Couple‐focused interventions for men with localized prostate cancer and their spouses: A randomized clinical trial

Abstract

Objectives Few couple‐focused interventions have improved psychological and relationship functioning among men diagnosed with localized prostate cancer and their spouses. This study compared the impact of intimacy‐enhancing therapy (IET), a general health and wellness intervention (GHW), and usual care (UC) on the psychological and relationship functioning of localized prostate cancer patients and their partners. Relationship length, relationship satisfaction, and patient masculinity were evaluated as moderators. Design This study was a randomized clinical trial with three study arms and four assessment time points. Methods A total of 237 patients and partners were randomly assigned to receive IET, GHW, or UC. Participants completed measures of psychological functioning and relationship satisfaction at baseline, 5 weeks, 3 months, and 6 months post‐baseline. Primary outcomes were psychological adjustment, depression, cancer‐specific distress, cancer concerns, and relationship satisfaction. Results Spouses in IET showed greater increases in relationship satisfaction than spouses in GHW and UC between the baseline and 5‐week follow‐up. Among patients in longer relationships, significant increases in psychological adjustment were found in both treatments compared to UC. Among spouses in longer relationships, psychological adjustment increased in both IET and UC but declined in GHW. Conclusions Intimacy‐enhancing therapy did not show an impact on general or cancer‐specific distress, but did show an early impact on relationship satisfaction among spouses. IET was superior to UC for patients in longer relationships. It will be important for researchers to understand which couple‐focused interventions benefits both patients and spouses and to identify characteristics of patients, partners, and couples who may not benefit from psychological treatments. What is already known on this subject? Men diagnosed with localized prostate cancer report lower health‐related quality of life and both patients and spouses report elevated distress. Relationship communication plays a role in couples’ psychological adaptation to prostate cancer. Couple‐focused interventions have illustrated an impact on relationship communication. There are no studies comparing different couple‐focused interventions. What does this study add? Intimacy‐enhancing therapy was not superior to no treatment or a comparison treatment for the broad range of psychological and relationship outcomes. Intimacy‐enhancing therapy was superior to no treatment for patients in longer‐term relationship. The general health and wellness intervention was not beneficial for men in shorter relationships and for men who did not endorse traditional masculine norms.

Female Partner Experiences of Prostate Cancer Patients’ Engagement With A Community-Based Football Intervention: A Qualitative Study

“…As such, the results of the current study con rm the potential bene ts of capitalizing on the cultural representation of football as a sport that builds on and cultivates masculine ideals [22]. As such, the ndings align with a recent study of the effects of couple-focused interventions for men with localized prostate cancer and their spouses, which suggested that endorsement of traditional masculine norms may be requisite for improving psychological and relationship function [9]. Also inherent was the recognition that men can bene t by being with other men to discuss vulnerabilities and uncertainties, potentially alleviating women's aloneness in their caregiver roles.…”

Eficacia de la terapia de pareja con pacientes con cáncer: una revisión sistemática

“…Atendiendo a la potencia en cuanto al tamaño muestral y teniendo en cuenta que una potencia media sería de 50 parejas por condición, solo 6 estudios estarían en el rango superior, siendo los más potentes: el estudio de Manne et al (2017) (10) con una muestra de 151 parejas por condición; y el estudio de Nicolaisen et al (2018) (9) con 102 parejas en la condición de intervención y 96 parejas en atención habitual. (7) [EE.UU] N= 237 Tipo de cáncer: Cáncer de próstata.…”

“…Sin embargo, en cuanto al resto de criterios, el estudio de Manne et al (2019) (7) parece reunir aspectos más concretos de cara al reclutamiento de la muestra, como son las puntuaciones de 0 o 1 en ECOG (calidad de vida), puntuaciones altas en IES (distrés) o que el 80% de la muestra informe de disfunción eréctil. En este sentido, recoger una muestra con unas características tan concretas permite conocer más datos sobre la problemática existente en la pareja, así como de la forma de intervención que pueda ser más eficaz ante dicha problemática.…”

“…Otras variables que se evalúan, pero solo en algunos de los estudios han sido el afrontamiento, beneficio de la experiencia y autoimagen (en el caso del paciente). En cuanto a las medidas, parece reseñable que en su mayoría todos los estudios siguen la misma línea, pero 3 de ellos añaden algo más; estos son el último estudio de Manne et al (2019) (7) quienes haciendo un estudio secundario del ensayo clínico inicial obtienen además datos relacionados con el clima grupal o la alianza o realización terapéutica. Por otro lado, Chambers et al (2011) (12) se centran más en variables relacionadas con aspectos sexuales.…”

“…Aunque en el estudio se menciona que aquellos que continúan, valoran como positivo el hecho de poder llegar al acuerdo de las sesiones convenientes con el psicólogo. Por el contrario, el estudio donde menos abandono se produce es el de Manne et al (2019) (7) con un porcentaje de abandono del 10,1%, quizá porque con el paso del tiempo han estudiado y aplicado la intervención introduciendo mejoras. En segundo lugar, el estudio con menos abandonos es el de Heinrichs et al (2012) (14) con un 16%.…”