Dieperink Karin B, Johansen Christoffer, Hansen Steinbjørn, Wagner Lis, K Andersen Klaus, Minet Lisbeth R, Hansen Olfred
a Department of Oncology , Odense University Hospital , Odense C , Denmark.
b Survivorship , Danish Cancer Society Research Center , Copenhagen , Denmark.
Acta Oncol. 2017 Feb;56(2):254-261. doi: 10.1080/0284186X.2016.1267395. Epub 2017 Jan 17.
The objective of this study was to examine if rehabilitation influenced self-reported male coping styles during and up to three years after treatment with radiotherapy for prostate cancer.
In a single-center oncology unit in Odense, Denmark, 161 prostate cancer patients treated with radiotherapy and androgen deprivation therapy were included in a randomized controlled trial from 2010 to 2012. The trial examined the effect of a multidisciplinary rehabilitation program within six months of treatment consisting of two nursing counseling sessions and two instructive sessions with a physical therapist (n = 79), or standard care (n = 82). As secondary outcomes coping was measured before radiotherapy, one month after radiotherapy (baseline), six month post-intervention (assessment) and three years after radiotherapy (follow-up) by the Mini-mental adjustment to cancer scale (Mini-MAC). The male coping styles towards the illness are expressed in five mental adjustment styles: Fighting Spirit, Helplessness-Hopelessness, Anxious Preoccupation, Fatalism and Cognitive Avoidance. Descriptive analysis and multiple linear regression analysis adjusting for the longitudinal design were conducted.
Most coping styles remained stable during the patient trajectory but Anxious Preoccupation declined from before radiotherapy to follow-up in both intervention and control groups. After six months the intervention group retained Fighting Spirit significantly (p = 0.025) compared with controls, but after three years this difference evened out. After three years the intervention group had lower Cognitive Avoidance (p = 0.044) than the controls. Factors as educational level, and depression influenced the use of coping styles after three years.
Multidisciplinary rehabilitation in irradiated prostate cancer patients retained the adjustment style Fighting Spirit stable after six months of radiotherapy, and in the long term reduced Cognitive Avoidance. Thus, the rehabilitation program supported the patient's active coping style and played down the passive coping style.
本研究的目的是探讨康复治疗是否会影响前列腺癌患者在接受放射治疗期间及治疗后长达三年的自我报告男性应对方式。
在丹麦欧登塞的一个单中心肿瘤科室，161例接受放射治疗和雄激素剥夺治疗的前列腺癌患者被纳入2010年至2012年的一项随机对照试验。该试验考察了在治疗后六个月内进行的多学科康复计划的效果，该计划包括两次护理咨询课程和两次与物理治疗师的指导课程（n = 79），或标准护理（n = 82）。作为次要结果，通过癌症心理调适简易量表（Mini-MAC）在放射治疗前、放射治疗后一个月（基线）、干预后六个月（评估）和放射治疗后三年（随访）测量应对情况。男性对疾病的应对方式通过五种心理调适方式来表达：斗志、无助-绝望、焦虑关注、宿命论和认知回避。进行了描述性分析以及针对纵向设计进行的多元线性回归分析。
在患者病程中，大多数应对方式保持稳定，但焦虑关注在干预组和对照组中均从放射治疗前到随访期间有所下降。六个月后，干预组与对照组相比显著保留了斗志（p = 0.025），但三年后这种差异消失。三年后，干预组的认知回避低于对照组（p = 0.044）。教育水平和抑郁等因素在三年后影响应对方式的使用。
接受放疗的前列腺癌患者的多学科康复在放疗六个月后使调适方式“斗志”保持稳定，并且从长期来看降低了认知回避。因此，康复计划支持了患者的积极应对方式并淡化了消极应对方式。
