Supportive care needs of men living with prostate cancer in England: A survey

King's College London, Division of Health and Social Care Research, Florence Nightingale School of Nursing Midwifery, 5th Floor, Waterloo Bridge Wing, Franklin Wilkins Building, 150 Stamford Street, London SE19NN, UK.
British Journal of Cancer (Impact Factor: 4.84). 07/2008; 98(12):1903-9. DOI: 10.1038/sj.bjc.6604406
Source: PubMed


Men with prostate cancer have various treatment options depending upon their stage of disease, age and presence of comorbidity. However, these treatments typically induce side effects, which generate currently ill-defined supportive care needs. This study examined the supportive care needs of men with prostate cancer within England. A postal questionnaire survey was conducted in six acute NHS Trusts. Seven hundred and forty-one men with prostate cancer participated. They had been diagnosed 3-24 months prior to the survey and had received various treatments. Men surveyed had specific and significant unmet supportive care needs. Areas of greatest need are related to psychological distress, sexuality-related issues and management of enduring lower urinary tract symptoms. High levels of psychological distress were reported, and those reporting psychological distress reported greater unmet supportive care needs. Unmet sexuality-related need was highest in younger men following radical prostatectomy. Lower urinary tract symptoms were almost universal in the sample. Perceived quality of life varied; men unsure of their remission status reported lowest quality of life. Psychological distress impacts significantly on perceived unmet need and is currently not being assessed or managed well in men living with prostate cancer in England.

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Available from: Emma Ream, May 18, 2014
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    • "The propositions of social support theory suggest that social support may operate through main and moderation effects, but existing social support theoretical models do not explicitly detail the possibility of mediation effects, i.e. that coping is related to emotional outcome because of social support, see Fig. 1. The importance of social support as a resource for people affected by cancer is not a new concept, but specifically, prostate cancer survivors have reported a lack of support for their unmet physical and psychological problems (Cockle-Hearne et al., 2013; Paterson et al., 2015; Ream et al., 2008). Therefore, understanding the mechanism effect of how coping and social support operate on emotional outcome over time has the potential to help to identify men who are at high risk of inadequate support provision and suggest directions for intervention (Paterson et al., 2013). "
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    ABSTRACT: Purpose: Unmet support needs are prevalent in men affected by prostate cancer. Moreover, little is known about the optimal type of social support, or its mechanism effect between coping and emotional outcome in men affected by this disease to identify areas for clinical intervention. This study aimed to empirically test the propositions of social support theory in "real time" within individual men living with and beyond prostate cancer. Methods: Purposeful sub-sample from a larger prospective longitudinal study of prostate cancer survivors, took part in real time data collection using mobile technology. Self-reports were collected for 31 days prompted by an audio alarm 3 times per day (a total of 93 data entries) for each of the 12 case studies. Electronic data were analysed using time series analysis. Results: Majority of response rates were >90%. Men reported a lack of satisfaction with their support over time. Testing the propositions of social support theory "within individuals" over time demonstrated different results for main effect, moderation and mediation pathways that linked coping and social support to emotional outcome. For two men, negative effects of social support were identified. For six men the propositions of social support theory did not hold considering their within-person data. Conclusion: This innovative study is one of the first, to demonstrate the acceptability of e-health technology in an ageing population of men affected by prostate cancer. Collectively, the case series provided mixed support for the propositions of social support theory, and demonstrates that "one size does not fit all".
    Full-text · Article · Oct 2015 · European journal of oncology nursing: the official journal of European Oncology Nursing Society
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    • "The physical aftermath of this disease has been well documented; but the extent to which coping and social support influence HRQoL and emotional outcome is still limited (Paterson et al., 2013). Men with prostate cancer have reported a number of difficulties and these include: psychological distress, sexuality-related issues, self-management of enduring lower urinary tract symptoms, informational support particularly regarding the on-going issues of recurrence and the after effects of treatment (Ream et al., 2008). There is some evidence to support that men living with and beyond prostate cancer are keen to engage as active partners in the management of their disease (Mroz et al., 2010), but remain inadequately supported to do so (Department of Health Macmillan Cancer Support & NHS Improvement, 2010). "

    Full-text · Article · Mar 2015 · European Journal of Oncology Nursing
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    • "Men affected by prostate cancer have a unique understanding of their symptom experience and can therefore, contribute to the effective self-management of these (Hubbard et al., 2007), if approprite support is provided by healthcare professionals. Men have reported that they have experienced a lack of awareness of available resources (Breau et al., 2003; Ream et al., 2008) and have reported unmet informational needs around the following aspects of self-management: management of side-effects, lack of awareness of appropriate signposting to healthcare professionals, and a lack of dietary and physical exercise advice (Breau et al., 2003; Ream et al., 2008). Consequently, there is now a XML Template (2014) [19.3.2014–9:59am] "
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    ABSTRACT: Purpose Prostate cancer survivors are keen to engage as active partners in the management of their condition but have voiced a number of unmet support needs that make effective self-management problematic. Identifying self-management behaviours and evaluating how self-management changes over time may provide valuable insights into how men can be better supported to self-manage. Our systematic review aimed to identify the self-management behaviours for prostate cancer survivors and to evaluate whether these change over time.Methods Using the PRISMA statement we performed a systematic review of studies that identified the self-management behaviours of prostate cancer survivors. Databases searched included: DARE, CDSR, Medline, CINAHL, PsycINFO and ASSIA. Studies were classified by levels of evidence and quality assessment.Results 111 publications were retrieved from the search and 5 publications were included. Men performed a variety of self-management behaviours for psychological and physical problems. Only one study assessed changes in self-management behaviours over time and was limited to men treated by radiotherapy.Conclusion Despite the recent political drive for cancer survivors to self-manage, this review has demonstrated the evidence base is under-developed and a wide range of research is needed to address the unmet supportive care needs of prostate cancer survivors. Practically, this review has identified that Dodd’s Self-Care Log was found to have the strongest psychometric properties for additional research in this area.
    Full-text · Article · Mar 2014
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