomly assigned to an intervention or a control group. The intervention included 170 g/day of whole-grain rye and 3 × 45 minutes/week of vigorous physical activity. The duration of the intervention was 6 months and end of follow-up 12 months after baseline. Clinic visits were scheduled at baseline and 3, 6 and 12 months after baseline. Compliance with the intervention was evaluated by diaries, food frequency questionnaires, biomarkers, and heart rate monitor data. The effect of the intervention was evaluated by linear multiple regression analysis. RESULTS In the intervention group, the mean daily intake of whole-grain rye measured from diaries was 146 g (SD: 19) for the first 3 months and 125 g (SD: 40) for the last 3 months of the intervention. The median level (5th and 95th percentiles) of vigorous physical activity was 91 (17, 193) min/week for the first 3 months and 66 (13, 259) min/week for the last 3 months. No recordings of physical activity were done for the control group. Aerobic fitness (VO2 peak) increased in the intervention group compared to the control group after the intervention. No effects were found on other cardio-metabolic outcomes or prostate cancer progression. CONCLUSIONS The lifestyle intervention appeared feasible for 6 months among Danish men and the results are encouraging for conducting full-scale studies, where the impact of whole-grain rye and vigorous physical activity on prostate cancer progression and metabolic parameters can be evaluated. TRIAL REGISTRATION ClinicalTrials.gov, NCT01300104 . Registered on 18 February 2011.
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Affiliation(s)
- Anne Kirstine Eriksen
- Unit of Diet, Genes and Environment, Danish Cancer Society Research Center, Strandboulevarden 49, 2100 Copenhagen, Denmark
| | - Rikke Dalgaard Hansen
- Unit of Diet, Genes and Environment, Danish Cancer Society Research Center, Strandboulevarden 49, 2100 Copenhagen, Denmark
| | - Michael Borre
- Institute for Clinical Medicine – Department of Urology, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, 8200 Aarhus N, Denmark
| | - Ryan Godsk Larsen
- Physical Activity and Performance Group, SMI, Department of Health Science and Technology, Aalborg University, Fredrik Bajers Vej 7, 9220 Aalborg, Denmark
| | - Jeppe Munthe Jensen
- Section of Sport Science, Department of Public Health, Aarhus University, Dalgas Avenue 4, 8000 Aarhus, Denmark
| | - Kristian Overgaard
- Section of Sport Science, Department of Public Health, Aarhus University, Dalgas Avenue 4, 8000 Aarhus, Denmark
| | - Mette Borre
- Department of Hepatology and Gastroenterology, Aarhus University Hospital, Nørrebrogade 44, 8000 Aarhus C, Denmark
| | - Cecilie Kyrø
- Unit of Diet, Genes and Environment, Danish Cancer Society Research Center, Strandboulevarden 49, 2100 Copenhagen, Denmark
| | - Rikard Landberg
- Food and Health, Department of Food Science, Swedish University of Agricultural Sciences, Almas Allé 5, 75007 Uppsala, Sweden
- Food and Nutrition Science, Department of Biology and Biotechnology, Chalmers University of Technology, SE-412 96, Gothenburg, Sweden
- Unit of Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institute, SE-171 77, Stockholm, Sweden
| | - Anja Olsen
- Unit of Diet, Genes and Environment, Danish Cancer Society Research Center, Strandboulevarden 49, 2100 Copenhagen, Denmark
| | - Anne Tjønneland
- Unit of Diet, Genes and Environment, Danish Cancer Society Research Center, Strandboulevarden 49, 2100 Copenhagen, Denmark
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