Hedden Lindsay, Wassersug Richard, Mahovlich Sarah, Pollock Phil, Sundar Monita, Bell Robert H, Goldenberg Larry, Higano Celestia S
Centre for Clinical Epidemiology and Evaluation, University of British Columbia, Vancouver General Hospital, Vancouver, BC, Canada.
Vancouver Prostate Centre, Gordon and Leslie Diamond Health Care Centre, Vancouver General Hospital, Vancouver, BC, Canada.
BJU Int. 2017 Nov;120(5B):E21-E29. doi: 10.1111/bju.13885. Epub 2017 May 17.
To determine whether an education session alleviates distress for both patients with prostate cancer and their partners; and whether their partner's attendance at the session; and disease, treatment, and sociodemographic characteristics affect changes in distress levels.
PATIENTS, SUBJECTS AND METHODS: We identified men with untreated prostate cancer at the Vancouver Prostate Centre between February 2015 and March 2016 who agreed to attend our education session. The session consisted of a didactic presentation covering the biology of prostate cancer, treatment options, and side-effects, followed by a private joint session with a urologist and radiation oncologist. We assessed distress using the Distress Thermometer (DT) and compared pre- and post-session distress, and change in distress between patients and partners using matched and unmatched t-tests, respectively. We also assessed pre-session anxiety using the seven-item Generalised Anxiety Disorder measure, and decisional certainty using the Decisional Conflict Scale.
In all, 71 patients and 48 partners participated in the study. Attending the session led to a significant reduction in the median DT score for patients (4.0-3.0, P < 0.01) and partners (5.0-4.0, P = 0.02). Partners reported higher distress both before and after the session (4.9 vs 3.8, P = 0.03 pre-session and 4.2 vs 3.2, P = 0.03 post-session). The presence of a partner at the session did not affect patients' pre- or post-session distress or the success of the session at alleviating distress. Sociodemographic and clinical characteristics had little effect on distress levels.
An interdisciplinary education session is equally effective at alleviating distress for both patients with prostate cancer and their female partners.
确定一场教育课程是否能减轻前列腺癌患者及其伴侣的痛苦;其伴侣参加该课程与否;以及疾病、治疗和社会人口学特征是否会影响痛苦水平的变化。
患者、受试者与方法:我们在2015年2月至2016年3月期间于温哥华前列腺中心识别出未接受治疗的前列腺癌男性患者,他们同意参加我们的教育课程。该课程包括一场涵盖前列腺癌生物学、治疗选择及副作用的讲授式报告,随后是与一名泌尿科医生和一名放射肿瘤学家进行的私人联合问诊。我们使用痛苦温度计(DT)评估痛苦程度,并分别采用配对和非配对t检验比较课程前后的痛苦程度以及患者与伴侣之间的痛苦变化。我们还使用七项广泛性焦虑障碍量表评估课程前的焦虑,并使用决策冲突量表评估决策确定性。
共有71名患者和48名伴侣参与了该研究。参加课程导致患者的DT中位数得分显著降低(从4.0降至3.0,P<0.01),伴侣的DT中位数得分也显著降低(从5.0降至4.0,P = 0.02)。伴侣在课程前后均报告有更高的痛苦程度(课程前4.9对3.8,P = 0.03;课程后4.2对3.2,P = 0.03)。伴侣参加课程与否并不影响患者课程前后的痛苦程度或课程减轻痛苦的效果。社会人口学和临床特征对痛苦水平影响甚微。
一场跨学科教育课程在减轻前列腺癌患者及其女性伴侣的痛苦方面同样有效。