Intimacy-Enhancing Couples' Intervention for Localized Prostate Cancer

描述（由申请人提供）：局部前列腺癌的诊断和治疗会降低患者和伴侣的生活质量。我们的初步研究以及其他人的工作表明，夫妻之间的沟通和亲密关系在患者和伴侣的心理和关系功能中都起着重要作用。这些结果表明，通过改善夫妻沟通策略来增强亲密关系可能是心理干预的主要目标。我们开发了一种增强亲密关系的夫妻干预（IEC），并在一项小型随机临床试验中对其与常规护理对照（UC）进行了测试。IEC的主要目标是教授夫妻关系，提高沟通技巧，加强亲密关系。初步结果表明，IEC减少了患者和伴侣的痛苦，改善了沟通和亲密关系。拟议研究的目标是进行一项更大规模的试验，以评估IEC对注意力控制（一般健康和保健干预；GHW）的疗效，并评估治疗效果的调节因子和机制。469名确诊为局限性前列腺癌的男性及其伴侣将被随机分配到IEC、GHW或UC组。参与者将在干预前、基线后5周、12周和6个月完成调查。目的是：1)评估IEC与GHW和UCl对患者和伴侣心理和关系结果的影响。2)探讨婚姻关系长度、干预前的婚姻满意度和干预前男性的传统男子气概是否能调节IEC对夫妻心理和关系结局的影响。在结婚时间较长的患者和伴侣、患者和伴侣报告干预前婚姻满意度较低以及患者报告传统男子气概较高的情况下，信息、教育和教育将对患者和伴侣的心理和关系功能产生更大的影响；3)对比GHW和UC，评估IEC对夫妻沟通和亲密度的影响，确定关系沟通和亲密度的变化是否介导夫妻心理和关系结局的变化。

DESCRIPTION (provided by applicant): The diagnosis and treatment of localized prostate cancer can reduce the quality of life for both patient and partner. Our preliminary studies as well as the work of others suggest that couples' communication and intimacy play a role in the psychological and relationship functioning of both patient and partner. These results suggest that enhancing intimacy via improvements in the communication strategies couples utilize may be a prime target for psychological intervention. We have developed an Intimacy- Enhancing Couples' Intervention (IEC) and tested it against a Usual care control (UC) in a small randomized clinical trial. The primary goal of IEC is to teach couples relationship-enhancing communication skills and bolster relationship intimacy. Preliminary results suggested that IEC reduced patient and partner distress and improved communication and intimacy. The goal of the proposed study is to conduct a larger scale trial to evaluate IEC's efficacy against an attention control (a General Health and Wellness Intervention; GHW) and to evaluate moderators and mechanisms for the treatment's effects. 469 men diagnosed with localized prostate cancer and their partners will be randomly assigned to IEC, GHW, or UC. Participants will complete surveys pre-intervention, 5 weeks, 12 weeks, and six months post-baseline. The aims are: 1) To evaluate the impact of an IEC versus a GHW and UCl on patient and partner psychological and relationship outcomes. 2) To determine whether relationship length, pre-intervention marital satisfaction, and men's pre-intervention traditional masculinity moderate the effects of IEC on couples' psychological and relationship outcomes. IEC will have a stronger impact on patient and partner psychological and relationship functioning among patients and partners married a longer period of time, patients and partners reporting lower pre-intervention levels of marital satisfaction, and among patients reporting higher levels of traditional masculinity; 3) To evaluate whether IEC has an effect on couples' communication and intimacy when compared with GHW and UC, and to determine whether changes in relationship communication and intimacy mediate changes in couples' psychological and relationship outcomes. PUBLIC HEALTH RELEVANCE: Our prior research has indicated that relationship communication and intimacy are related to psychological distress and relationship satisfaction of men diagnosed with early stage prostate cancer and their partners. We have developed and conducted a pilot study to evaluate the efficacy of a new intimacy-enhancing couples' intervention for this population. In the proposed study, we seek to evaluate the intervention in a large randomized clinical trial, identify characteristics of patients and partners who may benefit the most from this intervention, and evaluate possible mechanisms of change