Trial of personalised care after treatment-Prostate cancer: A randomised feasibility trial of a nurse-led psycho-educational intervention

Abstract

Objective The present parallel randomised control trial evaluated the feasibility of a nurse‐led psycho‐educational intervention aimed at improving the self‐management of prostate cancer survivors. Methods We identified 305 eligible patients from a district general hospital, diagnosed 9–48 months previously, who completed radical treatment, or were monitored clinically (ineligible for treatment). Ninety‐five patients were recruited by blinded selection and randomised to Intervention (N = 48) and Control (N = 47) groups. Participant allocation was revealed to patients and researchers after recruitment was completed. For 36 weeks, participants received augmented usual care (Control) or augmented usual care and additional nurse support (Intervention) provided in two community hospitals and a university clinic, or by telephone. Results Data from 91 participants (Intervention, N = 45; Control, N = 46) were analysed. All feasibility metrics met predefined targets: recruitment rate (31.15%; 95% CI: 25.95%–36.35%), attrition rate (9.47%; 95% CI: 3.58%–15.36%) and outcome measures completion rates (77%–92%). Forty‐five patients received the intervention, with no adverse events. The Extended Prostate Cancer Index Composite can inform the minimum sample size for a future effectiveness trial. The net intervention cost was £317 per patient. Conclusions The results supported the feasibility and acceptability of the intervention, suggesting that it should be evaluated in a fully powered trial to assess its effectiveness and cost‐effectiveness.

Effect of nurse‐led interventions on patient outcomes in patients with prostate cancer: A systematic review

“…According to the clinical stage of the disease; hormonal therapy, radiotherapy, chemotherapy, cryotherapy or radical prostatectomy are among the treatment options. While making the treatment plan, the patient's age, histopathological classification of the tumour, PSA value and other comorbid diseases of the patient are taken into consideration 5,6 . When prostate cancer is diagnosed at an early stage, the survival rate is high with the effect of the treatment methods applied.…”

“…Depending on the stage of cancer and the treatment methods applied, patients; stress, anxiety, depression, social isolation, erectile dysfunction, urinary incontinence etc. may experience many physiological and psychological problems such as 4,5 . Nurses continue to care for patients with prostate cancer in the diagnosis stage, treatment process and post‐treatment rehabilitation stages to ensure that the patients are in good physical, psychological and social well‐being and apply many interventions.…”

“…While making the treatment plan, the patient's age, histopathological classification of the tumour, PSA value and other comorbid diseases of the patient are taken into consideration. 5,6 When prostate cancer is diagnosed at an early stage, the survival rate is high with the effect of the treatment methods applied. Depending on the stage of cancer and the treatment methods applied, patients; stress, anxiety, depression, social isolation, erectile dysfunction, urinary incontinence etc.…”

“…may experience many physiological and psychological problems such as. 4,5 Nurses continue to care for patients with prostate cancer in the diagnosis stage, treatment process and posttreatment rehabilitation stages to ensure that the patients are in good physical, psychological and social well-being and apply many interventions. Especially in recent years, it has been emphasized that nurse-led interventions have improved patient outcomes.…”

When cancer is diagnosed as an emergency

“…These needs varied considerably; factors such as functional status, anxiety, fear of recurrence and quality of life, attitudes, demographics and stage of disease predicted needs for follow‐up—further evidence of the need for more personalised follow‐up of cancer patients. Stanciu et al () also looked at the concept of personalised care after treatment, in this case for prostate cancer. They looked at the feasibility of a nurse‐led psychoeducational intervention which aimed to improve self‐management of prostate cancer survivors.…”