Giannopoulos Eleni, Catton Charles, Giuliani Meredith Elana, Kucharski Edward, Matthew Andrew, Quartey Naa Kwarley, Papadakos Janet
Cancer Health Literacy Research Centre, Cancer Education, Princess Margaret Cancer Centre, Toronto, ON, Canada.
Department of Radiation Oncology, Princess Margaret Cancer Centre, Toronto, ON, Canada.
Can Urol Assoc J. 2023 Feb;17(2):49-60. doi: 10.5489/cuaj.7982.
Prostate cancer survivors experience a multitude of late treatment effects, resulting in greater unmet needs, elevated symptom burden, and reduced quality of life. Survivors can engage in appropriate self-management strategies post-treatment to help reduce the symptom burden. The objectives of this study were to: 1) survey the unmet needs of prostate cancer survivors using the validated Cancer Survivor Unmet Needs instrument; 2) explore predictors of high unmet needs; and 3) investigate prostate cancer survivors' willingness to engage in self-management behaviors.
Survivors were recruited from a prostate clinic and a cross-sectional survey design was employed. Inclusion criteria was having completed treatment two years prior. Descriptive statistics were used to summarize participant characteristics. Univariate and multivariate analyses were done to determine predictors of unmet needs and readiness to engage.
A total of 206 survivors participated in the study, with a mean age of 71 years. Most participants were university/college-educated (n=123, 61%) and had an annual household income of ≥$99 999 (n=74, 38%). Participants reported erectile dysfunction (81%) and nocturia (81%) as the most frequently experienced symptoms with the greatest symptom severity χ̄=5.8 and χ̄=4.5, respectively). More accessible parking was the greatest unmet need in the quality-of-life domain (n=34/57, 60%). Overall, supportive care unmet needs were predicted by symptom severity on both univariate (p<0.001) and multivariate analyses (odds ratio [OR ] 1.81, 95% confidence interval [CI] 0.92-1.00, p<0.001). Readiness to engage in self-management was predicted by an income of <$49 000 (OR 3.99, 95% CI 1.71-9.35, p=0.0014).
Income was the most significant predictor of readiness to engage in self-management. Consideration should be made to establishing no-cost and no-barrier education programs to educate survivors about how to engage in symptom self-management.
前列腺癌幸存者会经历多种后期治疗影响，导致更多未满足的需求、症状负担加重以及生活质量下降。幸存者可以在治疗后采取适当的自我管理策略，以帮助减轻症状负担。本研究的目的是：1）使用经过验证的癌症幸存者未满足需求工具，调查前列腺癌幸存者未满足的需求；2）探索未满足需求较高的预测因素；3）调查前列腺癌幸存者参与自我管理行为的意愿。
从前列腺诊所招募幸存者，并采用横断面调查设计。纳入标准是两年前已完成治疗。使用描述性统计来总结参与者特征。进行单变量和多变量分析，以确定未满足需求和参与意愿的预测因素。
共有206名幸存者参与了该研究，平均年龄为71岁。大多数参与者受过大学教育（n = 123，61%），家庭年收入≥99,999美元（n = 74，38%）。参与者报告勃起功能障碍（81%）和夜尿症（81%）是最常出现的症状，症状严重程度最高（分别为χ̄ = 5.8和χ̄ = 4.5）。在生活质量领域，更方便的停车位是最大的未满足需求（n = 34/57，60%）。总体而言，单变量（p < 0.001）和多变量分析（优势比[OR]1.81，95%置信区间[CI]0.92 - 1.00，p < 0.001）均显示，症状严重程度是支持性护理未满足需求的预测因素。年收入低于49,000美元是参与自我管理意愿的预测因素（OR 3.99，95% CI 1.71 - 9.35，p = 0.0014）。
收入是参与自我管理意愿的最显著预测因素。应考虑设立免费且无障碍的教育项目，向幸存者传授如何进行症状自我管理。
