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MacDonald C, Ilie G, Kephart G, Rendon R, Mason R, Bailly G, Bell D, Patil N, Bowes D, Wilke D, Kokorovic A, Rutledge RDH. 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. Cancers (Basel) 2024; 16:2352. [PMID: 39001414 PMCID: PMC11240715 DOI: 10.3390/cancers16132352] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2024] [Revised: 06/24/2024] [Accepted: 06/25/2024] [Indexed: 07/16/2024] Open
Abstract
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.
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Affiliation(s)
- Cody MacDonald
- Department of Urology, Faculty of Medicine, Dalhousie University, Halifax, NS B3H 2Y9, Canada
- Department of Community Health and Epidemiology, Faculty of Medicine, Dalhousie University, Halifax, NS B3H 1V7, Canada
| | - Gabriela Ilie
- Department of Urology, Faculty of Medicine, Dalhousie University, Halifax, NS B3H 2Y9, Canada
- Department of Community Health and Epidemiology, Faculty of Medicine, Dalhousie University, Halifax, NS B3H 1V7, Canada
- Department of Radiation Oncology, Faculty of Medicine, Dalhousie University, Halifax, NS B3H 1V7, Canada
| | - George Kephart
- Department of Community Health and Epidemiology, Faculty of Medicine, Dalhousie University, Halifax, NS B3H 1V7, Canada
| | - Ricardo Rendon
- Department of Urology, Faculty of Medicine, Dalhousie University, Halifax, NS B3H 2Y9, Canada
| | - Ross Mason
- Department of Urology, Faculty of Medicine, Dalhousie University, Halifax, NS B3H 2Y9, Canada
| | - Greg Bailly
- Department of Urology, Faculty of Medicine, Dalhousie University, Halifax, NS B3H 2Y9, Canada
| | - David Bell
- Department of Urology, Faculty of Medicine, Dalhousie University, Halifax, NS B3H 2Y9, Canada
| | - Nikhilesh Patil
- Department of Radiation Oncology, Faculty of Medicine, Dalhousie University, Halifax, NS B3H 1V7, Canada
| | - David Bowes
- Department of Radiation Oncology, Faculty of Medicine, Dalhousie University, Halifax, NS B3H 1V7, Canada
| | - Derek Wilke
- Department of Radiation Oncology, Faculty of Medicine, Dalhousie University, Halifax, NS B3H 1V7, Canada
| | - Andrea Kokorovic
- Department of Urology, Faculty of Medicine, Dalhousie University, Halifax, NS B3H 2Y9, Canada
| | - Robert D H Rutledge
- Department of Radiation Oncology, Faculty of Medicine, Dalhousie University, Halifax, NS B3H 1V7, Canada
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