Factors related to self‐rated health and life satisfaction one year after radical prostatectomy for localised prostate cancer: a cross‐sectional survey

Abstract

Background Localised prostate cancer affects patient's quality of life in many ways. The aim of this study was to explore factors related to self‐rated health and life satisfaction for patients treated for prostate cancer, and to compare the results of these generic quality‐of‐life measures to the prostate cancer‐specific quality‐of‐life measure (UCLA Prostate Cancer Index), which focuses on physical functioning. Material and methods This cross‐sectional survey was carried out among 183 men who underwent radical prostatectomy in 2012–2015 at a university hospital in Finland and were seen 1 year postsurgery. Approval from an ethics committee and written consents from participants were received. A questionnaire was used to evaluate patients’ perceived quality of life. Logistic regression model, Spearman's correlation, Kruskal–Wallis test and Mann–Whitney U‐test were used to analyse factors related to quality of life. Results Of the 183 men in the study, 63% rated their health status as good, and 70% were satisfied with their lives after prostatectomy. Older age and better urinary function were the only factors that explained both better self‐rated health and better satisfaction with life. The patients seemed not to interpret problems with sexual function as health‐related problems. In our sample, sexual dysfunction was relatively severe, but patients considered them to be less harmful than urinary or bowel symptoms. Interestingly, 24% of the men with low sexual function did not find that dysfunction bothersome. Conclusions Objectively measured physical functioning is not necessarily in line with patients’ experienced satisfaction with life and their self‐ratings of health. More longitudinal and qualitative research is needed about the meanings that patients attach to physical treatment side effects and the extent to which they can adapt to them over time. With a bigger sample and longer follow‐up time, it would be possible to identify men who particularly benefited from pretreatment counselling.

Quality of life in urologic cancer patients: importance of and satisfaction with specific quality of life domains

“…When compared with controls from the general population, prostate cancer survivors often rate global QoL dimensions similarly [12][13][14]. However, when specific symptoms are considered such as urinary incontinence, bowel or rectal function, or sexual function, prostate cancer patients report significant detriments [15,16].…”

The Tablet-Based, Engagement, Assessment, Support, and Sign-Posting (EASSi) Tool for Facilitating and Structuring Sexual Well-Being Conversations in Routine Prostate Cancer Care: Mixed-Methods Study

“…The tool can be used across settings and without specific training or expertise in sexual care counselling. In addition, the tool might be used during pretreatment consultations to assist with improving a patient's awareness of the possible impact of different treatment options on sexual well-being and to reduce decisional regret, which is often experienced when patients feel they had a passive role in treatment decision-making [9,38]. The tool could also be viewed by patients alone (not only during appointments with a health professional) to help provide information on the side-effects of treatment and on approaches to help manage these effects.…”

“…In a recent large-scale survey, 81% of men reported poor sexual function after treatment [8]. Changes to sexual function are subsequently regarded as a major issue that can result in higher levels of anxiety, depression, relational dissatisfaction, and reduced overall quality of life [9,10]. Current guidelines [11,12] support delivery of psychosexual care for prostate cancer patients and recommend a minimal level of support throughout all phases of care.…”

“…Men can also feel uncertain about discussing concerns and may not be fully aware of the potential side-effects of treatment on sexual function. Despite these barriers, given their frequency and substantial impact [9], sexual concerns should be discussed with all patients. To adequately address sexual well-being issues, health care professionals need to initiate conversations and effectively engage with patients and assess needs in order to provide essential support and appropriate evidence-based management [25].…”

Quality of Life in Urologic Cancer Patients: Importance of and Satisfaction With Specific Quality of Life Domains

“…When compared with controls from the general population, prostate cancer survivors often rate global QoL dimensions similarly [12][13][14]. However, when speci c symptoms are considered such as urinary incontinence, bowel or rectal function, or sexual function, prostate cancer patients report signi cant detriments [15,16].…”