Rutgers Cancer Institute of New Jersey, New Brunswick, New Jersey, USA.
Michigan State University, East Lansing, Michigan, USA.
Br J Health Psychol. 2019 May;24(2):396-418. doi: 10.1111/bjhp.12359. Epub 2019 Mar 10.
Few couple-focused interventions have improved psychological and relationship functioning among men diagnosed with localized prostate cancer and their spouses. This study compared the impact of intimacy-enhancing therapy (IET), a general health and wellness intervention (GHW), and usual care (UC) on the psychological and relationship functioning of localized prostate cancer patients and their partners. Relationship length, relationship satisfaction, and patient masculinity were evaluated as moderators.
This study was a randomized clinical trial with three study arms and four assessment time points.
A total of 237 patients and partners were randomly assigned to receive IET, GHW, or UC. Participants completed measures of psychological functioning and relationship satisfaction at baseline, 5 weeks, 3 months, and 6 months post-baseline. Primary outcomes were psychological adjustment, depression, cancer-specific distress, cancer concerns, and relationship satisfaction.
Spouses in IET showed greater increases in relationship satisfaction than spouses in GHW and UC between the baseline and 5-week follow-up. Among patients in longer relationships, significant increases in psychological adjustment were found in both treatments compared to UC. Among spouses in longer relationships, psychological adjustment increased in both IET and UC but declined in GHW.
Intimacy-enhancing therapy did not show an impact on general or cancer-specific distress, but did show an early impact on relationship satisfaction among spouses. IET was superior to UC for patients in longer relationships. It will be important for researchers to understand which couple-focused interventions benefits both patients and spouses and to identify characteristics of patients, partners, and couples who may not benefit from psychological treatments. Statement of contribution What is already known on this subject? Men diagnosed with localized prostate cancer report lower health-related quality of life and both patients and spouses report elevated distress. Relationship communication plays a role in couples' psychological adaptation to prostate cancer. Couple-focused interventions have illustrated an impact on relationship communication. There are no studies comparing different couple-focused interventions. What does this study add? Intimacy-enhancing therapy was not superior to no treatment or a comparison treatment for the broad range of psychological and relationship outcomes. Intimacy-enhancing therapy was superior to no treatment for patients in longer-term relationship. The general health and wellness intervention was not beneficial for men in shorter relationships and for men who did not endorse traditional masculine norms.
很少有以夫妻为中心的干预措施能改善被诊断为局限性前列腺癌的男性及其配偶的心理和关系功能。本研究比较了增强亲密关系疗法（IET）、一般健康和保健干预（GHW）和常规护理（UC）对局限性前列腺癌患者及其伴侣的心理和关系功能的影响。研究还评估了关系长度、关系满意度和患者男子气概作为调节因素的作用。
这是一项具有三个研究组和四个评估时间点的随机临床试验。
共有 237 名患者及其伴侣被随机分配接受 IET、GHW 或 UC。参与者在基线、5 周、3 个月和 6 个月时完成心理功能和关系满意度的测量。主要结果是心理调整、抑郁、癌症特异性困扰、癌症担忧和关系满意度。
与 GHW 和 UC 相比，IET 组配偶在基线和 5 周随访期间关系满意度的增加更为显著。在关系较长的患者中，与 UC 相比，两种治疗方法都显著改善了心理调整。在关系较长的配偶中，IET 和 UC 都提高了心理调整，但 GHW 却下降了。
增强亲密关系疗法对一般或癌症特异性困扰没有影响，但确实显示出对配偶关系满意度的早期影响。对于关系较长的患者，IET 优于 UC。研究人员需要了解哪些以夫妻为中心的干预措施对患者和配偶都有益，并确定哪些患者、伴侣和夫妇可能无法从心理治疗中获益的特征，这一点很重要。
关于本主题已知的内容？
被诊断为局限性前列腺癌的男性报告的健康相关生活质量较低，患者和配偶都报告了更高的困扰。
夫妻沟通在夫妻对前列腺癌的心理适应中起着重要作用。
夫妻为中心的干预措施已显示出对夫妻沟通的影响。
目前尚无比较不同夫妻为中心的干预措施的研究。
本研究增加了哪些内容？
增强亲密关系疗法并不优于无治疗或比较治疗对广泛的心理和关系结果。
对于长期关系的患者，增强亲密关系疗法优于无治疗。
一般健康和保健干预对短期关系的男性和不认可传统男子气概规范的男性没有益处。
