A randomized trial of internet-based versus traditional sexual counseling for couples after localized prostate cancer treatment.
A randomized trial of internet-based versus traditional sexual counseling for couples after localized prostate cancer treatment.
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DOI：
10.1002/cncr.26308
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发表时间：
2012-01-15
期刊：
影响因子：
6.2
通讯作者：
Rhodes MM
中科院分区：
文献类型：
--
作者：
Schover LR;Canada AL;Yuan Y;Sui D;Neese L;Jenkins R;Rhodes MM
前列腺癌治疗后，涉及夫妇的多学科性康复似乎比传统的泌尿治疗勃起功能障碍（艾德）更有前途。我们进行了一项随机试验，将传统或基于互联网的性咨询与等待名单对照进行比较。夫妇自适应随机分配到一个3个月的等待名单（WL），一个3次会议的面对面的格式（FF），或基于互联网的格式与电子邮件联系的治疗师（WEB 1）。增加了第二个因特网小组（WEB2），以进一步审查网站使用与成果之间的关系。在基线、等待名单后、治疗后以及3个月、6个月和12个月的随访中，参与者完成了国际勃起功能指数（IIEF）、女性性功能指数（FSFI）、简明症状量表-18（用于测量情绪困扰）和简化的二元适应量表。结果在等待名单期间没有变化。在115对进入随机试验的夫妇和71对进入WEB2组的夫妇中，33%的人退出了。然而，包括所有参与者的线性混合模型分析证实，IIEF评分的改善在1年随访时仍然显着（P<0.001）。FSFI评分异常的女性最初也有显著改善（P=0.0255）。在基线时找到一种有效的治疗艾德和正常女性性功能的药物，而不是治疗形式，与更好的结果相关。在WEB组中，只有完成75%以上干预的男性在IIEF评分上有显著改善。基于互联网的夫妻性咨询计划与简短的传统性治疗形式一样有效，可以持久改善前列腺癌后男性的性结果。
After treatment for prostate cancer, multidisciplinary sexual rehabilitation involving couples appears more promising than traditional urologic treatment for erectile dysfunction (ED). We conducted a randomized trial comparing traditional or internet-based sexual counseling with a waitlist control. Couples were adaptively randomized to a 3-month waitlist (WL), a 3-session face-to-face format (FF), or an internet-based format with email contact with the therapist (WEB1). A second internet-based group (WEB2) was added to further examine the relationship between web site usage and outcomes. At baseline, post-waitlist, post-treatment, and at 3-, 6-, and 12-month follow-ups participants completed the International Index of Erectile Function (IIEF), the Female Sexual Function Index (FSFI), the Brief Symptom Inventory-18 to measure emotional distress, and the abbreviated Dyadic Adjustment Scale. Outcomes did not change during the waitlist period. Of 115 couples entering the randomized trial and 71 entering the WEB2 group, 33% dropped out. However, a linear mixed model analysis including all participants confirmed improvements in IIEF scores that remained significant at 1-year follow-up (P<0.001). Women with abnormal FSFI scores initially also improved significantly (P=0.0255). Finding an effective medical treatment for ED and normal female sexual function at baseline, but not treatment format, were associated with better outcomes. In the WEB groups, only men completing more than 75% of the intervention had significant improvements in IIEF scores. An internet-based sexual counseling program for couples is as effective as a brief, traditional sex therapy format in producing enduring improvements in men’s sexual outcomes after prostate cancer.
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