Living With Prostate Cancer: Patients' and Spouses' Psychosocial Status and Quality of Life

Harvard University, Cambridge, Massachusetts, United States
Journal of Clinical Oncology (Impact Factor: 18.43). 10/2007; 25(27):4171-7. DOI: 10.1200/JCO.2006.09.6503
Source: PubMed


Despite the high prevalence of prostate cancer, little information is available on the quality of life of men and their spouses during the phases of illness. This study assessed patients' and spouses' quality of life, appraisal of illness, resources, symptoms, and risk for distress across three phases of prostate cancer: newly diagnosed, biochemical recurrence, and advanced.
The sample consisted of 263 patient/spouse dyads. A stress-appraisal conceptual model guided the selection of variables which were then assessed with established instruments. Study variables were examined for phase effects (differences in dyads across three phases), role effects (patients v spouses), and phase-by-role interactions (differences within dyads across phases) using analysis of variance (ANOVA).
More phase effects than role effects were found, indicating that the psychosocial experiences of patients and their spouses were similar, but differed from dyads in other phases. Dyads in the advanced phase were at highest risk for distress. These patients had the lowest physical quality of life, and their spouses had the lowest emotional quality of life of all participants. Dyads in the biochemical recurrence and advanced phases had more negative appraisals of illness and caregiving, greater uncertainty, and more hopelessness compared with dyads in the newly diagnosed phase. Spouses, in contrast to patients, had less confidence in their ability to manage the illness and perceived less support across all phases of illness.
Phase-specific programs of care are needed to assist both men with prostate cancer and their spouses to manage the effects of illness.

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    • "The Cronbach alpha ranged from 0.74–0.9 in the authors' previous study of patients with PCa and their partners (Song et al., 2012). General symptoms (e.g., fatigue, pain, sleep disturbance) were measured with the 21-item symptom scale, in which patients and partners rated their own symptoms (Mood, Song, Kershaw, & Northouse, 2007). The Cronbach alpha ranged from 0.76–0.84 in the authors' previous study (Song et al., 2012). "
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    ABSTRACT: The incidence of localized prostate cancer (PCa) has risen dramatically in the past several decades with the widespread use of prostate-specific antigen testing. About 70%-90% of patients with localized PCa are treated with surgery or radiation, with or without hormonal treatment; younger patients more frequently choose aggressive treatment in the form of radical prostatectomy (Cooperberg, Broering, & Carroll, 2010; Schymura et al., 2010). Potential side effects include transient or persistent bowel, hormonal, sexual, and urinary symptoms; general symptoms (e.g., fatigue, pain, sleep disturbance); and emotional distress. These symptoms reduce patients' quality of life and negatively affect their relationship with their partners (Ferrer et al., 2008; Gore, Kwan, Lee, Reiter, & Litwin, 2009; Litwin et al., 2007; Sanda et al., 2008; Song et al., 2011). .
    Preview · Article · Mar 2015 · Oncology Nursing Forum
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    • "More broadly, Soloway et al. (2005), Badr and Taylor (2009) and Hawkins et al. (2009) researched the impact of prostate cancer on a couple's sexuality and relationships. Couper et al. (2006), Northouse et al. (2007) and Sinfield et al. (2009) have investigated the unique psycho-social needs of these couples. Themes such as regret, distress and lowered levels of sexual satisfaction were common among all these emerging bodies of research. "
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    ABSTRACT: To explore issues related to sexual function and relationships, for men and their wives or partners, following diagnosis and treatment for prostate cancer. A diagnosis of prostate cancer and subsequent treatment result in a significant number of men experiencing some impairment to their sexual function. There is scant research into the impact of changed sexual function on these men's masculinity, sexuality, intimate relationships and their needs regarding counselling and supportive care. Internet-based survey. Focus groups and couple interviews were used to improve validity for questionnaire items designed to provide insight into men's experiences of prostate cancer in areas such as sexual function and relationships. The questionnaire included both closed and open-ended questions and had the option for the wife or partner to complete a section. Qualitative research revealed 17 specific categories within three key themes: sexual dysfunction, loss of libido and masculinity. The questionnaire found, unexpectedly, the majority of men said that they had sufficient emotional and psychological support. Wives/partners confirmed cancer had impacted on their partner's feelings of masculinity (71%), compared to 42% of men who felt that this was the case. Predictors of loss of libido, erectile dysfunction and 'feeling less of a man' were developed. Univariate predictors included hormone therapy, regrets about treatment choice, cancer having impacted on masculinity and distress during the last week. Men are not able to clearly identify the challenges prostate cancer brings especially changes to their masculinity. The findings strongly suggest that for men with prostate cancer, nursing assessments of men's sexual health be augmented by information gained from their partners; further, these assessments should be augmented with a careful exploration of these men's psyche guided by the knowledge that masculinity influences perceptions of self (being a man) and help seeking.
    Full-text · Article · Dec 2013 · Journal of Clinical Nursing
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    • "Men with prostate cancer and their partners live with symptoms associated with the disease and the outcomes of treatment over an extended period of time. Outcomes vary according to the type of treatment received, with prostate cancer survivors often reporting negative urinary, bowel, and sexual function outcomes that persist years after treatment has ended (Namiki & Arai, 2010; Northouse et al., 2007). "
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    ABSTRACT: Purpose/Objectives: To determine the long-term effects of prostate cancer treatment on spouse quality of life (QOL) at 36 months following treatment. Design: Descriptive-exploratory; community-based study. Setting: Telephone interviews. Sample: 95 female spouses of men treated for early-stage prostate cancer. Methods: A computer-assisted telephone interview was used to evaluate QOL among spouses of prostate cancer survivors at 36 months after initial prostate cancer treatment. Main Research Variables: Lymphedema, demographic information, self-reported comorbid diseases or medical issues, and medication usage. Findings: Spouses who had more negative appraisal of caregiving had lower sexual satisfaction, poorer cancer-specific QOL, and poorer mental QOL. Spouses who perceived bother related to the patient's sexual or hormone function reported more threatening appraisals of caregiving, less sexual satisfaction, and poorer QOL. Conclusions: Spouses continued to experience negative appraisal of caregiving, which affected QOL 36 months after their husbands' treatment for prostate cancer. Additional studies related to factors that influence spouse QOL during survivorship will help guide clinical practice. Implications for Nursing: Healthcare providers must help spouses find strategies that promote positive coping and lessen negative appraisal. Giving caregivers information early in the treatment process will help them understand what to expect over time. Supporting caregivers and helping them manage stress will enhance QOL during survivorship. Knowledge Translation: Spouses who experienced more bother related to urinary, sexual, and hormonal function experience more stress and worse QOL at 36 months post-treatment. Spouse appraisal can have a significant effect on QOL. Offering counseling to couples following treatment for prostate cancer may improve QOL by helping couples manage relationship intimacy.
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