Faculty of Health, University of Technology Sydney, Sydney, Australia.
Menzies Health Institute Queensland, Griffith University, Southport, Australia.
Psychooncology. 2019 Apr;28(4):775-783. doi: 10.1002/pon.5019. Epub 2019 Feb 18.
Psychosexual morbidity is common after prostate cancer treatment, however, long-term prospective research is limited. We report 5-year outcomes from a couples-based intervention in dyads with men treated for localised prostate cancer with surgery.
A randomised controlled trial was conducted involving 189 heterosexual couples, where the man received a radical prostatectomy for prostate cancer. The trial groups were peer support vs. nurse counselling versus usual care. Primary outcomes were sexual adjustment, unmet sexual supportive care needs, masculine self-esteem, marital satisfaction, and utilisation of erectile aids at 2-, 3-, 4- and 5-year follow-up.
The effects of the interventions varied across the primary outcomes. Partners in the peer group had higher sexual adjustment than those in the usual care and nurses group at 2 and 3 years (P = 0.002-0.035). Men in usual care had lower unmet sexual supportive care needs than men in the peer and nurse groups (P = 0.001; P = 0.01) at 3 years. Women in usual care had lower sexual supportive care needs than women in the peer group at 2 and 3 years (P = 0.038; P = 0.001). Men in the peer and nurse group utilised sexual aids more than men in usual care; at 5 years 54% of usual care men versus 87% of men in peer support and 80% of men in the nurse group.
Peer and nurse-administered psychosexual interventions have potential for increasing men's adherence to treatments for erectile dysfunction. Optimal effects may be achieved through an integrated approach applying these modes of support.
前列腺癌治疗后常出现精神性性功能障碍，但长期前瞻性研究有限。我们报告了一项基于夫妇的干预措施在接受局部前列腺癌手术治疗的男性双体中的 5 年结果。
一项随机对照试验涉及 189 对异性恋夫妇，其中男性接受根治性前列腺切除术治疗前列腺癌。试验组为同伴支持组、护士咨询组和常规护理组。主要结局为 2 年、3 年、4 年和 5 年随访时的性调整、未满足的性支持性护理需求、男性自尊、婚姻满意度和勃起功能辅助工具的使用。
干预措施的效果在主要结局上有所不同。同伴组的伴侣在 2 年和 3 年时的性调整高于常规护理组和护士组（P=0.002-0.035）。常规护理组的男性在 3 年时的未满足性支持性护理需求低于同伴组和护士组（P=0.001；P=0.01）。常规护理组的女性在 2 年和 3 年时的性支持性护理需求低于同伴组（P=0.038；P=0.001）。同伴组和护士组的男性比常规护理组的男性更常使用性辅助工具；5 年后，常规护理组的男性中有 54%，同伴支持组中有 87%，护士组中有 80%。
同伴和护士管理的精神性性功能障碍干预措施有可能增加男性对勃起功能障碍治疗的依从性。通过应用这些支持模式的综合方法，可能会达到最佳效果。
