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Intervening to improve psychological outcomes for men with prostate cancer

Authors

  • Suzanne K. Chambers,

    Corresponding author
    1. Viertel Centre for Research in Cancer Control, Cancer Council Queensland, Brisbane, Australia
    2. School of Applied Psychology, Griffith University, Brisbane, Australia
    • Griffith Health Institute, Griffith University, Gold Coast, Australia
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  • Megan Ferguson,

    1. Viertel Centre for Research in Cancer Control, Cancer Council Queensland, Brisbane, Australia
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  • R. A. Gardiner,

    1. University of Queensland Centre for Clinical Research, University of Queensland, Brisbane, Australia
    2. Department of Urology, Royal Brisbane and Women's Hospital, Brisbane, Australia
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  • Joanne Aitken,

    1. Griffith Health Institute, Griffith University, Gold Coast, Australia
    2. Viertel Centre for Research in Cancer Control, Cancer Council Queensland, Brisbane, Australia
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  • Stefano Occhipinti

    1. Griffith Health Institute, Griffith University, Gold Coast, Australia
    2. School of Applied Psychology, Griffith University, Brisbane, Australia
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Correspondence to: Gold Coast Campus, Griffith Health Institute, Griffith University, Gold Coast, QLD 4222, Australia. E-mail: suzanne.chambers@griffith.edu.au

Abstract

Background

Prostate cancer is the most common cancer in men in the Western world with well-described negative effects from treatments. However, outcomes are highly heterogeneous. A Phase 3 trial of a psycho-educational intervention was undertaken, aiming to reduce cancer-specific and decision-related distress and improve quality of life for men newly diagnosed with localised prostate cancer.

Methods

Seven hundred forty (81.7%) men were recruited after diagnosis and before treatment and randomised to a tele-based nurse-delivered five-session psycho-educational intervention (N = 372) or usual care (N = 368). Participants were assessed before treatment and 2, 6, 12 and 24 months post-treatment. Outcome measures included cancer-specific and decision-related distress, cognitive judgmental adjustment, subjective well-being, and domain-specific and health-related quality of life. Social support was assessed as a potential moderator.

Results

No unconditioned effects were found. Classification analyses on pre-randomisation measures distinguished three subgroups: younger, higher education and income men (N = 290); younger, lower education and income men (N = 106); and older men (N = 344). Younger, higher education and income men showed positive intervention effects for cancer-specific distress ( p = 0.008) and mental health ( p = 0.042). By contrast, for younger, lower education men, participation in the intervention was associated with decreases in cognitive judgmental adjustment over time ( p = 0.006).

Conclusions

Response to intervention and adjustment over time varied according to previous sexual functioning, age, educational level and income. How to best intervene with younger, low education, low income men with prostate cancer is a critical future research question. Copyright © 2012 John Wiley & Sons, Ltd.

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