针对夫妻的ProsCan：对接受根治性前列腺切除术的局限性前列腺癌男性进行基于夫妻的性干预的随机对照试验。
ProsCan for Couples: randomised controlled trial of a couples-based sexuality intervention for men with localised prostate cancer who receive radical prostatectomy.
作者信息
Chambers Suzanne K, Schover Leslie, Halford Kim, Clutton Samantha, Ferguson Megan, Gordon Louisa, Gardiner R A, Occhipinti Stefano, Dunn Jeff
机构信息
Viertel Centre for Research in Cancer Control, Cancer Council Queensland, Brisbane, Australia.
出版信息
BMC Cancer. 2008 Aug 8;8:226. doi: 10.1186/1471-2407-8-226.
BACKGROUND
Prostate cancer is the most common male cancer in the Western world. The most substantial long term morbidity from this cancer is sexual dysfunction with consequent adverse changes in couple and intimate relationships. Research to date has not identified an effective way to improve sexual and psychosocial adjustment for both men with prostate cancer and their partners. As well, the efficacy and cost effectiveness of peer counselling as opposed to professional models of service delivery has not yet been empirically tested. This paper presents the design of a three arm randomised controlled trial (peer vs. nurse counselling vs. usual care) that will evaluate the efficacy of two couples-based sexuality interventions (ProsCan for Couples: Peer support vs. nurse counselling) on men's and women's sexual and psychosocial adjustment after surgical treatment for localised prostate cancer; in addition to cost-effectiveness.
METHODS/DESIGN: Seventy couples per condition (210 couples in total) will be recruited after diagnosis and before treatment through urology private practices and hospital outpatient clinics and randomised to (1) usual care; (2) eight sessions of peer-delivered telephone support with DVD education; and (3) eight sessions of oncology nurse-delivered telephone counselling with DVD education. Two intervention sessions will be delivered before surgery and six over the six months post-surgery. The intervention will utilise a cognitive behavioural approach along with couple relationship education focussed on relationship enhancement and helping the couple to conjointly manage the stresses of cancer diagnosis and treatment. Participants will be assessed at baseline (before surgery) and 3, 6 and 12 months post-surgery. Outcome measures include: sexual adjustment; unmet sexuality supportive care needs; attitudes to sexual help seeking; psychological adjustment; benefit finding and quality of life.
DISCUSSION
The study will provide recommendations about the efficacy of peer support vs. nurse counselling to facilitate better sexual and couple adjustment after prostate cancer as well as recommendations on whether the interventions represent efficient health service delivery.
TRIAL REGISTRATION
ACTRN12608000358347.
背景
前列腺癌是西方世界最常见的男性癌症。这种癌症最严重的长期发病情况是性功能障碍，进而导致夫妻关系和亲密关系出现不良变化。迄今为止的研究尚未找到一种有效的方法来改善前列腺癌男性患者及其伴侣的性和心理社会适应情况。此外，与专业服务模式相比，同伴咨询的疗效和成本效益尚未经过实证检验。本文介绍了一项三臂随机对照试验（同伴咨询与护士咨询对比常规护理）的设计，该试验将评估两种基于夫妻的性干预措施（针对夫妻的前列腺癌康复计划：同伴支持与护士咨询）对局限性前列腺癌手术治疗后男性和女性的性及心理社会适应情况的疗效；此外还将评估成本效益。
方法/设计：每种情况招募70对夫妻（共210对夫妻），在诊断后、治疗前通过泌尿外科私人诊所和医院门诊招募，并随机分为：（1）常规护理；（2）八次由同伴提供电话支持并配有DVD教育；（3）八次由肿瘤学护士提供电话咨询并配有DVD教育。两次干预课程将在手术前进行，术后六个月内进行六次。干预将采用认知行为方法以及夫妻关系教育，重点在于增进关系，并帮助夫妻共同应对癌症诊断和治疗带来的压力。将在基线（手术前）以及术后3、6和12个月对参与者进行评估。结果指标包括：性适应；未满足的性支持护理需求；对寻求性帮助的态度；心理适应；益处发现和生活质量。
讨论
该研究将提供有关同伴支持与护士咨询在促进前列腺癌后更好的性和夫妻适应方面的疗效的建议，以及关于这些干预措施是否代表高效医疗服务提供的建议。
试验注册
ACTRN12608000358347。
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