Pilot intervention to enhance sexual rehabilitation for couples after treatment for localized prostate carcinoma
Pilot intervention to enhance sexual rehabilitation for couples after treatment for localized prostate carcinoma
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DOI：
10.1002/cncr.21537
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发表时间：
2005-12-15
期刊：
影响因子：
6.2
通讯作者：
Schover, LR
中科院分区：
文献类型：
--
作者：
Canada, AL;Neese, LE;Schover, LR
背景。大多数前列腺癌幸存者在明确治疗后的几年里都会经历持久的性困难和相关的痛苦。一项旨在提高性满意度水平和提高勃起功能障碍 (ED) 药物治疗成功率的咨询干预措施已针对前列腺癌幸存者及其伴侣进行了试点测试。方法。所有男性参与者都是局限性前列腺癌 3 个月至 5 年的幸存者，接受过根治性前列腺切除术或放射治疗，并且已婚或处于稳定的关系中。夫妻们被随机安排一起参加四次咨询，或者让男性单独参加。在两组中，合作伙伴都完成了行为作业。这些课程包括有关前列腺癌和性功能的教育、治疗 ED 的选择以及性沟通和刺激技巧。基线、治疗后以及 3 个月和 6 个月随访时的标准化问卷评估了性功能、婚姻调整、心理困扰以及 ED 治疗的利用。随机接受治疗的 84 对夫妇中有 51 对完成了干预（61%）。合作伙伴的出席并不影响结果。完成干预的参与者在 3 个月的随访中表现出男性整体痛苦 (P < 0.01)、男性整体性功能 (P < 0.0001) 和女性整体性功能 (P < 0.05) 的改善，但在 6 个月的随访中注意到向基线的回归。然而，ED 治疗的利用率从研究开始时的 31% 增加到 6 个月随访时的 49% (P = 0.003)。 结论。这项简短的试点咨询干预的结果表明，性功能和满意度显着提高，并且 ED 治疗的利用率有所提高。然而，未来的随机试验需要进行修改，以降低提前终止的发生率并改善收益的长期维持。 (c) 2005 年美国癌症协会。
BACKGROUND. The majority of prostate carcinoma survivors experience enduring sexual difficulties and associated distress in the years after definitive treatment. A counseling intervention aimed at improving levels of sexual satisfaction and increasing successful utilization of medical treatment for erectile dysfunction (ED) was developed and pilot-tested for both the survivor of prostate carcinoma and his partner.METHODS. All male participants were 3-month to 5-year survivors of localized prostate carcinoma who had been treated with radical prostatectomy or radiation therapy, and were married or in a committed relationship. Couples were randomized to attend four sessions of counseling together or to have the man attend alone. In both groups, partners completed behavioral homework. The sessions included education on prostate carcinoma and sexual function and options to treat ED as well as sexual communication and stimulation skills. Standardized questionnaires at baseline, posttreatment, and at 3-month and 6-month follow-up assessed sexual function, marital adjustment, psychologic distress, and utilization of treatments for ED.RESULTS. Fifty-one of 84 couples randomized to treatment completed the intervention (61%). Attendance by the partner did not affect outcomes. Participants completing the intervention demonstrated improvment in male overall distress (P < 0.01), male global sexual function (P < 0.0001), and female global sexual function (P < 0.05) at 3-month follow-up, but regression toward baseline was noted at 6-month follow-up. However, utilization of ED treatments increased from 31 % at the time of study entry to 49% at the 6-month follow-up (P = 0.003).CONCLUSIONS. The results of this brief pilot counseling intervention demonstrated significant gains in sexual function and satisfaction and increased utilization of treatments for ED. However, modifications are needed in future randomized trials to reduce the rate of premature termination and to improve long-term maintenance of gains. (c) 2005 American Cancer Society.