Acceptance and Commitment Therapy for Erectile Dysfunction Following Radical Pros

接受和承诺治疗勃起功能障碍的激进专家

• 批准号: 7871955
• 负责人: Christian J Nelson
• 金额: $ 24.91万
• 依托单位: SLOAN-KETTERING INST CAN RESEARCH
• 依托单位国家: 美国
• 财政年份: 2010
• 资助国家: 美国
• 起止时间: 2010-04-12 至 2012-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7871955
• 关键词: Address; Adverse effects; Atrophic; Bayer brand of vardenafil hydrochloride; Behavior Therapy; Blood; Cancer Survivor; Chronic; Cialis; Cognitive; Commit; Continuance of life; Data; Diagnosis; Diagnostic Neoplasm Staging; Early Diagnosis; Erectile dysfunction; Exploratory/Developmental Grant; Female; Frustration; Gold; Happiness; Healed; Health; Injection of therapeutic agent; Institute of Medicine (U.S.); Intervention; Lead; Life; Malignant Neoplasms; Malignant neoplasm of prostate; Medical; Medicine; Names; Nerve; Nitric Oxide; Operative Surgical Procedures; Oral; Oxygen; Persons; Pharmaceutical Preparations; Prostate; Psychosocial Influences; Psychotherapy; Public Health; Qualifying; Quality of life; Radical Prostatectomy; Recovery; Rehabilitation therapy; Relative (related person); Reporting; Research; Running; Self Perception; Sex Functioning; Sexual Dysfunction; Sexual Health; Shame; Staging; Stress; Survival Rate; Survivors; Telephone; Therapeutic; Time; Tissues; Viagra; Woman; brief intervention; cancer diagnosis; cancer therapy; cancer type; compliance behavior; cost; depressive symptoms; design; erection; healing; improved; innovation; intimate behavior; malignant breast neoplasm; men; novel; novel strategies; programs; psychologic; public health relevance; satisfaction; self esteem; standard care

DESCRIPTION (provided by applicant): The Institute of Medicine's recent report highlights the distinct need to address sexual dysfunction in cancer survivors. Prostate cancer is the most common cancer in men in the US; 90 percent of all prostate cancers are diagnosed in the early stage, and the relative 5 and 10 year survival rates are over 90 percent. A primary side-effect of prostate cancer treatment is erectile dysfunction (ED), with as many as 85 percent of men reporting problems with erections more than 4 years after early stage treatment. ED can have negative quality of life implications. Men who have ED report significant frustration, increased depressive symptoms, and reduced general happiness with life. ED can also have deleterious effects on men's intimate relationships, often times causing relationship stress, a reduction in intimacy, and sexual dysfunctions in female partners. Radical prostatectomy (RP) is one of the gold standard treatments for early stage prostate cancer, and the medical field has made important advances in understanding ED after RP. The current best practices treatment for ED after RP is the concept of "erectile rehabilitation." Despite these medical advances, frustration, shame, and disappointment often lead men to avoid seeking and sustaining treatment for ED. This delay in pursuing and difficulty sustaining treatment can be especially damaging in men following RP since it is imperative for erectile rehabilitation that treatment start immediately after RP and continue for 2 years post RP. We propose an innovative psychological intervention that will be integrated with an erectile rehabilitation program. This treatment will consist of 7 sessions (4 sessions in person, 3 over the phone) that will help men accept the need for ED treatment, identify and overcome the barriers to this treatment, and then commit to an erectile rehabilitation program. This novel intervention will utilize therapeutic concepts from the cognitive-behavioral treatment Acceptance and Commitment Therapy (ACT), and apply these concepts to ED after RP (i.e., intervention name, ACT-ED). The innovativeness of this intervention lies in 1) the shift to a proactive focus on erectile rehabilitation, increasing the chance of erectile recovery and avoiding the psychosocial issues related to chronic ED, and 2) the novel approach of applying ACT concepts to sexual medicine. Our research group is uniquely situated and qualified to run this type of intervention. This proposal is relevant to the PA-09-130 R21 mechanism as it will assess the feasibility and initial efficacy of applying this innovative intervention to a novel setting, with high significance for hundreds of thousands of prostate cancer survivors. The primary aim of the study is to investigate the feasibility, tolerability, and acceptability of a psychotherapy treatment integrated into an erectile rehabilitation program (i.e., ACT-ED). The secondary aim is to investigate the impact of ACT-ED on penile injection compliance, ED treatment satisfaction, sexual functioning, sexual self-esteem, ED bother, depression symptoms, acceptance and self-awareness. PUBLIC HEALTH RELEVANCE: Although life saving, prostate cancer treatment can have a high cost to survivors in regard to their sexual health. Prostate cancer is the most common type of cancer in men in the US; over 90 percent of men are diagnosed in the early stage, and the 5 and 10 year survivor rates are over 90 percent. Since 85 percent of men treated for early stage cancer report difficulties with erections, sexual functioning after early stage treatment for prostate cancer impacts hundreds of thousands of prostate cancer survivors. ACT-ED is designed to address this significant survivorship issues by providing a brief intervention to promote acceptance of ED and a commitment to an erectile rehabilitation program after radical prostatectomy to improve sexual functioning.

描述（由申请人提供）：医学研究所最近的报告强调了解决癌症幸存者性功能障碍的独特需要。前列腺癌是美国男性最常见的癌症; 90%的前列腺癌在早期被诊断出来，相对的5年和10年生存率超过90%。前列腺癌治疗的主要副作用是勃起功能障碍（艾德），多达85%的男性报告在早期治疗后4年以上出现勃起问题。艾德可对生活质量产生负面影响。患有艾德的男性报告说，他们有明显的挫折感，抑郁症状增加，对生活的总体幸福感降低。艾德也会对男性的亲密关系产生有害影响，通常会导致关系紧张、亲密度降低和女性伴侣的性功能障碍。根治性前列腺切除术（RP）是早期前列腺癌的金标准治疗方法之一，医学界对RP后艾德的认识取得了重要进展。目前RP后艾德的最佳实践治疗是“勃起康复”的概念。“尽管这些医学进步，挫折感，羞耻感和失望往往导致男性避免寻求和维持ED治疗。这种延迟追求和难以维持治疗对RP后的男性尤其有害，因为RP后立即开始治疗并持续RP后2年对于勃起康复至关重要。我们提出了一种创新的心理干预，将与勃起康复计划相结合。这种治疗将包括7个疗程（4个面对面，3个通过电话），这将帮助男性接受艾德治疗的需要，识别和克服这种治疗的障碍，然后致力于勃起康复计划。这种新的干预将利用认知行为治疗接受和承诺疗法（ACT）的治疗概念，并将这些概念应用于RP后的艾德（即，干预名称，ACT-ED）。这种干预的创新性在于1）转向积极关注勃起康复，增加勃起恢复的机会，避免与慢性艾德相关的心理社会问题，以及2）将ACT概念应用于性医学的新方法。我们的研究小组是独特的位置和资格运行这种类型的干预。该提案与PA-09-130 R21机制相关，因为它将评估将这种创新干预措施应用于新环境的可行性和初步疗效，这对数十万前列腺癌幸存者具有重要意义。本研究的主要目的是调查心理治疗与勃起康复计划（即，ACT-ED）。次要目的是调查ACT-艾德对阴茎注射依从性、艾德治疗满意度、性功能、性自尊、艾德困扰、抑郁症状、接受和自我意识的影响。 公共卫生相关性：虽然可以挽救生命，但前列腺癌治疗对幸存者在性健康方面的成本很高。前列腺癌是美国男性最常见的癌症类型;超过90%的男性在早期被诊断出来，5年和10年的存活率超过90%。由于85%接受早期癌症治疗的男性报告勃起困难，前列腺癌早期治疗后的性功能影响了数十万前列腺癌幸存者。ACT-艾德旨在通过提供简短的干预措施来解决这一重大的生存问题，以促进对艾德的接受，并致力于根治性乳房切除术后的勃起康复计划，以改善性功能。