Helping Men Adhere to Sexual Rehabilitation Following Prostate Cancer Surgery

帮助男性在前列腺癌手术后坚持性康复

• 批准号: 9030435
• 负责人: Christian J Nelson
• 金额: $ 70.83万
• 依托单位: SLOAN-KETTERING INST CAN RESEARCH
• 依托单位国家: 美国
• 财政年份: 2015
• 资助国家: 美国
• 起止时间: 2015-12-01 至 2020-11-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9030435
• 关键词: Address; Adherence; Adverse effects; Aftercare; Anxiety; Cancer Survivor; Cialis; Continuance of life; Data; Diagnosis; Diagnostic Neoplasm Staging; Early Diagnosis; Education; Erectile dysfunction; Exploratory/Developmental Grant; Female; Frustration; Goals; Gold; Happiness; Healed; Injection of therapeutic agent; Institute of Medicine (U.S.); Intervention; Lead; Life; Malignant Neoplasms; Malignant neoplasm of prostate; Mediating; Medical; Monitor; Nature; Nerve; Nitric Oxide; Nurse Practitioners; Operative Surgical Procedures; Oral; Outcome; Pattern; Pharmaceutical Preparations; Pilot Projects; Quality of life; Radical Prostatectomy; Randomized; Recovery; Regrets; Rehabilitation therapy; Reporting; Research; Sex Functioning; Sexual Dysfunction; Sexual Health; Staging; Stress; Survival Rate; Survivors; Therapeutic Intervention; Tissues; Viagra; Work; anxiety treatment; arm; base; brief intervention; cancer diagnosis; cancer surgery; cancer therapy; cancer type; cost; depressive symptoms; design; erection; experience; follow-up; group intervention; healing; improved; innovation; intimate behavior; men; mindfulness; novel; programs; psychologic; psychosocial; public health relevance; satisfaction; self esteem; standard care; therapy design; vardenafil; willingness

 DESCRIPTION (provided by applicant) The Institute of Medicine highlights the distinct need to address sexual dysfunction in cancer survivors. Sexual dysfunction is especially prominent in prostate cancer. Prostate cancer is the most common cancer in men, with approximately 233,000 new cases diagnosed in 2014. A primary side effect of prostate cancer treatment is erectile dysfunction (ED), with as many as 85% of men reporting problems with erections. Men who have ED report significant frustration, increased depressive symptoms, and reduced general happiness with life. Surgery (radical prostatectomy) is a gold standard treatment for early stage prostate cancer, and the medical field has made important advances in treating ED following surgery. The current best practice is the concept of "erectile rehabilitation," which helps increase the chance of recovering erections following surgery. However, men have difficulty complying with these programs. Our data suggest that only 10% of men who receive proactive nurse practitioner phone calls are compliant with erectile rehabilitation. We developed a novel intervention designed to increase compliance with an erectile rehabilitation program. This intervention uses Acceptance and Commitment Therapy (ACT) and helps men focus on the long-term goals of rehabilitation, accept the frustration related to ED, identify and overcome barriers, and commit to an erectile rehabilitation program. In our pilot work, a greater percentage of men in the intervention group, compared to a nurse practitioner enhanced monitoring control, adhered to the erectile rehabilitation program (44% vs.10%, p = 0.02). We propose a larger, two arm, RCT to determine if increased compliance in the intervention leads to improved erectile function at 24 months following surgery. One hundred and fifty-five subjects will be randomized to each arm: Arm 1- Standard care plus the ACT intervention; Arm 2 - Standard care plus nurse practitioner enhanced monitoring and education (EME). We believe this intervention is innovative as it: 1) describes a conceptual framework for avoidance of rehabilitation and outlines how this leads to poor compliance, 2) shifts the primary treatment focus from increasing education to reducing avoidance, 3) applies ACT concepts to a sexual-based intervention, 4) integrates a psychological intervention into an erectile rehabilitation program, and 5) proactively focuses on rehabilitation, increasing the chance of recovery and reducing the negative quality-of-life issues related to ED.