Survivor QOL/Spouse Satisfaction after Prostate Therapy

这项研究的主要假设是，初级治疗或积极监测对结果的影响 前列腺癌患者和他们的伴侣报告的，包括生活质量和不确定性，是由 患者和治疗特征决定了患者和配偶对 总体癌症护理结果。我们对1826例前列腺癌患者进行了2年的随访。 患者和合作伙伴(队列1)，这是为解决第一个供资周期的目标而提出的。我们 确定了患者和患者治疗后HRQOL和结果满意度的基线决定因素 他们的搭档。我们进行了初步研究(在一个单独的横断面队列中 联盟网站)，这表明在未来5年的随访中，HRQOL预计会有进一步的变化 对于预期的多中心队列1参与者。我们收集了S健康内科医生的证据 研究表明，主动监测可能与某些前列腺HRQOL领域的益处有关，但 对其他领域的不利影响。我们开发并试行了一种干预措施，以减轻患者的不确定性 在主动监视期间。我们的初步调查结果支持以下具体目标： 1)评估原发性前列腺癌治疗对患者的长期影响-报道 并将这些结果与基线、治疗前患者特征、癌症严重程度和 治疗因素，并确定癌症复发和随后的抢救治疗对 患者及配偶或伴侣报告的HRQOL和对护理结果的满意度。 2)评估护理满意度、HRQOL和对不确定性或危险的感知的决定因素 在接受主动监视的受试者中。 3)测试主动监控的不确定性管理干预(UMI-AS)是否会减少 患者从积极监测到初级治疗的进展，并提高对癌症的满意度 患者及其配偶或伴侣之间的关怀。 第一个目标将通过对1201名患者和625名配偶的持续随访来实现 是在第一个供资周期内完成的。第二个和第三个目标将在新的队列中解决 (队列2)1080名正在接受积极监测或治疗的患者和540名将被累加的配偶 在新提议的供资期间。第三个目标将集中在一项随机研究，评估 咨询干预，特别是在队列2的积极监测子集中。完成 拟议的研究将使患者和他们的伴侣能够更好地预测早期前列腺癌的结果 癌症护理，并减少与癌症相关的不确定性和危险感知。通过这样做，我们的 调查结果将有助于根据每个人的独特特征进行适当的个性化决策 前列腺癌患者和他的伴侣。

The primary hypothesis of this study is that the effects of primary treatment or active surveillance on outcomes reported by prostate cancer patients and their partners, including quality of life and uncertainty, are modified by patient and treatment characteristics which consequently determine patient and spouse satisfaction with overall cancer care outcome. We have accrued and completed 2 year follow-up of 1826 prostate cancer patients and partners (Cohort 1) that had been proposed to address Aims of the first funding cycle. We identified baseline determinants of post-treatment HRQOL and Satisfaction with outcome among patients and their partners. We conducted preliminary studies (in a separate cross-sectional cohort at one of the consortium sites) which showed that further changes in HRQOL are anticipated in the next 5 years of follow-up for the prospective, multicenter Cohort 1 participants. We assembled evidence from the Physician¿s Health Study that Active Surveillance, may be associated with benefits in some prostate HRQOL domains but detriment in other domains. We developed and pilot-tested an intervention to mitigate patient uncertainty during Active Surveillance. Our preliminary findings support the following Specific Aims: 1) To measure the long-term consequences of primary prostate cancer treatment on patient-reported outcomes and to relate these to baseline, pretreatment patient characteristics, cancer severity and treatment factors and to determine the effects cancer recurrence and consequent salvage treatment on HRQOL and satisfaction with care outcome reported by patients and spouses or partners. 2) To evaluate the determinants of satisfaction with care, HRQOL, and perception of uncertainty or danger among subjects undergoing active surveillance. 3) To test whether the Uncertainty Management Intervention for Active Surveillance (UMI-AS) will reduce progression of patients from active surveillance to primary treatment, and improve satisfaction with cancer care among patients and their spouses or partners. The first Aim will be accomplished through continued follow-up of 1201 patients and 625 spouse partners that was assembled during the first cycle of funding. The second and third Aims will be addressed in a new cohort (Cohort 2) of 1080 patients undergoing active surveillance or treatment and 540 spouses that will be accrued during the newly proposed period of funding. The third Aim will focus on a randomized study evaluating the counseling intervention specifically among the active surveillance subset of Cohort 2. Completion of the proposed studies will better enable patients and their partners to anticipate outcomes of early stage prostate cancer care, and to reduce uncertainty and perception of danger related to the cancer. In so doing, our findings will facilitate appropriately individualizing decision making based on unique characteristics of each prostate cancer patient and his partner.