ProsCan for Couples: Randomised controlled trial of a couples-based sexuality intervention for men with localised prostate cancer who receive radical prostatectomy
ProsCan for Couples: Randomised controlled trial of a couples-based sexuality intervention for men with localised prostate cancer who receive radical prostatectomy
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DOI：
10.1186/1471-2407-8-226
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发表时间：
2008-08-08
期刊：
影响因子：
3.8
通讯作者：
Dunn, Jeff
中科院分区：
文献类型：
--
作者：
Chambers, Suzanne K.;Schover, Leslie;Dunn, Jeff
背景：前列腺癌是西方世界最常见的男性癌症。这种癌症最实质性的长期发病率是性功能障碍，随之而来的是夫妇和亲密关系的不利变化。迄今为止的研究还没有确定一种有效的方法来改善前列腺癌患者及其伴侣的性和心理社会适应。此外，相对于专业提供服务模式而言，同伴咨询的功效和成本效益尚未得到经验检验。本文介绍了一项三组随机对照试验的设计（同伴与护士咨询与常规护理），将评估两种基于夫妇的性干预措施的有效性（ProsCan for Couples：Peer Support vs. Nurse Counseling）对男性和女性在局部前列腺癌手术治疗后的性和心理社会调整;以及成本效益。方法/设计：每种情况70对夫妇将在诊断后和治疗前通过泌尿科私人诊所和医院门诊招募（共210对夫妇），并随机分配至（1）常规护理;（2）8次同行提供的电话支持和DVD教育;（3）肿瘤科护士电话咨询8次，并辅以DVD教育。手术前将进行两次干预，手术后六个月内将进行六次干预。干预将利用认知行为方法沿着夫妻关系教育，重点是加强关系，帮助夫妻共同管理癌症诊断和治疗的压力。将在基线（术前）和术后3、6和12个月对受试者进行评估。成果指标包括：性适应;未得到满足的性支持护理需求;性寻求帮助的态度;心理调整;利益发现和quality of life.Discussion：这项研究将提供有关同伴支持与护士咨询的有效性的建议，以促进更好的性和夫妇的调整后，前列腺癌以及建议的干预措施是否代表有效的卫生服务提供。
Background: Prostate cancer is the most common male cancer in the Western world. The most substantial long term morbidity from this cancer is sexual dysfunction with consequent adverse changes in couple and intimate relationships. Research to date has not identified an effective way to improve sexual and psychosocial adjustment for both men with prostate cancer and their partners. As well, the efficacy and cost effectiveness of peer counselling as opposed to professional models of service delivery has not yet been empirically tested. This paper presents the design of a three arm randomised controlled trial (peer vs. nurse counselling vs. usual care) that will evaluate the efficacy of two couples-based sexuality interventions (ProsCan for Couples: Peer support vs. nurse counselling) on men's and women's sexual and psychosocial adjustment after surgical treatment for localised prostate cancer; in addition to cost-effectiveness.Methods/design: Seventy couples per condition (210 couples in total) will be recruited after diagnosis and before treatment through urology private practices and hospital outpatient clinics and randomised to (1) usual care; (2) eight sessions of peer-delivered telephone support with DVD education; and (3) eight sessions of oncology nurse-delivered telephone counselling with DVD education. Two intervention sessions will be delivered before surgery and six over the six months post-surgery. The intervention will utilise a cognitive behavioural approach along with couple relationship education focussed on relationship enhancement and helping the couple to conjointly manage the stresses of cancer diagnosis and treatment. Participants will be assessed at baseline (before surgery) and 3, 6 and 12 months post-surgery. Outcome measures include: sexual adjustment; unmet sexuality supportive care needs; attitudes to sexual help seeking; psychological adjustment; benefit finding and quality of life.Discussion: The study will provide recommendations about the efficacy of peer support vs. nurse counselling to facilitate better sexual and couple adjustment after prostate cancer as well as recommendations on whether the interventions represent efficient health service delivery.