Division of Health and Social Care, Faculty of Health & Medical Sciences, University of Surrey, Guildford, Surrey, UK.
Psychooncology. 2010 Sep;19(9):909-22. doi: 10.1002/pon.1657.
In the context of increasing prostate cancer survivorship, evidence of unmet supportive care needs and growing economic health-care restraints, this review examined and evaluated best approaches for developing self-management programmes to meet men's survivorship needs.
A search of international literature published in the last 12 years was conducted. Only randomised controlled trials were included in the analysis. Key components of the interventions were evaluated to determine what has been offered, and which elements are most beneficial in improving health outcomes. Methodological issues were also considered.
Targeting participant need and promoting motivation to participate and maintain programme adherence were the most important factors to emerge in ensuring positive health outcomes. Both need and motivation are multi-faceted, the components of which are identified and evaluated. Guidance was also identified in relation to delivery design, theoretical mechanisms for change, modes of delivery and facilitator issues.
Self-management is a viable and appropriate way of providing health-care solutions to ameliorate men's functional and emotional problems associated with increased prostate cancer survivorship. Integration into clinical practice will require training, resources and commitment and, in addition, economic viability will be difficult to assess since cost comparison with current provision is not straightforward. Nevertheless, from the psychosocial and behavioural studies reviewed there is convincing evidence that can be used to design, implement and evaluate future self-management programmes for men surviving prostate cancer.
在前列腺癌生存者不断增加的背景下，鉴于支持性护理需求未得到满足和医疗保健经济压力不断增大，本研究旨在探讨和评估制定自我管理方案以满足男性生存者需求的最佳方法。
对过去 12 年发表的国际文献进行了检索。仅纳入分析了随机对照试验。评估干预措施的关键组成部分，以确定提供了哪些内容，以及哪些内容最有益于改善健康结果。还考虑了方法学问题。
确定参与者的需求，以及促进参与和维持方案依从性的动机，是确保积极健康结果的最重要因素。需求和动机都是多方面的，对其组成部分进行了识别和评估。还确定了与交付设计、改变的理论机制、交付模式和促进者问题有关的指导。
自我管理是提供医疗保健解决方案以改善与前列腺癌生存者相关的功能和情绪问题的可行且适当的方法。将其纳入临床实践需要培训、资源和承诺，此外，由于与当前提供的方案进行成本比较并不简单，因此难以评估其经济可行性。然而，从审查的心理社会和行为研究中，有令人信服的证据可用于设计、实施和评估未来针对前列腺癌生存者的自我管理方案。
