Men’s experience of a guided self-help intervention for hot flushes associated with prostate cancer treatment

Abstract

Up to 80% of men who receive androgen deprivation therapy report hot flushes and for many these are associated with reduced quality of life. However it is recognised that there are a number of barriers to men's engagement with support to manage symptoms and improve quality of life. This qualitative study was embedded within a larger randomised controlled trial (MANCAN) of a guided self-help cognitive behavioural intervention to manage hot flushes resulting among men androgen deprivation therapy. The study aimed to explore the engagement and experiences with the guided selfhelp intervention. Twenty men recruited from the treatment arm of the MANCAN trial participated in a semi-structured interview exploring acceptability of the intervention, factors affecting engagement and perceived usefulness of the intervention. Interviews were audio-recorded, transcribed verbatim and analysed using a Framework approach. Over two thirds of respondents (69%) reported reading the intervention booklet in full and over 90% reporting practising the relaxation CD at least once a week. Analysis of the interviews identified three super-ordinate themes and these related to changes in hot flush symptomatology (learned to cope with hot flushes in new ways), the skills that participants had derived from the intervention (promoting relaxation and reducing stressors), and to a broader usefulness of the intervention (broader impact of the intervention and skills). The present study identified positive engagement with a guided self-help intervention and that men applied the skills developed through the intervention to help them undertake general lifestyle changes. Psychoeducational interventions (e.g. cognitive behaviour therapy, relaxation, and positive lifestyle elements) offer the potential to be both effective and well received by male cancer survivors.

Psychological support for patients with cancer: evidence review and suggestions for future directions

“…34 CBT articles have been published, including: eight systematic/meta-analytic reviews [23,24,25*,26,27*,28-30]; two protocol papers [31,32]; two qualitative studies [33,34]; five singlearm pilot/feasibility/secondary analysis studies [35,36,37*,38,39]; and 17 randomised controlled trial (RCT) papers [40, 1). Many newer studies focus on adaptations for different delivery modalities to increase reach and accessibility, including both online and print-based self-help, and blended approaches where face-to-face therapy is supplemented with telephone or online components.…”

“…[INSERT CBT is adaptable across clinical presentations and recently published trials include tailoring for: FCR [45*,51*]; clinically-elevated distress [40]; insomnia [36,39,40,44,48]; sexual dysfunction [43,55]; depression and/or anxiety [33,40,41**,47,50*]; fatigue [49]; symptom clusters [35,46]; hot flushes [34]; and broader non-specific psychosocial coping [53][54][55] Whilst this evidence is promising, much of it derives from trials under 'ideal' conditions. Few pragmatic trials have been conducted, and it remains unclear how well CBT works in 'real world' settings -for example, in patients with complex physical or psychological comorbidities.…”

A multicentre randomised controlled trial of a guided self-help cognitive behavioural therapy to MANage the impact of hot flushes and night sweats in patients with prostate CANcer undergoing androgen deprivation therapy (MANCAN2)

“…There were also significant reductions in negative HFNS beliefs and behaviours, but not in mood or quality of life. A qualitative study with men who participated in the intervention found that the self-help format was acceptable and that the intervention helped them to undertake positive lifestyle changes [ 14 ]. We have also developed and validated the HFNS Beliefs and Behaviour Scale for Men assessing men’s beliefs and behaviours in relation to their HFNS [ 15 ].…”

Usefulness and engagement with a guided workbook intervention (WorkPlan) to support work related goals among cancer survivors

“…Existing literature evaluating print-based interventions have examined how participants engaged with the material through reading and acquiring knowledge, discussing the material with others, writing personal diaries, and retaining the written materials for future reference [ 15 , 16 ]. But there is little research examining how participants engage with an intervention in terms of the application or implementation of the material to their individual situations.…”