Improving the quality of life of patients with prostate carcinoma

A randomized trial testing the efficacy of a nurse-driven intervention

Authors

  • R. Brian Giesler Ph.D.,

    Corresponding author
    1. School of Nursing, Indiana University, Indianapolis, Indiana
    2. School of Medicine, Indiana University, Indianapolis, Indiana
    3. Indiana University Cancer Center, Indianapolis, Indiana
    4. Behavioral Cooperative Oncology Group, Indiana University, Indianapolis, Indiana
    • Indiana University Cancer Center and Behavioral Cooperative Oncology Group, NU 338, 1111 Middle Drive, Indianapolis, IN 46202
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    • Fax: (317) 278-2021

  • Barbara Given R.N., Ph.D.,

    1. Behavioral Cooperative Oncology Group, Indiana University, Indianapolis, Indiana
    2. College of Nursing, Michigan State University, Lansing, Michigan
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  • Charles W. Given Ph.D.,

    1. Behavioral Cooperative Oncology Group, Indiana University, Indianapolis, Indiana
    2. Department of Family Practice, College of Human Medicine, Michigan State University, Lansing, Michigan
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  • Susan Rawl R.N., Ph.D.,

    1. School of Nursing, Indiana University, Indianapolis, Indiana
    2. Indiana University Cancer Center, Indianapolis, Indiana
    3. Behavioral Cooperative Oncology Group, Indiana University, Indianapolis, Indiana
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  • Patrick Monahan Ph.D.,

    1. School of Medicine, Indiana University, Indianapolis, Indiana
    2. Indiana University Cancer Center, Indianapolis, Indiana
    3. Behavioral Cooperative Oncology Group, Indiana University, Indianapolis, Indiana
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  • Debra Burns Ph.D.,

    1. School of Nursing, Indiana University, Indianapolis, Indiana
    2. Indiana University Cancer Center, Indianapolis, Indiana
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  • Faouzi Azzouz M.S.,

    1. School of Medicine, Indiana University, Indianapolis, Indiana
    2. Indiana University Cancer Center, Indianapolis, Indiana
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  • Kristina M. Reuille M.S.N., R.N.,

    1. School of Nursing, Indiana University, Indianapolis, Indiana
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  • Sally Weinrich R.N., Ph.D.,

    1. Schools of Nursing and Graduate Studies, Medical College at Georgia, Augusta, Georgia
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  • Michael Koch M.D.,

    1. School of Medicine, Indiana University, Indianapolis, Indiana
    2. Indiana University Cancer Center, Indianapolis, Indiana
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  • Victoria Champion R.N., D.N.S.

    1. School of Nursing, Indiana University, Indianapolis, Indiana
    2. Indiana University Cancer Center, Indianapolis, Indiana
    3. Behavioral Cooperative Oncology Group, Indiana University, Indianapolis, Indiana
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  • This research was conducted in affiliation with the Mary Margaret Walther Program for Cancer Care Research and the Behavioral Cooperative Oncology Group.

Abstract

BACKGROUND

Treatments for clinically localized prostate carcinoma are accompanied by sexual, urinary, and bowel dysfunction and other sequelae that can result in significant distress and reduced well being. Methods capable of improving quality of life are needed that can be integrated into clinical practice. To address this need, a nurse-driven, cancer care intervention was developed and tested.

METHODS

Within 6 weeks after completing treatment, 99 patients, along with their partners, were enrolled into a prospective, controlled trial and were randomized to receive the cancer care intervention or to receive standard care. Participants in the intervention arm met once each month for 6 months with an oncology nurse intervenor, who helped patients identify their quality-of-life needs using an interactive computer program. The intervener then provided education and support tailored to participants' needs. Primary outcome variables included 1) disease-specific quality of life, including sexual, urinary, and bowel outcomes and cancer worry; 2) depression; 3) dyadic adjustment; and 4) general quality of life. Outcomes data were collected prior to randomization and again at 4 months, 7 months, and 12 months posttreatment.

RESULTS

Patients in the intervention arm experienced long-term improvements in quality-of-life outcomes related to sexual functioning and cancer worry compared with patients who received standard care. Baseline depression moderated the impact of the intervention on several other quality-of-life outcomes.

CONCLUSIONS

The findings of the current study indicated that a computer-assisted, nurse-driven intervention was capable of providing durable improvements in the quality of life of men who underwent treatment for clinically localized prostate carcinoma. Cancer 2005. © 2005 American Cancer Society.

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