Division of Psychosocial Oncology, Department of Oncology, University of Calgary, Calgary, AB T2N 4N1, Canada.
Arnie Charbonneau Cancer Institute, University of Calgary, Calgary, AB T2N 4N1, Canada.
Curr Oncol. 2024 Aug 28;31(9):5040-5056. doi: 10.3390/curroncol31090373.
Although Androgen Deprivation Therapy (ADT) is effective in controlling prostate cancer (PCa) and increasing survival, it is associated with a myriad of side effects that cause significant morbidity. Previous research has shown that PCa patients starting on ADT are neither fully informed nor well-equipped to manage the breadth of ADT's side effects. The ADT Educational Program (a 1.5 h interactive class plus a book) was developed as an evidence-based resource for patients dealing with ADT. Our aim here was to compare the efficacy of an online version of the class with a previously assessed in-person version of the class. Using mixed MANOVAs within a non-randomized comparison design, we assessed: (1) changes in patients' experiences of self-efficacy to manage and bother associated with side effects approximately 10 weeks after attending a class, and (2) potential differences in these variables between online and in-person class formats. Side effect bother decreased from pre- to post-class but did not differ between in-person ( = 94) and online ( = 137) class cohorts. While self-efficacy to manage side effects was slightly higher post-class in both cohorts, the increase was not statistically significant. Average self-efficacy ratings were significantly higher among in-person versus online class participants ( < 0.05; η = 0.128). Both online and in-person classes are associated with a significant reduction in the severity of side effect bother reported by PCa patients, suggesting non-inferiority of online versus in-person formats. Online classes offer greater accessibility to the program for patients outside the reach of in-person classes, increasing the availability of the program to more PCa patients and family members across Canada.
虽然雄激素剥夺疗法（ADT）在控制前列腺癌（PCa）和提高生存率方面有效，但它与许多副作用有关，这些副作用会导致严重的发病率。先前的研究表明，开始接受 ADT 的 PCa 患者既没有充分了解，也没有很好地准备好应对 ADT 副作用的广泛性。ADT 教育计划（一个 1.5 小时的互动课程加一本书）是作为患者应对 ADT 的基于证据的资源而开发的。我们的目的是比较在线版本的课程与之前评估的面对面版本的课程的效果。我们使用非随机比较设计中的混合 MANOVA 评估：（1）大约 10 周后参加课程后，患者管理和困扰副作用的自我效能感的变化；（2）在线和面对面课程格式之间这些变量的潜在差异。副作用困扰从课前到课后减少，但面对面（ = 94）和在线（ = 137）课程队列之间没有差异。虽然在两个队列中，管理副作用的自我效能感在课后略有提高，但增加并不具有统计学意义。平均自我效能感评分在面对面课程参与者中明显高于在线课程参与者（<0.05；η=0.128）。在线课程和面对面课程都与 PCa 患者报告的副作用严重程度显著降低相关，表明在线课程与面对面课程具有非劣效性。在线课程为无法参加面对面课程的患者提供了更大的课程可及性，增加了加拿大更多 PCa 患者及其家属获得该计划的机会。
