Investigating intervention opportunities for prostate cancer patients and partner

描述（由申请人提供）：前列腺癌（PC）最近已超过肺癌，成为美国男性最常见的癌症。接受手术或放射治疗的PC男性经常会出现大小便失禁和勃起功能障碍，并且可能会伴随这些问题多年。因此，PC不仅会对患者产生负面影响，还会对其配偶/伴侣产生负面影响。随着癌症治疗越来越多地在门诊提供，大部分癌症护理负担已从医疗保健专业人员转移到非正式护理人员（例如，伴侣/配偶）。家庭照顾（CG）带来了心理社会成本，照顾者比非照顾者更有可能忽视自己的心理和身体健康需求。对癌症患者的家庭照顾者的研究表明，长期承担责任和癌症病程的不确定性可能导致照顾者痛苦增加。PC可以通过多种方式对患者和伴侣二人组产生负面影响，包括身体/性功能，社会功能和心理健康的变化。为帮助PC患者而开发和测试的心理社会干预措施相对较少;而那些经过评估的干预措施往往会最大限度地减少配偶的参与。虽然已经为癌症患者的家庭护理者开发了几种干预措施，但针对治疗相关症状（如恶心或疼痛）的癌症护理者干预措施在涉及性功能障碍和大小便失禁的局部PC体验中似乎不太相关。只有一个随机临床试验集中在PC配偶照顾者非常温和的结果。此外，越来越多的研究表明，PC配偶报告缺乏准备，在采取的替代作用，并有各种未满足的需求，值得额外的调查，以协助有效的干预设计和交付。拟议项目的主要研究者记录了为家庭照顾者制定干预措施的专业知识;然而，他希望将工作重点重新放在癌症行为研究上，重点是为PC配偶照顾者设计有效的干预措施。该应用程序使用了混合方法的方法和创新的模型，在文献中出现，探讨病人的痛苦和照顾者的同情心之间的关系，并实现该项目的目标。该项目收集和分析来自PC患者及其照顾者的定性和定量数据，代表3个不同的文化群体。研究结果将用于修改PC患者及其护理人员的现有干预措施或开发新的干预措施。关注患者痛苦和照顾者同情心的干预措施将为PC幸存者和CG合作伙伴的干预措施提供一个重要的新视角;而且，这些类型的计划可能对临床医生和政策制定者特别有用，因为它们可能会改善患者和照顾者的功能。前列腺癌（PC）是美国男性最常见的癌症，接受手术或放射治疗的PC患者通常会经历多年的尿失禁和肠失禁以及性功能障碍。因此，PC可能会对患者和他的未婚配偶/伴侣产生负面影响，因此，他们经常会经历大量的身体和情绪紧张。该项目进行形成性研究，以帮助制定干预措施，以改善PC夫妇的身体和心理功能。

DESCRIPTION (provided by applicant): Prostate cancer (PC) has recently surpassed lung cancer as the most common cancer of U.S. men. Men with PC who are treated with surgery or radiation therapy often experience urinary and bowel incontinence and erectile dysfunction, and are likely to live with these problems for years. As a result, PC can negatively impact not only the patient, but also his caregiving spouse/partner. As cancer treatment becomes increasingly provided on an outpatient basis, much of the cancer burden of care has shifted from health care professionals to informal caregivers (e.g., partners/spouses). Family caregiving (CG) carries psychosocial costs, with caregivers more likely than non-caregivers to ignore their own mental and physical health needs. Research with family caregivers of cancer patients suggest that chronic caregiving responsibilities and the uncertainties of cancer disease course can lead to increased caregiver distress. PC can have a negative impact on the patient and caregiving partner dyad in a number of ways including changes in physical/sexual functioning, social functioning and psychological well-being. Relatively few psychosocial interventions have been developed and tested to help PC patients; and those that have been evaluated tend to minimize spouse involvement. Although several interventions have been developed for family caregivers of cancer patients in general, cancer caregiver interventions that target treatment related symptoms like nausea or pain appear less relevant in the localized PC experience which involves sexual dysfunction and urinary and bowel incontinence. Only one randomized clinical trial has focused on PC spousal caregivers with very modest results. Moreover, growing research suggests that PC spouses report a lack of preparedness in taking on the caregiving role and have a variety of unmet needs that warrant additional investigation to assist in effective intervention design and delivery. The principal investigator of the proposed project has documented expertise in the development of interventions for family caregivers; however, he has a desire to refocus his work to behavioral research in cancer with an emphasis on the design of effective interventions for PC spousal caregivers. This application uses a mixed method approach and an innovative model of caregiving emerging in the literature to explore the relationship between patient suffering and caregiver compassion and to achieve the project's aims. The project collects and analyzes qualitative and quantitative data from PC patients and their caregivers representing 3 different cultural groups. Results will be used to modify existing or develop new interventions for PC patients and their caregivers. Interventions focusing on patient suffering and caregiver compassion would provide an important new perspective on interventions for PC survivors and CG partners; and, these types of programs may prove particularly useful to clinicians and policy makers, since they are likely to improve both patient and caregiver functioning. Prostate cancer (PC) is the most common cancer of U.S. men, and PC patients treated with surgery or radiation therapy often experience urinary and bowel incontinence and sexual dysfunction for years. Thus, PC can negatively impact both the patient and his caregiving spouse/partner who, as a result, often experiences substantial physical and emotional strain. This project conducts formative research to help develop interventions to improve the physical and psychosocial functioning of the PC couple.