Wootten Addie C, Meyer Denny, Abbott Jo-Anne M, Chisholm Katherine, Austin David W, Klein Britt, McCabe Marita, Murphy Declan G, Costello Anthony J
Department of Urology, The Royal Melbourne Hospital, Parkville, VIC, Australia.
Epworth Prostate Centre, Epworth Healthcare, Richmond, VIC, Australia.
Psychooncology. 2017 Jul;26(7):975-981. doi: 10.1002/pon.4244. Epub 2016 Sep 26.
Prostate cancer treatment often results in significant psycho-sexual challenges for men following treatment; however, many men report difficulty in accessing appropriate care.
A randomized controlled trial was undertaken to assess the efficacy of a 10-week self-guided online psychological intervention called My Road Ahead (MRA) for men with localized prostate cancer in improving sexual satisfaction. Participants were randomized to 1 of 3 conditions MRA alone or MRA plus online forum, or forum access alone. Pre, post, and follow-up assessments of overall sexual satisfaction were conducted. Mixed models and structural equation modeling were used to analyze the data.
One hundred forty-two men (mean age 61 y; SD = 7) participated. The majority of participants had undergone radical prostatectomy (88%) and all men had received treatment for localized prostate cancer. Significant differences were obtained for the 3 groups (P = .026) and a significant improvement in total sexual satisfaction was observed only for participants who were allocated to MRA + forum with a large effect size (P = .004, partial η = 0.256). Structural equation modeling indicated that increases in sexual function, masculine self-esteem, and sexual confidence contributed significantly to overall sexual satisfaction for the MRA + forum plus forum condition.
This study is the first, to our knowledge, that has evaluated a self-guided online psychological intervention tailored to the specific needs of men with prostate cancer. The findings indicate the potential for MRA to deliver support that men may not otherwise receive and also highlight the importance of psychological intervention to facilitate improved sexual outcomes.
前列腺癌治疗常常给接受治疗后的男性带来重大的心理性挑战；然而，许多男性表示难以获得适当的护理。
开展了一项随机对照试验，以评估一项名为“我的前进之路”（MRA）的为期10周的自我引导式在线心理干预对局限性前列腺癌男性改善性满意度的疗效。参与者被随机分配到3种情况中的一种：单独接受MRA，或MRA加在线论坛，或仅获得论坛访问权限。对总体性满意度进行了治疗前、治疗后及随访评估。使用混合模型和结构方程模型分析数据。
142名男性（平均年龄61岁；标准差=7）参与了研究。大多数参与者接受了根治性前列腺切除术（88%），所有男性均接受了局限性前列腺癌治疗。3组之间存在显著差异（P = 0.026），仅分配到MRA + 论坛组的参与者的总体性满意度有显著提高，且效应量较大（P = 0.004，偏η² = 0.256）。结构方程模型表明，性功能、男性自尊和性自信的提高对MRA + 论坛组的总体性满意度有显著贡献。
据我们所知，本研究首次评估了一种针对前列腺癌男性特定需求的自我引导式在线心理干预。研究结果表明，MRA有可能提供男性可能无法通过其他方式获得的支持，也凸显了心理干预对促进改善性结局的重要性。
