Helping patients with localized prostate carcinoma manage uncertainty and treatment side effects

Abstract

BACKGROUNDThe objective of this study was to test the efficacy of an individualized uncertainty management intervention delivered by telephone to Caucasian and African‐American men with localized prostate carcinoma and directed at managing the uncertainties of their disease and treatment.METHODSThe authors delivered a psychoeducational intervention by phone to men with prostate carcinoma, with or without supplemented delivery to a close family member, that was directed at managing uncertainty and improving symptom control. One hundred thirty‐four Caucasian men and 105 African‐American men were assigned randomly to one of two approaches to delivering the intervention or to the control condition. Men entered the study immediately after surgical treatment or in the first 3 weeks of radiation therapy. Trained nurses delivered the intervention through weekly phone calls for 8 weeks.RESULTSThe authors found that the majority of intervention effects were from baseline to 4 months postbaseline, when treatment side effects are most intense. Both Caucasian men and African‐American men who received either one of the two approaches for delivering the intervention improved in the two uncertainty management methods of cognitive reframing and problem solving. Similarly, when the intervention groups were combined, men who received the intervention also improved significantly in control of incontinence by 4 months postbaseline. Decreases in the number of treatment side effects differed by time and treatment/ ethnic group interactions as did satisfaction with sexual functioning.CONCLUSIONSThis is one of the first tests of a psychoeducational intervention among men with prostate carcinoma and was the first test that included a sufficient number of African‐American men to test by ethnic group. Therefore, replication of these findings is advised. Cancer 2002;94:1854–66. © 2002 American Cancer Society.DOI 10.1002/cncr.10390

Exploring the effectiveness of couples interventions for adults living with a chronic physical illness: A systematic review

“…RC led to the greatest improvements in interpersonal outcomes for couples, and had some of the strongest effect sizes overall, which suggests that this may be an important area of need for couples living with chronic illness. Another key observation was that many couples interventions achieved greater effects than the same or similar patient-only intervention across emotional [42], interpersonal [37,43,44], cognitive [41,49], and somatic outcomes [46,48]. This suggests that partner-inclusion may provide benefits beyond that of the content of the intervention itself.…”

“…Six studies compared the couples intervention with a patient-only intervention [35,36,37,38,39,40], eight studies used a patient-only comparison group and a usual care control group [41,42,43,44,45,46,47,48], one study compared two types of couples interventions with a patient-alone comparison group [49], and the remaining twenty compared a couples intervention with usual care or waiting-list controls. Twenty-eight studies reported effect sizes, or provided information to calculate effect sizes.…”

“…When compared with a patient-only or control group, couples interventions based on CBST improved cognitive outcomes including self-efficacy [36,49,38,59] and illness appraisals [41,60,61,39,62].…”

“…Interventions using CBST improved somatic/ physical outcomes including symptom perception [41,42,63,61,48], fitness/ muscle strength [49], sexual limitation [64], physical Quality of Life (QOL) [61], Cholesterol [34], and fear of movement [48]. In comparison with a patient-only/ control group, CBST interventions enhanced behaviours such as dyadic coping [43], medication adherence [65], and increased dietary self-efficacy and spousal support [59].…”

Interventions to Improve Decision Making and Reduce Racial and Ethnic Disparities in the Management of Prostate Cancer: A Systematic Review

“…Mishel et al conducted two related RCTs assessing symptom management in both AA and white men, focused on improving selfefficacy for symptom management in men receiving treatment for localized PCa using a DVD/booklet/telephone intervention. 37,38 Telephone/Videotape/DVD Interventions (n=2). The effect of an "uncertainty management" invention on symptom control, using weekly telephone conversations with nurses for 8 weeks, was assessed at baseline, 3 months, and 7 months.…”