National Institute of Nursing Research, National Institutes of Health, Bethesda, Maryland 20892-1506, USA.
Cancer Nurs. 2011 Nov-Dec;34(6):470-8. doi: 10.1097/NCC.0b013e31820a5943.
Patients treated with radical prostatectomy (RP) or radiation therapy (RT) for prostate cancer can experience stress and symptoms that impact quality of life.
The objectives of this study were to describe cortisol levels, perceived stress, symptoms, and symptom distress; compare differences in variables measured between RP and RT; and identify associations among cortisol levels, perceived stress, symptoms, and symptom distress in patients treated for localized prostate cancer.
A descriptive, cross-sectional study was conducted with 53 patients (RP n = 24, RT n = 29). Data from saliva, questionnaires, and interviews were collected within 3 months of treatment. Saliva samples were collected at 4 times over 2 consecutive days. Data were analyzed using descriptive statistics, correlations, and regressions.
A robust diurnal rhythm of cortisol secretion with heightened levels in the early morning and lowered levels late in the day was found. On average, the entire sample had moderate symptoms and symptom distress for urinary, bowel, and sexual dysfunction. The RP group reported significantly more urinary and sexual dysfunction symptoms and fewer bowel symptoms than did the RT group. Perceived stress was positively correlated with higher afternoon cortisol levels and greater symptom distress.
Moderate symptoms and symptom distress found in our sample indicate the need for interventions to address these outcomes in men treated for prostate cancer. Self-reported perceived stress can be used to assess the stress level and symptom distress in clinic setting.
Patients treated for prostate cancer with RP or RT should be assessed for symptoms and symptom distress and targeted for early symptom management interventions.
接受根治性前列腺切除术（RP）或放射治疗（RT）的前列腺癌患者可能会经历影响生活质量的压力和症状。
本研究的目的是描述皮质醇水平、感知压力、症状和症状困扰；比较 RP 和 RT 治疗患者之间测量变量的差异；并确定接受局限性前列腺癌治疗的患者中皮质醇水平、感知压力、症状和症状困扰之间的关联。
对 53 名患者（RP 组 n = 24，RT 组 n = 29）进行了描述性、横断面研究。治疗后 3 个月内收集唾液、问卷和访谈数据。在连续两天的 4 个时间点采集唾液样本。使用描述性统计、相关性和回归分析来分析数据。
发现皮质醇分泌具有强烈的昼夜节律，清晨水平升高，傍晚水平降低。总体而言，整个样本的尿、肠和性功能障碍的症状和症状困扰程度中等。RP 组报告的尿和性功能障碍症状明显多于 RT 组，而肠症状较少。感知压力与下午皮质醇水平升高和更大的症状困扰呈正相关。
我们样本中发现的中度症状和症状困扰表明需要干预措施来解决接受前列腺癌治疗的男性的这些结果。自我报告的感知压力可用于评估诊所环境中的压力水平和症状困扰。
接受 RP 或 RT 治疗的前列腺癌患者应评估症状和症状困扰，并针对早期症状管理干预措施进行针对性治疗。
