The physical and psychosocial consequences for patients undergoing blood SCT for the treatment of cancer and their families have been extensively documented. There has, however, been far less investigation into the psychosocial consequences for sibling donors who are both family members and undergoing an invasive medical procedure. The aim of this study was therefore to explore the psychosocial impact of PBSC donation before, during and after donation, and to gain insight into donors' experiences of the preparation for, and procedures associated with, donation. Participants included 13 men and 9 women, with a mean age of 53.1 (SD ¼ 9.4) years, who underwent PBSC or BM donation between 2007 and 2010. Data were collected via face-to-face or telephone interviews and a questionnaire. Results revealed that a broad range of both positive and negative emotions were experienced at different time points during donation. The psychosocial impact of donation was also influenced by the interactions between factors such as pragmatic aspects of the donation process; family dynamics; perceived adequacy of preparation and emotional support; and uncertainty related to health outcomes for the recipient and donor. Routine provision of psychosocial support to donors as well as recipients is therefore important.
Given that SOC was related to depression and QoL dimensions post-transplantation, it may be important for health care professionals to conduct psychosocial assessments to determine patient SOC. This would enable provision of tailored psychological support prior to and following stem cell transplantation.
Background
Penile prosthesis surgery is last-line treatment to regaining erectile function after radical prostatectomy (RP) for localized prostate cancer.
Aims
To assess quality of life, psychological functioning, and treatment satisfaction of men who underwent penile implantation after RP; the psychosocial correlates of treatment satisfaction and sexual function after surgery; and the relation between patients’ and partners’ ratings of treatment satisfaction.
Methods
98 consecutive patients who underwent penile implantation after RP from 2010 and 2015 and their partners were invited to complete a series of measures at a single time point. Of these, 71 patients and 43 partners completed measures assessing sexual function, psychological functioning, and treatment satisfaction. Proportions of patients who demonstrated good sexual function and satisfaction with treatment and clinical levels of anxiety and depression were calculated. Hierarchical regression analyses were conducted to determine psychosocial factors associated with patient treatment satisfaction and sexual function and patient-partner differences in treatment satisfaction.
Outcomes
Patients completed the Expanded Prostate Cancer Index Composite Short Form (EPIC-26), Erectile Dysfunction Inventory of Treatment Satisfaction (EDITS), Prostate Cancer-Related Quality of Life Scale, Self-Esteem and Relationship Questionnaire (SEAR), Generalized Anxiety Disorder–7 (GAD-7), and Patient Health Questionnaire–9 (PHQ-9). Partners completed the GAD-7, PHQ-9, EDITS (partner version), and SEAR.
Results
94% of men reported satisfaction with treatment (EDITS score > 50). 77% of men reported good sexual function (EPIC-26 score > 60). Lower depression scores were associated with higher sexual confidence and sexual intimacy, and these were correlated with better treatment satisfaction and sexual function. Patients experienced higher sexual relationship satisfaction (median score = 90.6) than their partners (median score = 81.2), but there was no difference in treatment satisfaction between groups. Higher patient treatment satisfaction was more likely to be reported for couples whose depression scores were more similar.
Clinical Implications
It is important to provide preoperative penile implant counseling and encourage patients to seek postoperative counseling if needed.
Strengths and Limitations
This is one of the first Australian-based studies comprehensively assessing treatment satisfaction and psychosocial health of men after penile prosthesis surgery after RP. This was a retrospective cross-sectional study, so there is a possibility of recall bias, and causal associations could not be determined.
Conclusion
Men in this Australian series who underwent penile prosthesis surgery after RP generally reported good sexual function and treatment satisfaction. Nevertheless, patient and partner mental health influenced their reported experience of the treatment.
The association among psychological distress, coping responses and QoL indicates that poor psychosocial functioning pre-transplant renders an increased likelihood of experiencing impaired QoL across various dimensions. It thus seems important that psychologically vulnerable patients are identified early in the treatment process. If psychosocial adjustment were improved, patients may experience better QoL pre-transplant with a potential subsequent influence on post-transplant outcomes.
Despite the significant influence of acute post-transplant factors in predicting survival following allogeneic HSCT, multidisciplinary pre-transplant assessments are important in identifying patients who are likely to experience poorer survival outcomes.
Objective: Men affected by incurable prostate cancer is expected to increase worldwide. Research is needed to enable men to share their experiences of unmet supportive care needs in current care delivery. We aimed to identify the most frequently reported domains of unmet supportive care needs, levels of anxiety, depression, distress, health-related quality of life, and to identify any perceived barriers to receiving supportive care.Data Sources: Men diagnosed with prostate cancer who had received a minimum of 6 months of ADT were recruited into a cross-sectional study. Participants completed standardised questionnaires, clinical and demographic data was also collected.
Conclusion:272 patients were invited, and 102 participated. No statistically significant differences were found between participants scores from Australia and UK in relation to anxiety and depression, exercise, HRQoL or distress scores. Perceived barriers in service delivery related to information provision and difficulties in the navigation of complex care systems.Implications for Nursing Practice: Men affected by prostate cancer receiving ADT reported unmet supportive care needs, specifically related to sexual, informational and psychological aspects of care.Mapping future trajectories of needs and identifying men at high risk can significantly improve timely and tailored interventions.
The review identified a range of intervention types designed to enhance sexual outcomes following the challenges that many individuals face after cancer diagnosis and treatment. It is evident that the use of online technology in improving sexual outcomes in cancer care is still in its infancy; however, there is emerging evidence to support the delivery of psychosexual care using the online environment. Further research, using larger, more well controlled methodologies, is required to confirm that sexual outcomes can be improved through the use of online interventions.
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