Early quality of life in patients with localized prostate carcinoma: an examination of treatment-related, demographic, and psychosocial factors.

BACKGROUND: Men with localized prostate carcinoma are faced with important treatment decisions, and quality of life (QoL) information has become a crucial element of decision making. The first objective of this study was to compare the early, health-related QoL (HRQoL) of men with localized prostate carcinoma who were treated with radical prostatectomy, external beam radiotherapy, or brachytherapy. A second objective was to identify demographic and psychosocial variables that predict HRQoL. METHODS: Two-hundred fifty-six men with localized prostate carcinoma were interviewed within 7 weeks of treatment initiation. The interview included measures of prostate-specific HRQoL (the University of California-Los Angeles Prostate Cancer Index), general HRQoL (the SF-36), and psychosocial variables. RESULTS: After adjusting for covariates, treatment group differences were found for both prostate specific HRQoL and general HRQoL. Men who underwent prostatectomy reported more urinary and sexual problems and more general physical dysfunction compared with men who were treated with either form of radiation therapy. Men who were treated with brachytherapy reported the fewest problems in sexual function and the least general physical dysfunction. Few treatment group differences were found in mental functioning. Both demographic factors and psychosocial factors predicted HRQoL. Older men and African-American men reported more physical problems than younger men and Caucasian men, respectively. A supportive social environment, high self-efficacy, and high self-esteem were predictive of better HRQoL. CONCLUSIONS: Shortly after undergoing treatment for localized prostate carcinoma, men who underwent radical prostatectomy, older men, and African-American men are at heightened risk for experiencing prostate-specific and general deficits in HRQoL. Having psychosocial resources from which to draw may enhance HRQoL.</p

Moderators of the benefits of psychoeducational interventions for men with prostate cancer.

The authors examined whether 3 individual difference variables--self-esteem, self-efficacy, and depressive symptoms--interacted with psychoeducational group interventions for men with prostate cancer (n = 250) to predict general and prostate-specific quality of life. Men with nonmetastatic prostate cancer were randomly assigned to an education intervention, an education plus group discussion intervention, or usual care and followed for 12 months. Eight groups of 10 to 12 men were convened in each condition. Men who began the study with lower self-esteem, lower prostate-specific self-efficacy, and higher depressive symptoms benefited the most from the interventions. Of these 3 moderator variables, the most consistent results emerged for self-esteem. That is, the benefits of the intervention were strongest for men with low self-esteem.</p

Psychological distress in spouses of men treated for early-stage prostate carcinoma.

BACKGROUND: The authors examined levels and predictors of psychological distress in the wives of men treated for early-stage prostate carcinoma (PCa). METHODS: Patients with PCa (N = 165) and spouses were interviewed to assess general and cancer-specific distress. Social and intrapersonal factors of spouses as well as clinical characteristics and quality of life of patients were assessed as potential predictors of spouses' distress. RESULTS: Spouses reported more cancer-specific distress than did patients (P CONCLUSIONS: The findings indicated that overall distress in spouses of early-stage patients with PCa was modest, and it was more likely to be predicted by psychosocial than medical factors.</p

Improving quality of life in men with prostate cancer: a randomized controlled trial of group education interventions.

Men who were recently treated for prostate cancer (N=250) were randomly assigned to a control group, a group education intervention (GE), or a group education-plus-discussion intervention (GED). Both GE and GED increased prostate cancer knowledge. In the year postintervention, men in the GED condition were less bothered by sexual problems than men in the control condition, and they were more likely to remain steadily employed (93.0%) than men in the GE (75.6%) or control (72.5%) conditions. Among noncollege graduates, GED and GE resulted in better physical functioning than the control condition, and GED resulted in more positive health behaviors than the control or GE condition. Among college graduates, controls were comparable with the GE and GED groups in physical functioning and positive health behaviors.</p

Conceptual model of stroke treatment burden.

<p>The arrows represent the possible pathways between components that stroke patients may follow. The ‘enacting management strategies’ component has four subcomponents.</p

Flowchart demonstrating the screening process of papers in the systematic review.

<p>Inclusions and exclusions are shown at each stage.</p

Treatment burden identified from the literature.

<p>A taxonomy of treatment burden in stroke, grouped within categories that correspond to the conceptual model of treatment burden shown in <a href="http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1001473#pmed-1001473-g002" target="_blank">Figure 2</a>.</p

A summary of the quality appraisal of included studies [50].

<p>Each study was appraised using the questions shown in the table. The number of studies with the answers ‘yes’, ‘no’, or ‘unclear’ are shown for each question.</p

Core set of PROQOL questions.

<p>In addition to identifying their concerns at the time of survey completion, patients are also presented with this core set of quality of life-related questions.</p

PROQOL report.

<p>PROQOL generates a report displaying the patient's single biggest concern (domain), the selected items in the domain, and suggested actions (left). The biggest concern and the results of the core set of questions are tracked over time. Graphs are used to display changes, and asterisks indicate meaningful change since the last report (a change of two or more points).</p