Assessing longitudinal quality of life in prostate cancer patients and their spouses: A multilevel modeling approach
University of North Carolina-Chapel Hill School of Nursing, 101 Carrington Hall, Chapel Hill, NC 27599, USA. Quality of Life Research
(Impact Factor: 2.49).
10/2010; 20(3):371-81. DOI: 10.1007/s11136-010-9753-y
This study aimed at examining the relationship between quality of life (QOL) in prostate cancer (PCa) patients and partners and how baseline demographics, cancer-related factors, and time-varying psychosocial and symptom covariates affect their QOL over time.
Guided by a modified Stress-Coping Model, this study used multilevel modeling to analyze longitudinal data from a randomized clinical trial that tested a family-based intervention to improve QOL in couples managing PCa. Patients and partners from the usual-care control group (N = 134 dyads) independently completed the measurements at baseline, and at 4-, 8-, and 12-month follow-ups.
Correlations of QOL between patients and partners over time were small to moderate. Patients' lower education level, partners' older age, higher family income, and localized cancer at baseline were associated with better QOL in couples. Over time, couples' QOL improved as their social support and cancer-related dyadic communication increased and as couples' uncertainty, general symptoms, and patients' prostate cancer-related sexual and hormonal symptoms decreased.
Evidence indicates that couples' QOL during cancer survivorship is affected by multiple contextual factors (e.g., baseline demographics and time-varying psychosocial factors and symptoms). Intervention research is needed to explore comprehensive strategies to improve couples' QOL during the continuum of PCa survivorship.
Available from: sciencedirect.com
- "In their study, Song et al. (2011) showed that there were correlations in QOL between patients and partners, which remained consistent during the survival of the patient (r ¼ 0.25, 0.24, 0.23, and 0.23, at baseline and at the 4-, 8-, and 12-month follow-up sessions, respectively). The QOL of the couples also improved with an increase in their social support (p < 0.001) and cancerrelated dyadic communication (p < 0.001); and a decrease in the couple's uncertainty of illness (p < 0.001), in the patient's cancerspecific hormonal (p < 0.001) and sexual symptoms (p < 0.05), and in the general symptoms (p < 0.001) of both partners (Song et al., 2011). A study that focused on the self-efficacy of the couples showed that both patient and caregiver self-efficacy had an effect on the well-being of the partners (Campbell et al., 2004). "
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A diagnosis of cancer is the start of a journey of distress and adjustment for both the patient and his/her spouse. However, the dyadic phenomena are less conceptualised and related research is in the early stages. This review explores concepts of mutuality among spousal caregiver–cancer patient dyads and identifies directions for future research.
A systematic search, including trawling through six electronic databases, a manual search, and an author search, was conducted to identity articles that had been published in English and Chinese from January 2000 to March 2013, using key terms related to caregiver–patients dyads in cancer care. An inductive content analysis approach was adopted to analyse and synthesise the concepts of spousal caregiver–cancer patient dyads.
Thirty-one articles were identified. The findings are described according to Fletcher et al.'s proposals for conceptualising spousal caregiver–patient dyads. The proposed concepts of ‘communication’, ‘reciprocal influence’, and ‘caregiver–patient congruence’ have been found to be interrelated, and to contribute to the spousal caregiver–patient dyads' mutual appraisal of caregiving and role adjustment through the cancer trajectory.
The findings highlight the importance of a perspective that focuses on the nature of the relationship between couples coping with cancer and the quality of their communication with each other. It is recognised that communication may act as a fundamental element of the abovementioned three concepts. Better communication between couples would probably facilitate reciprocal influence and caregiver–patient congruence, which in turn would have a positive effect on intimacy between the couple and improve the caregiving outcomes.
European Journal of Oncology Nursing 02/2014; 18(1):58–65. DOI:10.1016/j.ejon.2013.09.003 · 1.43 Impact Factor
Available from: iroi.seu.edu.cn
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ABSTRACT: This Intel architecture microprocessor (Pentium III) implements 70
additional instructions to further accelerate the performance of
data-streaming applications including 3D graphics and video
encode/decode. This processor is enhanced by addition of these
instructions along with circuit improvements for higher clock frequency.
The 10.17×12.10 mm<sup>2</sup> die contains 9.5 M transistors and
is in a CMOS 5-layer metal 0.25 μ process in an OLGA package with C4
interconnect technology. It has an operating range of 1.4 V to 2.2 V and
is currently running up to 60O MHz
Solid-State Circuits Conference, 1999. Digest of Technical Papers. ISSCC. 1999 IEEE International; 02/1999
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Androgen-deprivation therapy modalities are on continuing evolution. Leuprolide Acetate (LA) Eligard®45 mg was the first 6-monthly LHRH agonist (agoniste luteinizing hormone-releasing hormone [LHRHa]) treatment available for use in prostate cancer. The objective of this study was to assess the use of the 3-monthly and the 6-monthly LHRHa in patients with prostate cancer.
Patients and methods
A two-step survey (registration and follow-up) was held between July 2008 and January 2009. One hundred and sixty doctors included patients treated with LHRHa for prostate cancer. Then, a follow-up registry was implemented for patients who had been prescribed a 3- or 6-monthly LHRHa.
Data analysis showed that the 1853 registered patients had a mean age of 75 years old. Time to diagnosis was 7 months. Among them, 26.4% had an N+ and/or M+ cancer. The most tumor node metastasis (TNM) stage represented was T3N0M0 with Gleason score 7. High prostate specific antigen (PSA) level and metastatic stage were the main motives for LHRHa prescription. Choice criteria for a 3 or a 6-monthly LHRHa were patient autonomy (3.2 vs 18.4%), age (27.2 vs 44%) and anxiety (28 vs 16.8%). Patients for 6-monthly LHRHa were likely to be with low urinary symptoms, older, less autonomous and less anxious. The reported advantage of the 3-monthly LHRHa was the high satisfying quality of medical follow-up. For the 6-monthly form, the advantages were the flexibility and the freedom to stop worrying about their cancer for up to 6 months.
The 6-monthly LHRHa provides more flexibility in the management and follow-up of patients with locally advanced or metastatic prostate cancer.
Progrès en Urologie 11/2011; 21(12):866-874. DOI:10.1016/j.purol.2011.07.006 · 0.66 Impact Factor
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