Centre for Public Health, Queen's University Belfast, Belfast, United Kingdom.
Institute of Nursing & Health Research, Ulster University, Newtownabbey, United Kingdom.
J Med Internet Res. 2021 Jul 26;23(7):e21502. doi: 10.2196/21502.
Sexual dysfunction is a frequent side effect associated with different prostate cancer treatment approaches. It can have a substantial impact on men and their partners and is associated with increased psychological morbidity. Despite this, sexual concerns are often not adequately addressed in routine practice. Evidence-based web-based interventions have the potential to provide ongoing information and sexual well-being support throughout all stages of care.
The aim of this study is to examine the efficacy of a web-based self-management intervention designed to maximize sexual well-being in men living with prostate cancer and explore user perspectives on usability and acceptability.
We used a single-arm study design, and participants were provided with access to the 5-step intervention for a period of 3 months. The intervention content was tailored based on responses to brief screening questions on treatment type, relationship status, and sexual orientation. Efficacy was assessed by using two-tailed, paired sample t tests for comparing the mean differences between pre- and postintervention measurements for exploring the participants' self-reported knowledge and understanding, sexual satisfaction, and comfort in discussing sexual issues. Usability and acceptability were determined based on the program use data and a postintervention survey for exploring perceived usefulness.
A total of 109 participants were recruited for this study. Significant postintervention improvements at follow-up were observed in the total scores (out of 20) from the survey (mean 12.23/20 points, SD 2.46 vs mean 13.62/20, SD 2.31; t=9.570; P=.001) as well as in individual item scores on the extent to which the participants agreed that they had sufficient information to manage the impact that prostate cancer had on their sex life (mean 2.31/4 points, SD 0.86 vs mean 2.57/4, SD 0.85; t=3.660; P=.001) and had the potential to have a satisfying sex life following treatment (mean 2.38/4 points, SD 0.79 vs mean 3.17/4, SD 0.78; t=7.643; P=.001). The median number of intervention sessions was 3 (range 1-11), and intervention sessions had a median duration of 22 minutes (range 8-77). Acceptable usability scores were reported, with the highest result observed for the question on the extent to which the intervention provided relevant information.
This study provides evidence on the efficacy of a tailored web-based intervention for maximizing sexual well-being in men living with prostate cancer. The results indicate that the intervention may improve one's self-perceived knowledge and understanding of how to manage sexual issues and increase self-efficacy or the belief that a satisfactory sex life could be achieved following treatment. The findings will be used to refine the intervention content before testing as part of a larger longitudinal study for examining its effectiveness.
性功能障碍是与不同前列腺癌治疗方法相关的常见副作用。它会对男性及其伴侣产生重大影响，并与增加的心理发病率有关。尽管如此，在常规实践中，性问题通常没有得到充分解决。基于证据的网络干预措施有可能在整个治疗过程中提供持续的信息和性健康支持。
本研究旨在检验一种基于网络的自我管理干预措施的疗效，该措施旨在最大限度地提高前列腺癌患者的性健康，并探讨用户对可用性和可接受性的看法。
我们使用单臂研究设计，为参与者提供了 3 个月的 5 步干预措施。干预内容根据对治疗类型、关系状况和性取向的简短筛查问题的回答进行定制。通过使用双侧、配对样本 t 检验来评估疗效，比较干预前后测量的平均值差异，以探索参与者自我报告的知识和理解、性满意度以及讨论性问题的舒适度。根据程序使用数据和干预后的调查来确定可用性和可接受性，以探索感知有用性。
本研究共招募了 109 名参与者。在随访时，调查的总分（满分 20 分）显著提高（平均 12.23/20 分，标准差 2.46 与平均 13.62/20 分，标准差 2.31；t=9.570；P=.001），参与者对以下方面的同意程度也有所提高：他们有足够的信息来管理前列腺癌对他们性生活的影响（平均 2.31/4 分，标准差 0.86 与平均 2.57/4 分，标准差 0.85；t=3.660；P=.001），并且有可能在治疗后拥有满意的性生活（平均 2.38/4 分，标准差 0.79 与平均 3.17/4 分，标准差 0.78；t=7.643；P=.001）。干预次数的中位数为 3 次（范围为 1-11 次），干预次数的中位数持续时间为 22 分钟（范围为 8-77 分钟）。报告了可接受的可用性评分，其中最高的评分是关于干预措施提供相关信息的程度。
本研究提供了关于针对前列腺癌患者最大限度提高性健康的基于网络的个性化干预措施的疗效证据。结果表明，该干预措施可能会提高参与者对如何管理性问题的自我感知知识和理解，并增加自我效能感或对治疗后能够实现满意性生活的信念。研究结果将用于在更大的纵向研究中测试之前，对干预内容进行改进，以检验其有效性。
