What Patients and Partners Want in Interventions That Support Sexual Recovery After Prostate Cancer Treatment: An Exploratory Convergent Mixed Methods Study

Sexual Medicine - Tập 7 - Trang 184-191 - 2019
Akanksha Mehta1, Craig Evan Pollack2, Theresa W. Gillespie3,4, Ashley Duby5, Caroline Carter5, Steve Thelen-Perry5, Daniela Witmann5
1Department of Urology, Emory University School of Medicine, Atlanta, GA, USA
2Department of Health Policy and Management, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA
3Department of Surgery, Emory University School of Medicine, Atlanta, Ga., USA
4Department of Hematology and Medical Oncology, Emory University School of Medicine, Atlanta, GA, USA
5Department of Urology, University of Michigan, Ann Arbor, MI, USA

Tóm tắt

Abstract Introduction Men treated for prostate cancer suffer from treatment-related sexual side effects that adversely affect their relationships and quality of life. Aim To investigate what prostate cancer survivors and their partners want from a sexual recovery intervention, and whether they consider an online tool acceptable for use in promoting sexual recovery. Methods This mixed-methods study included focus groups and interviews with both heterosexual and gay cancer survivors, as well as their partners. Focus groups and interviews probed experiences with treatment, side effects, and support received/needed for sexual recovery. Participants responded to proposed web-based intervention content. Interviews were analyzed with thematic content analysis. Their sexual function was assessed with validated measures. Main Outcome Measures Acceptability of online tools for promoting sexual recovery was evaluated. Results Participants included 14 patients and 10 partners (2 male). Patient and partner median age was 62 and 62.5 years, respectively. Treatment ranged from surgery alone to combined radiation and hormonal therapy. Qualitative data analysis yielded 5 main intervention needs: (i) pretreatment discussion of sexual side effects, rehabilitation, emotional impact and realistic expectations, (ii) improved sexual communication within couples, (iii) strategies for promoting sexual intimacy beyond penetrative intercourse, (iv) attentiveness to partners' needs, and (v) access to peer support. Gay men specifically expressed the need for improved provider understanding of their sexuality and experiences. Most considered a web-based approach to be acceptable. Conclusion Patients and partners value both pretreatment preparation for sexual recovery and support for sexual recovery for both after treatment. A web-based approach may help mitigate barriers to access to these support services.

Tài liệu tham khảo

Perez, 2002, Sexuality and intimacy following radical prostatectomy: patient and partner perspectives, Health Psychol, 21, 288, 10.1037/0278-6133.21.3.288 Garos, 2007, Prostate cancer patients and their partners: Differences in satisfaction indices and psychological variables, J Sex Med, 4, 1394 Merz, 2011, Dyadic concordance among prostate cancer patients and their partners and health-related quality of life: Does it matter?, Psychol Health, 26, 651, 10.1080/08870441003721251 Wootten, 2014, Psychosocial interventions to support partners of men with prostate cancer: A systematic and critical review of the literature, J Cancer Surviv, 8, 472, 10.1007/s11764-014-0361-7 Eisemann, 2014, Quality of life in partners of patients with localised prostate cancer, Qual Life Res, 23, 1557, 10.1007/s11136-013-0588-1 Sanda, 2008, Quality of life and satisfaction with outcome among prostate-cancer survivors, N Engl J Med, 358, 1250, 10.1056/NEJMoa074311 Guercio, 2018, Predictors of patient and partner satisfaction following radical prostatectomy, Sex Med Rev, 6, 295, 10.1016/j.sxmr.2017.08.005 Fode, 2017, Sexuality following radical prostatectomy: Is restoration of erectile function enough?, Sex Med Rev, 5, 110, 10.1016/j.sxmr.2016.07.005 Cobo Cuenca, 2015, Psychological impact and sexual dysfunction in men with and without spinal cord injury, J Sex Med, 12, 436 Chou, 2015, Newly diagnosed erectile dysfunction and risk of depression: A population-based 5-year follow-up study in Taiwan, J Sex Med, 12, 804 Aghighi, 2015, Psychological determinants of erectile dysfunction among middle-aged men, Int J Impot Res, 27, 63, 10.1038/ijir.2014.34 Klaassen, 2018, Decreasing suicide risk among patients with prostate cancer: Implications for depression, erectile dysfunction, and suicidal ideation screening, Urol Oncol, 36, 60, 10.1016/j.urolonc.2017.09.007 Sunny, 2007, Economic conditions and marriage quality of men with prostate cancer, BJU Int, 99, 1391, 10.1111/j.1464-410X.2007.06807.x Resendes, 2006, Spousal responses to prostate cancer: An integrative review, Cancer Invest, 24, 192, 10.1080/07357900500524652 Wittmann, 2014, Exploring the role of the partner in couples' sexual recovery after surgery for prostate cancer, Support Care Cancer, 22, 2509, 10.1007/s00520-014-2244-x Canada, 2005, Pilot intervention to enhance sexual rehabilitation for couples after treatment for localized prostate carcinoma, Cancer, 104, 2689, 10.1002/cncr.21537 Manne, 2011, Intimacy-enhancing psychological intervention for men diagnosed with prostate cancer and their partners: A pilot study, J Sex Med, 8, 1197 Titta, 2006, Sexual counseling improved erectile rehabilitation after non-nerve-sparing radical retropubic prostatectomy or cystectomy—Results of a randomized prospective study, J Sex Med, 3, 267 Chambers, 2015, A randomised controlled trial of a couples-based sexuality intervention for men with localised prostate cancer and their female partners, Psychooncology, 24, 748, 10.1002/pon.3726 Paich, 2016, Preparing patients and partners for recovery from the side effects of prostate cancer surgery: A group approach, Urology, 88, 36, 10.1016/j.urology.2015.07.064 Schover, 2012, A randomized trial of internet-based versus traditional sexual counseling for couples after localized prostate cancer treatment, Cancer, 118, 500, 10.1002/cncr.26308 Wei, 2000, Development and validation of the expanded prostate cancer index composite (EPIC) for comprehensive assessment of health-related quality of life in men with prostate cancer, Urology, 56, 899, 10.1016/S0090-4295(00)00858-X Bland, 1997, Cronbach's alpha, BMJ, 314, 572, 10.1136/bmj.314.7080.572 Rosen, 2000, The Female Sexual Function Index (FSFI): A multidimensional self-report instrument for the assessment of female sexual function, J Sex Marital Ther, 26, 191, 10.1080/009262300278597 Rosen, 1997, The international index of erectile function (IIEF): A multidimensional scale for assessment of erectile dysfunction, Urology, 49, 822, 10.1016/S0090-4295(97)00238-0 Wittmann, 2017, TrueNTH sexual recovery study protocol: A multi-institutional collaborative approach to developing and testing a web-based intervention for couples coping with the side-effects of prostate cancer treatment in a randomized controlled trial, BMC Cancer, 17, 664, 10.1186/s12885-017-3652-3 Morgan, 1993, Qualitative content analysis: A guide to paths not taken, Qual Health Res, 3, 112, 10.1177/104973239300300107 Wheat, 2009, Clinical interpretation of the Expanded Prostate Cancer Index Composite-Short Form sexual summary score, J Urol, 182, 2844 Zhou, 2016, Physical and emotional health information needs and preferences of long-term prostate cancer survivors, Patient Educ Couns, 99, 2049, 10.1016/j.pec.2016.07.017 Nelson, 2015, Couples-based interventions following prostate cancer treatment: A narrative review, Transl Androl Urol, 4, 232 Albaugh, 2017, Life after prostate cancer treatment: a mixed methods study of the experiences of men with sexual dysfunction and their partners, BMC Urol, 17, 45, 10.1186/s12894-017-0231-5 Chung, 2013, Sexual rehabilitation and cancer survivorship: A state of art review of current literature and management strategies in male sexual dysfunction among prostate cancer survivors, J Sex Med, 10, 102 Song, 2018, Enhancing survivorship care planning for patients with localized prostate cancer using a couple-focused health symptom self-management program: Protocol for a feasibility study, JMIR Res Protoc, 7, e51, 10.2196/resprot.9118 Walker, 2017, Intimacy after prostate cancer: A brief couples' workshop is associated with improvements in relationship satisfaction, Psychooncology, 26, 1336, 10.1002/pon.4147 Allen, 2018, African American women's involvement in promoting informed decision-making for prostate cancer screening among their partners/spouses, Am J Mens Health, 12, 884, 10.1177/1557988317742257 Wittmann, 2017, Evidence supporting couple-based interventions for the recovery of sexual intimacy after prostate cancer treatment, Curr Sex Health Rep, 9, 32, 10.1007/s11930-017-0095-4 Wittmann, 2015, A pilot study of potential pre-operative barriers to couples' sexual recovery after radical prostatectomy for prostate cancer, J Sex Marital Ther, 41, 155, 10.1080/0092623X.2013.842194
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Sexual Medicine

Tập 7

184-191

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