Five-year outcomes from a randomised controlled trial of a couples-based intervention for men with localised prostate cancer
Five-year outcomes from a randomised controlled trial of a couples-based intervention for men with localised prostate cancer
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DOI：
10.1002/pon.5019
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发表时间：
2019-04-01
期刊：
影响因子：
3.6
通讯作者：
Dunn, Jeff
中科院分区：
文献类型：
--
作者：
Chambers, Suzanne K.;Occhipinti, Stefano;Dunn, Jeff
目的前列腺癌治疗后性心理障碍较为常见，但长期前瞻性研究有限。我们报告了一项以夫妻为基础的干预对男性局部前列腺癌患者手术治疗的5年结果。方法对189对异性伴侣进行随机对照试验，其中男性因前列腺癌接受根治性前列腺癌切除术。试验组是同伴支持VS护士咨询VS常规护理。主要结果是性适应、未得到满足的性支持护理需求、男性自尊、婚姻满意度以及在2年、3年、4年和5年的随访中使用勃起辅助工具。结果干预效果因主要结局不同而不同。2、3年时同伴组的性适应程度高于常规护理组(P=0.002~0.035)。3年后，常规护理组男性未得到满足的性支持护理需求低于同龄人组和护理组(P=0.001.0 5；P=0.0 1)。在2年和3年期间，接受常规护理的妇女的性支持护理需求低于同龄人组(P=0.038；P=0.001)。同伴和护理组的男性比一般护理组的男性更多地使用性辅助工具；在5年内，54%的常规护理男性与87%的同伴支持男性和80%的护士组男性相比。结论同伴和护士管理的性心理干预有可能提高男性对勃起功能障碍治疗的依从性。应用这些支助模式的综合办法可实现最佳效果。
Objective Psychosexual morbidity is common after prostate cancer treatment, however, long-term prospective research is limited. We report 5-year outcomes from a couples-based intervention in dyads with men treated for localised prostate cancer with surgery. Methods A randomised controlled trial was conducted involving 189 heterosexual couples, where the man received a radical prostatectomy for prostate cancer. The trial groups were peer support vs. nurse counselling versus usual care. Primary outcomes were sexual adjustment, unmet sexual supportive care needs, masculine self-esteem, marital satisfaction, and utilisation of erectile aids at 2-, 3-, 4- and 5-year follow-up. Results The effects of the interventions varied across the primary outcomes. Partners in the peer group had higher sexual adjustment than those in the usual care and nurses group at 2 and 3 years (P = 0.002-0.035). Men in usual care had lower unmet sexual supportive care needs than men in the peer and nurse groups (P = 0.001; P = 0.01) at 3 years. Women in usual care had lower sexual supportive care needs than women in the peer group at 2 and 3 years (P = 0.038; P = 0.001). Men in the peer and nurse group utilised sexual aids more than men in usual care; at 5 years 54% of usual care men versus 87% of men in peer support and 80% of men in the nurse group. Conclusion Peer and nurse-administered psychosexual interventions have potential for increasing men's adherence to treatments for erectile dysfunction. Optimal effects may be achieved through an integrated approach applying these modes of support.