Department of Social Psychology, Tilburg University, Warandelaan 2, 5037 AB, Tilburg, The Netherlands.
Department of Urology, Elisabeth-Tweesteden Hospital, Hilvarenbeekseweg 60, 5022 GC, Tilburg, The Netherlands.
Support Care Cancer. 2018 Apr;26(4):1297-1304. doi: 10.1007/s00520-017-3953-8. Epub 2017 Nov 10.
The objective of this study is to test if patients' health-related quality of life (HRQoL) declines after prostate biopsy to detect Pca, and after subsequent treatment decision-making in case Pca is confirmed, and to test whether personality state and traits are associated with these potential changes in HRQoL.
Patients who were scheduled for prostate biopsy to detect Pca (N = 377) filled out a baseline questionnaire about HRQoL (EORTC QLQ-C30 and PR25), "big five" personality traits (BFI-10), optimism (LOT-r), and self-efficacy (Decision Self-efficacy Scale) (t0). Patients with confirmed Pca (N = 126) filled out a follow-up questionnaire on HRQoL within 2 weeks after treatment was chosen but had not yet started (t1).
HRQoL declined between t0 and t1, reflected in impaired role and cognitive functioning, and elevated fatigue, constipation, and prostate-specific symptoms. Sexual activity and functioning improved. Baseline HRQoL scores were unrelated to the selection of a particular treatment, but for patients who chose a curative treatment, post-decision HRQoL showed a greater decline compared to patients who chose active surveillance. Optimism was associated with HRQoL at baseline; decisional self-efficacy was positively associated with HRQoL at follow-up. No associations between HRQoL and the "big five" personality traits were found.
Patients who have undergone prostate biopsy and treatment decision-making for Pca experience a decline in HRQoL. Choosing treatment with a curative intent was associated with greater decline in HRQoL. Interventions aimed at optimism and decision self-efficacy could be helpful to reduce HRQoL impairment around the time of prostate biopsy and treatment decision-making.
本研究旨在检验前列腺癌（Pca）筛查前列腺活检后以及后续治疗决策（若确诊 Pca）后患者的健康相关生活质量（HRQoL）是否下降，并检验人格状态和特质是否与这些潜在的 HRQoL 变化相关。
计划接受前列腺癌筛查前列腺活检的患者（N=377）填写了一份基线问卷，内容涉及 HRQoL（EORTC QLQ-C30 和 PR25）、“大五”人格特质（BFI-10）、乐观主义（LOT-r）和决策自我效能感（决策自我效能感量表）（t0）。确诊为 Pca 的患者（N=126）在选择但尚未开始治疗后 2 周内填写了一份 HRQoL 随访问卷（t1）。
t0 到 t1 之间 HRQoL 下降，表现在角色和认知功能受损，疲劳、便秘和前列腺特异性症状加重。性活动和功能改善。基线 HRQoL 评分与特定治疗选择无关，但对于选择根治性治疗的患者，与选择主动监测的患者相比，决策后 HRQoL 下降更大。乐观主义与基线 HRQoL 相关；决策自我效能感与随访时的 HRQoL 呈正相关。未发现 HRQoL 与“大五”人格特质之间存在关联。
接受前列腺活检和 Pca 治疗决策的患者 HRQoL 下降。选择有治愈意图的治疗与 HRQoL 更大下降相关。旨在提高乐观主义和决策自我效能感的干预措施可能有助于减少前列腺活检和治疗决策时的 HRQoL 损害。
