Rondorf-Klym LouAnn M, Colling Joyce
School of Medicine, Oregon Health Sciences University, Portland, OR, USA.
Oncol Nurs Forum. 2003 Mar-Apr;30(2):E24-32. doi: 10.1188/03.ONF.E24-E32.
PURPOSE/OBJECTIVES: To examine physical and psychosocial factors that affect the quality of life (QOL) for men 12-24 months after radical prostatectomy treatment for prostate cancer.
Cross-sectional survey.
An entire population from one tumor registry.
Of the 132 men meeting inclusion criteria, 97 men responded, with 91 meeting analysis requirements. Analysis was completed on the Caucasian sample (n = 88) with a mean age of 66 years. Most men were married, lived with a spouse or partner, and had a high level of education.
A survey was developed to assess men 12-24 months prostatectomy. The tumor registry mailed the survey, which was completed at home, and participants returned it in a prestamped, addressed envelope.
Major hypotheses in the causal model were that age, sexual function, urinary function, and sexual appraisal would only have indirect effects on QOL, whereas urinary function appraisal, self-esteem, anger suppression, perceived social support, depression, and health locus of control would directly affect QOL.
As analyzed by path analytic techniques, the hypothesized causal model explained 72% variance in the QOL variable. Perceived social support, self-esteem, and health locus of control were significant predictors of QOL. Urinary function appraisal contributed indirectly through health locus of control. Contrary to the hypotheses, anger suppression and depression were not significant predictors of QOL.
After radical prostatectomy for prostate cancer, perceived social support, self-esteem, and health locus of control may influence men's QOL. Future research is needed to increase understanding about the adaptation trajectory of men's response to the impact of prostate cancer.
Nurses can help patients by providing a thorough assessment of each patient's values that may affect QOL before any intervention begins, using research-based evidence regarding potential side effects of interventions, clear and concise information from a variety of sources that addresses the possible concerns of men and their spouses, and focused counseling that addresses patient-specific problems.
目的/目标:研究前列腺癌根治性前列腺切除术后12 - 24个月影响男性生活质量(QOL)的生理和心理社会因素。
横断面调查。
来自一个肿瘤登记处的全部人群。
在132名符合纳入标准的男性中,97名男性做出了回应,其中91名符合分析要求。对平均年龄为66岁的白种人样本(n = 88)进行了分析。大多数男性已婚,与配偶或伴侣生活在一起,且受教育程度较高。
制定了一项调查以评估前列腺切除术后12 - 24个月的男性。肿瘤登记处邮寄了调查问卷,该问卷在家庭中完成,参与者通过预先贴好邮票并写好地址的信封寄回。
因果模型中的主要假设是年龄、性功能、排尿功能和性评价只会对生活质量产生间接影响,而排尿功能评价、自尊、愤怒抑制、感知到的社会支持、抑郁和健康控制点将直接影响生活质量。
通过路径分析技术分析,假设的因果模型解释了生活质量变量72%的方差。感知到的社会支持、自尊和健康控制点是生活质量的重要预测因素。排尿功能评价通过健康控制点产生间接影响。与假设相反,愤怒抑制和抑郁不是生活质量的重要预测因素。
前列腺癌根治性前列腺切除术后,感知到的社会支持、自尊和健康控制点可能会影响男性的生活质量。需要进一步的研究来加深对男性应对前列腺癌影响的适应轨迹的理解。
在任何干预开始之前,护士可以通过对可能影响生活质量的每个患者的价值观进行全面评估来帮助患者,利用关于干预潜在副作用的基于研究的证据,从各种来源提供清晰简洁的信息以解决男性及其配偶可能存在的担忧,以及针对患者特定问题的针对性咨询。