Cancer Prevention and Control, Fox Chase Cancer Center, Philadelphia, Pennsylvania, USA.
Department of Family Medicine and Community Health, Rutgers Robert Wood Johnson Medical School, New Brunswick, New Jersey, USA.
Psychooncology. 2021 Sep;30(9):1466-1475. doi: 10.1002/pon.5701. Epub 2021 Apr 28.
Prostate cancer (PCa) survivors report poor physical functioning alongside negative psychological outcomes as they cope with treatment side effects and practical concerns after treatment completion. This study evaluated PROGRESS, a web-based intervention designed to improve adaptive coping among PCa survivors.
Localized PCa patients (N = 431) within one year of treatment completion were randomized to receive educational booklets or PROGRESS + educational booklets. Surveys completed at baseline, 1-, 3-, and 6-months assessed patient characteristics; functional quality of life and coping (primary outcomes); and psychosocial outcomes (e.g., self-efficacy, marital communication; secondary outcomes). Intent-to-treat and as-treated analyses were completed to assess change in outcomes from baseline to 6 months using linear mixed effects regression models.
In the intent-to-treat analyses, participants randomized to the intervention group had improved diversion coping (i.e., healthy redirection of worrying thoughts about their cancer), but more difficulties in marital communication (ps < 0.05). However, PROGRESS usage was low among those randomized to the intervention group (38.7%). The as-treated analyses found PROGRESS users reported fewer practical concerns but had worse positive coping compared to PROGRESS non-users (ps < 0.05).
The findings suggest PROGRESS may improve certain aspects of adaptive coping among PCa survivors that use the website, but does not adequately address the remaining coping and psychosocial domains. Additional research is needed to better understand the gaps in intervention delivery contributing to low engagement and poor improvement across all domains of functional quality of life and adaptive coping.
前列腺癌(PCa)患者在完成治疗后,由于需要应对治疗副作用和实际问题,会经历较差的身体机能和负面的心理后果。本研究评估了 PROGRESS,这是一种旨在改善 PCa 患者适应性应对的基于网络的干预措施。
在治疗完成后一年内的局限性 PCa 患者(N=431)被随机分配接受教育手册或 PROGRESS+教育手册。在基线、1、3 和 6 个月完成的调查评估了患者特征;功能生活质量和应对(主要结果);以及心理社会结果(例如,自我效能、婚姻沟通;次要结果)。使用线性混合效应回归模型完成意向治疗和实际治疗分析,以评估从基线到 6 个月的结果变化。
在意向治疗分析中,随机分配到干预组的参与者在转移应对方面有所改善(即,对癌症的担忧想法进行健康的转移),但在婚姻沟通方面遇到更多困难(p<0.05)。然而,随机分配到干预组的参与者中,PROGRESS 的使用率较低(38.7%)。实际治疗分析发现,与 PROGRESS 非使用者相比,PROGRESS 用户报告的实际问题较少,但积极应对能力更差(p<0.05)。
这些发现表明,PROGRESS 可能会改善某些使用该网站的 PCa 患者的适应性应对方面,但并不能充分解决其余的应对和心理社会领域。需要进一步研究以更好地了解导致所有功能生活质量和适应性应对领域参与度低和改善效果差的干预措施提供方面的差距。