The effects of information and negative affect on severity of side effects from radiation therapy for prostate cancer Dyadic support and quality-of-life after radical prostatectomy. A randomized clinical trial of group-based cognitive-behavioral stress management in localized prostate cancer: Development of stress management skills improves quality of life and benefit finding Health-related quality of life and distress in cancer patients: results from a large randomised study Effects of complementary therapies on clinical outcomes in patients being treated with radiation therapy for prostate cancer Intervening to improve psychological outcomes for men with prostate cancer. Evaluation of an evidence-based education package for men with prostate cancer on hormonal manipulation therapy. Coping with radiation therapy: optimism and the effect of preparatory interventions. Helping patients with localized prostate carcinoma manage uncertainty and treatment side effects A randomised trial of two information packages distributed to new cancer patients before their initial appointment at a regional cancer centre. Facilitating research participation and improving quality of life for African American prostate cancer survivors and their intimate partners Cognitive behavioral stress management intervention improves quality of life in spanish monolingual hispanic men treated for localized prostate cancer: Results of a randomized controlled trial The Effectiveness of Psychosocial Interventions with Cancer Patients: An Integrative Review of the Literature (2006–2011) The Effects and Expense of Augmenting Usual Cancer Clinic Care With Telephone Problem-Solving Counseling A pilot investigation of a multidisciplinary quality of life intervention for men with biochemical recurrence of prostate cancer. Sleep management training for cancer patients with insomnia Commentary: controversies in NICE guidance on prostate cancer Preoperative biofeedback assisted behavioral training to decrease post-prostatectomy incontinence: a randomized, controlled trial. Written emotional disclosure buffers the effects of social constraints on distress among cancer patients. Individual psychological support for cancer patients: utilisation and patient satisfaction. The Impact of Dyadic Social Support on Self-Efficacy and Depression After Radical Prostatectomy Active for Life After Cancer: a randomized trial examining a lifestyle physical activity program for prostate cancer patients. No change in health behavior, BMI or self-rated health after a psychosocial cancer rehabilitation: Results of a randomized trial Moderators of the benefits of psychoeducational interventions for men with prostate cancer. “Between Men”: A psychosocial rehabilitation programme for men with prostate cancer Expressive Disclosure and Health Outcomes in a Prostate Cancer Population A randomised, wait-list controlled trial: evaluation of a cognitive-behavioural group intervention on psycho-sexual adjustment for men with localised prostate cancer. Randomized clinical trial of a family intervention for prostate cancer patients and their spouses Effect of different forms of information produced for cancer patients on their use of the information, social support, and anxiety: randomised trial Moderators of an Uncertainty Management Intervention: For Men With Localized Prostate Cancer The effects of a presurgical stress management intervention for men with prostate cancer undergoing radical prostatectomy. Telephone social support and education for adaptation to prostate cancer: a pilot study. Educating men about prostate cancer screening. A randomized trial of a mailed pamphlet. Impact of providing audiotapes of primary treatment consultations to men with prostate cancer: a multi-site, randomized, controlled trial. Reduced utilisation of specialist care among elderly cancer patients: a randomised study of a primary healthcare intervention. Uncertainty Intervention for Watchful Waiting in Prostate Cancer Patients' supportive care needs beyond the end of cancer treatment: a prospective, longitudinal survey. Improving quality of life in men with prostate cancer: a randomized controlled trial of group education interventions. Effects of home-based diet and exercise on functional outcomes among older, overweight long-term cancer survivors: RENEW: a randomized controlled trial. Managing uncertainty about treatment decision making in early stage prostate cancer: a randomized clinical trial. No improvement in distress and quality of life following psychosocial cancer rehabilitation. A randomised trial. The impact of an informational self-management intervention on the association between control and illness uncertainty before and psychological distress after radiotherapy. Intervention of Urinary Incontinence and Quality of Life Outcome in Prostate Cancer Patients Intimacy-enhancing psychological intervention for men diagnosed with prostate cancer and their partners: a pilot study. Improving the quality of life of patients with prostate carcinoma A brief self-administered psychological intervention to improve well-being in patients with cancer: results from a feasibility study. Comparing a Generic and Individualized Information Decision Support Intervention for Men Newly Diagnosed With Localized Prostate Cancer Psychoeducational group intervention for wives of men with prostate cancer. Electroacupuncture relieves pain in men with chronic prostatitis/chronic pelvic pain syndrome: three-arm randomized trial. Behavioral therapy with or without biofeedback and pelvic floor electrical stimulation for persistent postprostatectomy incontinence: a randomized controlled trial.
Abstract A r and omized clinical trial with 152 patients was conducted to examine the effects of an informational intervention on the severity of side effects result ing from  radiation therapy for prostate cancer . We also examined negative affect both as a predictor and as an outcome variable . The informational intervention , given to patients at the first and fifth treatments , was based upon self-regulation theory and provided patients with specific , objective information about what to expect during their radiation treatments . Patients in the comparison group received general information at the same point in time .  Negative affect was measured using the Profile of Mood States ( POMS ) prior to the intervention and at the last treatment . The severity of side effects for each individual was assessed at their last treatment . The results showed that patients in the informational intervention group reported significantly fewer problems with sleep and less fatigue ( marginally significant ) than those in the comparison group . Negative affect was not influenced by group assignment . Baseline negative affect was not related to symptom development , although the development of side effects was associated with an increase in negative mood . The results suggest that patients could benefit from increased knowledge about what to expect during their radiation treatments BACKGROUND : Treatment side effects after radical prostatectomy include urinary , sexual , and bowel dysfunction . These functional declines , coupled with the bother associated with these dysfunctions , lead to a complicated pattern of change in quality -of-life and decreased self-efficacy . METHODS : In this study , 72 men who underwent radical prostatectomy 6-weeks prior were r and omly assigned to usual health care control group or peer-to-peer support ( dyadic support ) group . The dyadic meetings were held once a week for 8 weeks . Measured pre- and post-test was general health-related quality -of-life ( SF-36 ) , prostate cancer-specific quality -of-life ( UCLA Prostate Cancer Index ) , and self-efficacy ( Stanford Inventory of Cancer Patient Adjustment ) . RESULTS : By 8 weeks , self-efficacy significantly improved for men in the experimental group , but not for men in the control group . A series of logistic regression analyses showed that the dyadic intervention significantly accounted for changes in physical role functioning , bowel function , mental health , and social function . Age , education , and self-efficacy had significant interaction effects and increased the effects of the dyadic intervention on several outcomes . CONCLUSIONS : The intervention had a significant impact on how men react socially and emotionally to the side effects of radical prostatectomy Background : Recent literature has indicated that a significant percentage of oncology patients describe finding some benefit ( e.g. , improved personal growth , sense of meaning , and enhanced interpersonal relationships ) in the cancer experience . However , few studies have investigated the role of group-based psychosocial interventions in improving benefit finding ( BF ) , and virtually none have investigated these constructs in men . Purpose : This study examined whether a cognitive-behavioral stress management ( CBSM ) intervention improves BF and quality of life ( QoL ) in men recovering from treatment for localized prostate cancer . Methods : Participants in this study were 191 men ( M age = 65.1 ) treated with radiation or radical prostatectomy for clinical ly localized ( i.e. , Stage I or II ) prostate cancer . Participants were primarily non-Hispanic White ( 40 % ) or Hispanic ( 41 % ) , followed by Black ( 18 % ) and other ethnicity ( 1 % ) , were an average of 65.1 years old ( SD = 7.7 ) , and earned an average of $ 47,800 annually ( SD = $ 41,000 ) . Participants were r and omized to either a 10-week group-based cognitive-behavioral stress management intervention or a half-day educational seminar as a control condition . All participants provided demographic information and completed the Positive Contributions Scale-Cancer to assess BF , the Functional Assessment of Cancer Therapy to measure quality of life , and a measure of perceived stress management skills . Structural equation modeling was utilized for all analyses . Results : Results indicated that the CBSM condition led to increases in BF and QoL and that these changes were mediated by the development of stress management skills . Conclusions : Results support the use of group-based cognitive-behavioral interventions in promoting QoL and BF in this population To compare the effectiveness of individual support , group rehabilitation and a combination of the two in improving health-related quality of life ( HRQOL ) and psychological well-being in cancer patients during 24 months after diagnosis , as compared with st and ard care ( SC ) . Furthermore , to compare the study sample and a r and om sample of the Swedish population with regard to HRQOL . A total of 481 consecutive patients , newly diagnosed with cancer , were r and omly assigned to one of the four alternatives . Data on HRQOL and psychological well-being were collected at baseline and after 3 , 6 , 12 and 24 months . The interventions did not improve HRQOL or psychological well-being , as compared with SC . At 3 months , the study sample reported an HRQOL comparable with the normal population . Many cancer patients are able to manage their cancer-related concerns with the support available from SC . However , it is reasonable to assume that the findings suffer from a lack of data from especially vulnerable patients and a possible Hawthorne effect . It can not be concluded that cancer patients have no need for additional psychosocial interventions . Future projects should include screening and target interventions for those at risk for significant and prolonged psychological distress This pilot r and omized controlled trial ( RCT ) examined the clinical effects of 2 complementary ( CAM ) therapies , relaxation response therapy ( RRT ) and Reiki therapy , in men being treated with external beam radiotherapy ( EBRx ) for prostate cancer BACKGROUND Prostate cancer is the most common cancer in men in the Western world with well-described negative effects from treatments . However , outcomes are highly heterogeneous . A Phase 3 trial of a psycho-educational intervention was undertaken , aim ing to reduce cancer-specific and decision-related distress and improve quality of life for men newly diagnosed with localised prostate cancer . METHODS Seven hundred forty ( 81.7 % ) men were recruited after diagnosis and before treatment and r and omised to a  tele-based nurse-delivered five-session psycho-educational intervention ( N = 372 ) or usual care ( N = 368 ) . Participants were assessed before treatment and 2 , 6 , 12 and 24 months post-treatment . Outcome measures included cancer-specific and decision-related distress , cognitive judgmental adjustment , subjective well-being , and domain-specific and health-related quality of life . Social support was assessed as a potential moderator . RESULTS No unconditioned effects were found . Classification analyses on pre-r and omisation measures distinguished three subgroups : younger , higher education and income men ( N = 90 ) ; younger , lower education and income men ( N = 106 ) ; and older men ( N = 344 ) . Younger , higher education and income men showed positive intervention effects for cancer-specific distress ( p = 0.008 ) and mental health ( p = 0.042 ) . By contrast , for younger , lower education men , participation in the intervention was associated with decreases in cognitive judgmental adjustment over time ( p = 0.006 ) . CONCLUSIONS Response to intervention and adjustment over time varied according to previous sexual functioning , age , educational level and income . How to best intervene with younger , low education , low income men with prostate cancer is a critical future research question Prostate cancer has become a public health problem worldwide with considerable social and economic consequences . Many men have extraprostatic spread at diagnosis , and treatment usually involves hormonal manipulation therapy  , which can challenge the stereotypical male image . It is often assumed that merely the provision of educational material for patients in an accessible form is sufficient to address informational needs . However , with the increasing emphasis on evidence -based practice , an essential element of the patient education process is evaluation of the impact of educational interventions . In this study , a r and omised controlled trial was used to evaluate the effect of an evidence -based education package on the knowledge of disease and treatment , quality of life , coping and satisfaction of a sample ( n=55 ) of men with prostate cancer on hormonal manipulation therapy in the UK . The men were r and omly assigned to experimental ( n=28 ) and control group ( n=27 ) . Established instruments with satisfactory reliability and validity were used to measure the dependent variables . The independent variable , namely the education package , had been developed following the results of a previous study , which assessed the informational needs of this client group . This package consisted of an information booklet supplemented by the verbal teaching of a urology nurse . Results demonstrated that delivery of the education package had a significant effect on knowledge , quality of life and satisfaction with care , but not on coping . This study has contributed to the evidence -base for practice in urological nursing . This education package should become a routine , and not merely incidental aspect of care for this client group To test the hypotheses that pessimists might benefit from concrete objective information based on self-regulation theory and that optimists might benefit from instruction in self-care and coping based on self-care theory , 62 patients receiving radiation therapy ( RT ) for prostate cancer were studied . The two experimental and control intervention messages were given three times during RT .  Mood and disruption of activities were assessed three times during and three times after RT . The self-care instruction had no effects on either outcome . The prediction from self-regulation theory was supported , in part , with concrete objective information having a positive effect on mood among pessimistic patients . Concrete objective information result ed in less recreation and pastime disruption in both optimistic and pessimistic patients at the times they experienced the most RT side effects The objective of this study was to test the efficacy of an  individualized uncertainty management intervention delivered by telephone to Caucasian and African‐American men with localized prostate carcinoma and directed at managing the uncertainties of their disease and treatment The purpose of this study was to evaluate the extent to which a new patient information package ( NPIP ) or a mini version of the same package ( mini-NPIP ) reduces emotional distress and meets the informational needs of patients arriving at a tertiary cancer centre for the first time . A comprehensive package , NPIP , consisting of procedural information regarding cancer centre location , description of the health care team , treatment services , research , educational activities , accommodation and community services provided at the centre ; and a condensed version of the same package , mini-NPIP , were developed . Consecutive patients with newly diagnosed breast , gynaecological , lung and prostate cancer , referred to the centre for the first time were prer and omised to receive NPIP , mini-NPIP or no information package . Patients r and omised to NPIP or mini-NPIP  were mailed the information package at least one week before their first appointment . On arrival at the centre , patients were administered the Brief Symptom Inventory ( BSI ) which measures psychological distress , and interviewed regarding preferences for information and acceptability of the information packages . Of 465 r and omised patients , 161 were excluded post-r and omisation and 304 completed the entire interview : 100 were r and omised to the NPIP , 102 to the  mini-NPIP  and 102 to the  control group .  Emotional distress as measured by the BSI was similar for all groups ( P = 0.98 ) . Most patients preferred to receive the information ( 98 % ) , receive it before the first appointment ( 84 % ) and by mail ( 79 % ) . These preferences were more evident for those given the information packages . The majority of patients found the information packages easy to underst and ( 88 % ) and useful ( 89 % ) , and no differences were detected between packages . The cost of production and dissemination of NPIP was more than double the cost for mini-NPIP : $ 8.93 vs $ 3.98 ( Canadian dollars ) per patient . For patients presenting to a cancer centre for the first time , packages of procedural information do not appear to reduce psychological distress , but are preferred by patients . Given the cost of producing NPIP , mini-NPIP is the preferred approach African American men experience worse prostate cancer outcomes compared with those of Caucasian men , not only in incidence and mortality rates , but also in coping with the side effects of treatment . Unfortunately , African American men have been significantly under‐represented in research evaluating the efficacy of psychosocial interventions for improving coping in prostate cancer survivors . This pilot study explored the feasibility and efficacy of coping skills training ( CST ) , an intervention developed to enhance coping with treatment side effects in a sample of African American prostate cancer survivors and their intimate partners . The intervention was delivered in a telephone‐based format design ed to facilitate research participation . A total of 40 couples were r and omized to either 6 sessions of CST or usual care . Survivors completed measures of disease‐specific quality of life ( QOL ) related to urinary , sexual , bowel , and hormonal symptom domains , as well as measures of global QOL ( i.e. , physical functioning and mental health ) . Partners completed measures of caregiver strain , mood , and vigor . Analysis of data from 30 couples ( 12 couples in CST , 18 couples in usual care ) indicated that CST produced moderate to large treatment effects for QOL related to bowel , urinary , sexual , and hormonal symptoms .  Partners who underwent CST  reported less caregiver strain , depression , and fatigue , and more vigor , with moderate effect sizes observed that approached conventional levels of statistical significance . These preliminary findings suggest that telephone‐based CST is a feasible approach that can successfully enhance coping inAfrican American prostate cancer survivors and their intimate partners . Cancer 2007 . © 2006 American Cancer Society Background : The efficacy of a group-based psychosocial intervention with ethnic minority health population s may depend on consideration for cultural factors that can interact with group processes . Purpose : The current study explored the efficacy of a 10-week group-based cognitive-behavioral stress management ( CBSM ) intervention that was linguistically and culturally adapted for use with Hispanic monolingual men recently treated for localized prostate carcinoma ( PC ) . Methods : 71 Hispanic monolingual Spanish speakers were r and omly assigned to a 10-week CBSM intervention or a half-day stress management seminar ( control condition ) . Hierarchical regression was used to predict post-intervention QoL. Results : After controlling for relevant covariates , assignment to the CBSM condition significantly predicted greater physical well-being , emotional well-being , sexual functioning , and total well-being after the 10-week intervention period . Conclusions : Results suggest that participation in a culturally and linguistically adapted CBSM group intervention improved QoL in Hispanic monolingual men treated for localized PC Background . Previous integrative literature review s and meta-analyses have yielded conflicting results regarding the effectiveness of  psychosocial interventions for cancer patients . Methods . An integrative review of the literature focused on 19 r and omized , controlled trials ( 2006–2011 ) was completed to examine the effectiveness of psychosocial interventions for cancer patients . Eligibility criteria : Inclusion criteria were the study was an English language r and omized controlled clinical trial . Results . Seven studies involved nurses . Eleven studies result ed in positive outcomes . Overall , study quality was limited . In eight studies the intervention was not adequately described , 7 studies did not contain a hypothesis , 4 did not include clear eligibility criteria , 10 studies did not r and omize appropriately , 9 did not list recruitment date s , 11 did not include a power analysis , 14 did not include blinded patients or data collectors , 11 did not use an intent-to-treat analysis , 10 did not clarify reasons for drop outs , and 11 did not discuss treatment fidelity . Conclusions . Future studies should build on previous findings , use comparable outcome measures , and adhere to st and ards of quality research . Qualitative studies are needed to determine what cancer patients of varied ages , cancer stages , and racial/ethnic background s believe would be an effective intervention to manage their psychosocial needs This study was done to assess the effectiveness and efficiency of individualized , problem-solving counseling provided by baccalaureate nurses over the telephone to prevent the onset of depression in persons with breast , lung , or prostate cancer . Of 175 persons r and omized , 149 completed the 8-month follow-up . The primary outcome measures were changes in the Jalowiec Coping Scale , the Centre for Epidemiologic Studies in Depression Scale , and the Derogotis Psychosocial Adjustment to Illness Scale . In addition , expenditures for people 's use of all health and social services were computed at baseline and follow-up . Telephone counseling improved the use of more favorable coping behaviors , prevented a clinical ly important but not statistically significant decline into depression , and poor psychosocial adjustment in a group of people with mixed cancer . These results were associated with a greater total per person per annum expenditure for use of all other health and social services in the community compared with the control group . In a situation of limited re sources and a service producing more effect for more costs , one needs either to examine what services to forgo to offer this service or to carefully target the new service to those most likely to benefit OBJECTIVE This pilot project evaluated the acceptability and estimated the effect size of a tailored multidisciplinary quality of life ( MQOL ) intervention for men who have biochemical recurrence of prostate cancer . METHODS Participants included 57 men with localized prostate cancer with biochemical recurrence ( Median=76 years ; 89 % White ) . Participants were r and omized to wait list control  which offered the intervention upon conclusion of the study ( n=27 ) or to an eight-session group-based , MQOL ( n=30 ) intervention . Assessment s were completed at baseline , end of treatment , and 6 months post-treatment . RESULTS MQOL was acceptable as indicated by favorable participant retention ( 100 % retained ) , treatment compliance ( 97 % attended > 6 treatment sessions ) , and high ratings of helpfulness ( 80 % rated helpfulness > 4 on 5-point scale ) . MQOL had a favorable impact on the mental health composite score of the Short Form-36 at the end of treatment but not at 6 months ( effect size=0.52 and -0.04 ) ; health-related QOL as measured by the Functional Assessment of Cancer Therapy-Prostate at the end of treatment and 6 months ( effect size=0.14 and 0.10 ) ; and prostate cancer specific anxiety as measured by the Memorial Anxiety Scale for Prostate Cancer at the end of treatment and 6 months ( effect size=0.45 and 0.23 ) . CONCLUSIONS This pilot project provides preliminary data supporting the premise that a tailored behaviorally based MQOL intervention for men with biochemical recurrence of prostate cancer is acceptable to men and might reduce prostate cancer specific anxiety and enhance QOL . Further research examining the efficacy of this intervention in a larger r and omized trial is warranted Insomnia is a common phenomenon in cancer patients ; nevertheless , there are only a few intervention results published covering this topic . We examined the effects of a multi-modal psychological sleep management programme combining relaxation techniques , sleep hygiene , cognitive techniques and advice in stimulus control technique on various sleep and quality -of-life variables . We compared two intervention groups up to 6 months after treatment , one with progressive muscle relaxation ( n=80 ) , the other with autogenic training ( n=71 ) . A control group ( n=78 ) received only a st and ard rehabilitation programme . It was a heterogeneous sample of adult patients ( mean age 58 years ) predominantly with breast , kidney or prostate cancer staying for 3 or 4 weeks in an oncological rehabilitation clinic . In comparison to the control group , the analysis of variance for repeated measures ( R-MANOVA ) showed significant improvements over time , indicating that intervention group participants benefited with moderate- or large-scale effects on sleep latency ( p<0.001 ) , sleep duration ( p<0.001 ) , sleep efficiency ( p<0.001 ) , sleep quality ( p<0.001 ) , sleep medication ( p<0.05 ) and daytime dysfunction ( p<0.05 ) . In quality -of-life subscales , there was mainly improvement over time . This may indicate a benefit of the rehabilitation treatment in general . No evidence was found for any differences between the two intervention groups . The results suggest that the use of a multi-modal psychological sleep intervention could enhance various sleep parameters and well being of patients . The efficacy on quality of life is still under review The NICE guidelines on prostate cancer provide comprehensive advice on best practice for diagnosis and treatment of  prostate cancer .  They are based on systematic review s of the evidence , incorporate multidisciplinary opinions , and try to balance the values of healthcare providers and patients for various outcomes while emphasising a patient centred approach . Their conclusions are generally consistent with other review s and guidelines evaluating similar evidence .1 2 3 4 5 If followed , these recommendations will likely improve prostate cancer outcomes while reducing unnecessary , ineffective , harmful , and costly care . Although NICE ’s recommendations are generally appropriate , any guidelines on prostate cancer are going to be hampered by the lack of high quality information available . The paucity of r and omised trials limits the quality of data used for informed decision making , particularly regarding detection and treatment of localised disease . Even where r and omised trials have shown benefits , the absolute magnitude of benefit is generally small , requires many years to accrue , and must be weighed against accompanying harms and costs . Few studies enrolled men with disease that had been detected as a result of measuring the level of prostate specific antigen ( PSA ) or were adequately powered to assess  survival outcomes . Individual patients and providers may place different values on a particular outcome or have clinical and tumour characteristics that have not been adequately assessed by the trials providing the evidence used for drafting PURPOSE We tested the effectiveness of preoperative biofeedback assisted behavioral training for decreasing the duration and severity of incontinence , and improving quality of life in the 6 months following radical prostatectomy . MATERIAL S AND METHODS We performed a prospect i ve , r and omized , controlled trial comparing preoperative behavioral training to usual care . The volunteer sample included 125 men 53 to 68 years old who elected radical prostatectomy for prostate cancer . Patients were stratified according to age and tumor differentiation , and r and omized to 1 preoperative session of biofeedback assisted behavioral training plus daily home exercise or a usual care control condition , consisting of simple postoperative instructions to interrupt the urinary stream . The main outcome measurements were duration of incontinence ( time to continence ) , as derived from bladder diaries , incontinence severity ( the proportion with severe/continual leakage ) , pad use , Incontinence Impact Question naire , psychological distress ( Hopkins Symptom Checklist ) and health related quality of life ( Medical Outcomes Study Short Form Health Survey ) . RESULTS Preoperative behavioral training significantly decreased time to continence ( p = 0.03 ) and the proportion of patients with severe/continual leakage at the 6-month end point ( 5.9 % vs 19.6 % , p = 0.04 ) . There were also significant differences between the groups for self-reported urine loss with coughing ( 22.0 % vs 51.1 % , p = 0.003 ) , sneezing ( 26.0 % vs 48.9 % , p = 0.02 ) and getting up from lying down ( 14.0 % vs 31.9 % , p = 0.04 ) . No differences were found on return to work and usual activities or quality of life measures . CONCLUSIONS Preoperative behavioral training can hasten the recovery of urine control and decrease the severity of incontinence following radical prostatectomy The aims of the present study were to examine whether written emotional disclosure would reduce distress among cancer patients and whether it would buffer the effects of high levels of social constraint ( negative social responses to patients ' expressions of emotion regarding their cancer ) on distress . Cancer patients ( N=104 ) were r and omly assigned to write about their emotions regarding their cancer 20 min a day for 3 days or to write about a nonemotional topic . They completed question naires at baseline and 6 months postintervention . Results showed that written disclosure buffered the effects of social constraints on stress at the 6-month follow-up and that avoidance partly mediated these effects . The present data reinforce the notion that interventions should be tailored to patients ' needs A short-term , problem-focused Individual Psychological Support ( IPS ) intervention was evaluated . The IPS was one of the interventions in a study where 527 patients newly diagnosed with breast , colorectal , gastric or prostate cancer were r and omised between IPS ( n = 265 ) and a  control condition  ( n = 262 ) . The IPS made use of cognitive-behavioural techniques and aim ed at reducing depression and anxiety , to increase the feeling of mastery of the situation and to facilitate active participation in medical treatments . Half of the patients receiving the IPS had more than 2 sessions . After termination of the IPS , the patients were mailed a question naire concerning satisfaction with and perceived benefit from the IPS . A majority of the responding patients stated that their problems were addressed to a great extent , that the number of contacts was adequate and that the IPS came at the right time . Patients reporting problems received more sessions and perceived more benefits than patients reporting no problems Objectives : To assess the effect of one-on-one peer support at enhancing self-efficacy and decreasing depression in older men treated by radical prostatectomy for prostate cancer . Methods : Six weeks after surgery , 72 men ( M age = 60 ) were r and omly assigned to a treatment ( n = 37 ) or control group ( n = 35 ) . Treatment group participants were paired to form dyads with a trained support partner who had similar treatment and related side effects ; control group participants received usual health care . Dyads met 8 times over 8 weeks to discuss concerns and coping strategies . Results : At posttest , the treatment group had significantly higher self-efficacy than the controls ( M = 328.89 and M = 304.54 , respectively ) and significantly less depression ( M = 0.92 and M = 2.49 , respectively ) . Depression outcomes remained significant when controlling baseline self-efficacy and social support ( F = 4.845 , p = .032 ) . Discussion : Findings confirm pilot study results and are theoretically consistent with the self-efficacy enhancing nature of vicarious experience described by B and ura in self-efficacy theory BACKGROUND Active for Life After Cancer is a r and omized trial evaluating the efficacy of a 6-month group-based lifestyle physical activity program ( Lifestyle ) for prostate cancer patients to improve quality of life ( QOL ) including physical and emotional functioning compared to a group-based Educational Support Program and a St and ard Care Program ( no group ) . METHOD A total of 134 prostate cancer patients receiving continuous and rogen-ablation were r and omly assigned to one of the three study conditions . RESULTS Results indicated no significant improvements in QOL at 6 or 12 months . Both group-based programs were positively received and yielded good attendance and retention . Lifestyle participants demonstrated significant improvements in most theoretical mediators proposed by the Transtheoretical Model and Social Cognitive Theory to affect physical activity . Despite these improvements , no significant changes were found for most physical activity measures . CONCLUSIONS Results suggest a lifestyle program focusing on cognitive-behavioral skills training alone is insufficient for promoting routine physical activity in these patients Abstract Introduction . The aim of cancer rehabilitation is to enable patients to attain and maintain optimal physical , psychological and social functioning . We evaluated the effect on health behavior , BMI and self-rated health of a residential psychosocial rehabilitation course for cancer patients . Material and methods . Patients with a primary cancer of the breast , prostate , colon or rectum were r and omized to either a six-day multi-focus psychosocial residential rehabilitation intervention that included lectures , discussion s and peer group discussion s on issues related to treatment and life with cancer or to usual care . The end points were changes in smoking , alcohol consumption , physical activity , body mass index and self-rated health between baseline and follow-up after one and six months . The primary analyses included all participants who received their allocated condition . The two follow-up times were analyzed separately in general linear and logistic regression models for continuous and dichotomous outcomes , respectively . The analyses were adjusted for baseline outcome score , cancer site , time since diagnosis , age and education . Results . Of the 507 participants who were r and omly assigned , 452 were included in the analysis , of whom 404 completed the one month and 394 completed the six month assessment . The intervention group showed slightly more positive changes in health behavior , BMI and self-rated health than the usual care group , but the differences between the groups were small and not significant . Discussion . Participation in a six-day cancer rehabilitation course did not significantly influence health behavior , BMI or self-rated health among cancer patients The authors examined whether 3 individual difference variables -- self-esteem , self-efficacy , and depressive symptoms -- interacted with psychoeducational group interventions for men with prostate cancer ( n = 250 ) to predict general and prostate-specific quality of life . Men with nonmetastatic prostate cancer were r and omly assigned to an education intervention , an education plus group discussion intervention , or usual care and followed for 12 months . Eight groups of 10 to 12 men were convened in each condition . Men who began the study with lower self-esteem , lower prostate-specific self-efficacy , and higher depressive symptoms benefited the most from the interventions . Of these 3 moderator variables , the most consistent results emerged for self-esteem . That is , the benefits of the intervention were strongest for men with low self-esteem The aim of this study was to evaluate the effect of  psychosocial rehabilitation  on newly diagnosed prostate cancer patients . The “ Between Men ” programme consisted of seven weekly sessions of physical training ( Phys ) alone , information ( Info ) alone or physical training plus information ( PhysInfo ) .  After diagnoses , patients ( n = 211 ) were consecutively included , stratified and r and omised to one of four groups : Phys , Info , PhysInfo or st and ard care control ( C ) . A nurse specialised in urology , an urologist and a physiotherapist performed the interventions . Patients were followed up during one year with mailed st and ardised question naires . It could not be assumed that the “ Between Men ” programme had any effect on patients ’ anxiety and depression ( HADS ) . Health-related quality of life ( HRQOL ) was associated with stage of disease but not with psychosocial intervention . Thus , Physical Function ( PF ) , Role Function ( RF ) and Fatigue ( FA ) were inferior among patients with , than without , metastases of prostate cancer both at baseline and at the 12-month follow-up . This r and omized study did not demonstrate any significant effect of psychosocial rehabilitation  among prostate cancer patients . Considering the low rate ( 1/2 ) , of included/eligible patients a less complicated design ( intervention versus control ) would have been preferred in order to increase power Objective : This pilot study explored the feasibility and the efficacy of a brief , well-defined psychosocial intervention ( expressive disclosure ) in improving behavioral , medical , immunological , and emotional health outcomes in men with diagnosed prostate cancer . Method : Thirty prostate cancer patients receiving outpatient oncology care were r and omized into  experimental ( disclosure ) and control ( non-disclosure ) groups . All had been previously treated by surgery or radiation within the last 4 years and were being monitored without further intervention for change in PSA levels .  Psychological and physical health surveys were administered and peripheral blood for PSA levels and immune assays was obtained upon study enrollment and again at 3 and 6 months post enrollment . Multivariate analyses were used to examine how the expressive disclosure impacted the hypothesized domains of functioning : physical and psychological symptoms ; health care utilization ; and immunocompetence . Results : Compared to controls , patients in the expressive disclosure condition showed improvements in the domains of physical symptoms and health care utilization , but not in psychological variables nor in disease relevant aspects of immunocompetence . Conclusions : Study results support the feasibility of an expressive disclosure intervention for men with prostate cancer . The intervention was well accepted by this population , and participation/adherence was quite high . Results provide only limited support for the hypothesis that a written emotional disclosure task can positively impact health outcomes in a cancer population . However , this pilot study may have lacked adequate power to detect possible intervention benefits . Further studies with larger sample s are needed to better assess the intervention 's impact on psychological well-being and immunocompetence OBJECTIVE To examine the effectiveness of a cognitive-behavioural therapy ( CBT ) group intervention to facilitate improved psycho-sexual adjustment to treatment side effects in prostate cancer survivors post-radical prostatectomy . METHODS A r and omised , wait-list controlled trial was conducted with a total of 60 men who participated in a manualised 8-week cognitive-behavioural group intervention 6 months to 5 years post-radical prostatectomy for localised prostate cancer . Participants completed st and ardised question naires pre-intervention and post-intervention , which assessed mood state , stress , general and prostate cancer anxiety , quality of life and areas of sexual functioning . RESULTS Paired sample s t-tests identified a significant improvement in sexual confidence , masculine self-esteem , sexual drive/relationship and a significant decline in sexual behaviour from pre-intervention to post-intervention . Hierarchical regression analyses revealed that after controlling for covariates , participation in the group intervention significantly improved sexual confidence , sexual intimacy , masculine self-esteem and satisfaction with orgasm . CONCLUSIONS This group-based CBT intervention for men post-radical prostatectomy for localised prostate cancer shows promising results in terms of improving quality of life Few intervention studies have been conducted to help couples manage the effects of prostate cancer and maintain their quality of life . The objective of this study was to determine whether a family‐based intervention could improve appraisal variables ( appraisal of illness or caregiving , uncertainty , hopelessness ) , coping re sources ( coping strategies , self‐efficacy , communication ) , symptom distress , and quality of life in men with prostate cancer and their spouses Abstract Objective To explore the hypothesis that different methods of selecting and printing information for cancer patients could improve emotional support by affecting interaction with others , and so lead to improved psychological wellbeing . Design R and omised trial with eight groups ( three factors , 2′2′2 ) . Data collected at recruitment and three month follow-up . Participants 400 patients starting radiotherapy , of whom 325 with breast or prostate cancer and complete anxiety and depression data were included in the analysis . Interventions Printed booklets : half had only general information from CancerBACUP about each patient 's cancer and half had personalised information from the patient 's medical record plus selected general information ; half were composed of information chosen interactively by the patient and half were produced automatically with a larger volume of material ; and half had additional advice on anxiety management and half did not . Main outcome measures Patients ' views of the information , use of their booklets with others ; change in reported social support ; change in anxiety and depression . Results The larger booklets produced automatically were more likely to be found useful and to tell patients something new and less likely to be seen as too limited than the booklets produced interactively , but they were also more likely to overwhelm some patients . Personalised booklets were more likely than general booklets to tell patients something new . There was no difference in patients ' perceived underst and ing of their cancer by any of the intervention factors . Patients with personalised information were more likely to show their booklets to others and to think it helped in discussing their cancer or its treatment . There were no major differences in social support , anxiety , or depression by any intervention factors . Conclusions Patients were more likely to show personalised information to their confidants than general information . Further research is needed into the effects of sharing information on patients ' social support and anxiety . Trial registration US Government Clinical Trials Data base Background The effectiveness of psycho-educational interventions for cancer patients is well documented , but less is known about moderating characteristics that determine which subgroups of patients are most likely to benefit . Objectives The aim of this study was to determine whether certain individual characteristics of African-American and White men with localized prostate cancer moderated the effects of a psycho-educational Uncertainty Management Intervention on the outcomes of cancer knowledge and patient-provider communication . Methods Men were blocked by ethnicity and r and omly assigned to one of three conditions : Uncertainty Management Intervention provided to the patient only , Uncertainty Management Intervention supplemented by delivery to the patient and family member , or usual care . The individual characteristics explored were education , sources for information , and intrinsic and extrinsic religiosity . Results Using repeated measures multivariate analysis of variance , findings indicated that there were no significant moderator effects for intrinsic religiosity on any of the outcomes . Lower level of education was a significant moderator for improvement in cancer knowledge . For the outcome of patient-provider communication , fewer sources for cancer information was a significant moderator for the amount told the patient by the nurse and other staff . Less extrinsic religiosity was a significant moderator for three areas of patient provider communication . The three areas are the amount ( a ) the physician tells the patient ; ( b ) the patient helps with planning treatment ; and ( c ) the patient tells the physician . Conclusions Testing for moderator effects provides important information regarding beneficiaries of interventions . In the current study , men ’s levels of education , amount of sources for information , and extrinsic religiosity influenced the efficacy of the Uncertainty Management Intervention on important outcomes PURPOSE This study assessed the short-term and long-term efficacy of a presurgical stress management intervention at reducing mood disturbance and improving quality of life ( QOL ) in men undergoing radical prostatectomy ( RP ) for prostate cancer . PATIENTS AND METHODS One hundred fifty-nine men were r and omly assigned to a two-session ( plus two boosters ) presurgical stress management intervention ( SM ) , a two-session ( plus two boosters ) supportive attention group ( SA ) , or a st and ard care group ( SC ) . Assessment s occurred 1 month before surgery ; 1 week before surgery ; the morning of surgery ; 6 weeks after surgery , and 6 and 12 months after surgery . Results Results indicated significant group differences in mood disturbance before surgery ( P = .02 ) , such that men in the SM group had significantly less mood disturbance than men in the SC group ( P = .006 ) , with no significant differences between the SM and SA or SA and SC groups . In the year after surgery , there were significant group differences on Medical Outcomes Study 36-item short form survey ( SF-36 ) physical component summary ( PCS ) scores ( P = .004 ) ; men in the SM group had significantly higher PCS scores than men in the SC group ( P = .0009 ) , and there were no significant differences between the SM and SA or SA and SC groups . There were no group effects on prostate-specific QOL or SF-36 mental health scores . CONCLUSION These findings demonstrate the efficacy of a brief presurgical stress management intervention in improving some short-term and long-term outcomes . If these results are replicated , it may be a useful adjunct to st and ard care for men with prostate cancer undergoing surgery PURPOSE / OBJECTIVES To evaluate the feasibility of an intervention of telephone social support and education to increase the physical , emotional , functional , and interpersonal adaptation of men to prostate cancer . DESIGN Prospect i ve , r and om assignment to experimental or control treatments . SETTING Urban New Jersey . SAMPLE 17 men diagnosed with prostate cancer within four weeks of study entry . Mean age was 66 years ( range = 51 - 78 ) ; 59 % were Caucasian , 35 % were African American , and 6 % were American Indian . METHODS Subjects in the experimental group received telephone social support over a 12-month period in addition to education via mailed re source kits . The control group received education through mailed re source kits only . The Functional Assessment of Cancer Therapy Scale-General Physical , Emotional , Functional , and Social/Family Well-Being subscales ; Symptom Experience Scale-Prostate ; and the Relationship Change Scale were administered initially and at the end of each of the three phases ; the International Index of Erectile Function Scale was administered at the end of each of the three phases . Qualitative information was gathered throughout and at the conclusion of the study . MAIN RESEARCH VARIABLES Physiologic , emotional , functional , and social adaptation to prostate cancer . FINDINGS Results were somewhat more favorable for the experimental group on all outcome measures ; however , differences were not statistically significant . Structured interviews with 14 of 17 subjects revealed that  telephone social support and education  were effective in increasing adaptation to prostate cancer . CONCLUSIONS Despite the lack of a significant difference between the experimental and treatment groups in this small sample of men , analysis of trends and interview feedback indicated that telephone social support , in addition to education through a mailed re source kit , has the potential to be beneficial by increasing access to supportive services . IMPLICATION S FOR NURSING Telephone social support when supplementing patient education may assist men in adapting during the year following a prostate cancer diagnosis CONTEXT Although evidence -based guidelines recommend that physicians inform men about prostate cancer screening , the most efficient way to do this is not known . OBJECTIVE To evaluate whether a mailed educational pamphlet affected men 's knowledge about early detection of prostate cancer . DESIGN R and omized , controlled trial . SETTING Primary care clinic of the Minneapolis VA Medical Center . PATIENTS 342 men at least 50 years of age who responded to a mailed survey ( overall response rate , 68 % ) and did not report a history of prostate cancer . INTERVENTION " Early Prostate Cancer " pamphlet mailed to patients in the intervention group 1 week before their scheduled clinic appointments . OUTCOME MEASURES Patients ' responses to a survey mailed 1 week after their clinic appointments ; prostate-specific antigen ( PSA ) testing determined from electronic medical records . RESULTS Respondents were predominantly elderly white men ( mean age , 71 years ; 90 % white ) with chronic illnesses ( 48 % described their health as " fair " or " poor " ) . Men who received the educational pamphlet were better informed than men in the usual care group , as measured by correct responses to the following three questions about prostate cancer screening : the natural history of prostate cancer ( 32 % vs. 24 % ; P = 0.10 ) , whether treatment lengthens lives of men with early prostate cancer ( 56 % vs. 44 % ; P = 0.04 ) , and accuracy of PSA testing ( 46 % vs. 27 % ; P < 0.008 ) . The overall proportion of correctly answered questions was greater in the intervention group ( 45 % vs. 32 % ; P < 0.001 ) . Testing for PSA in the year after the index clinic appointments did not differ significantly between the intervention group and the usual care group ( 31 % vs. 37 % ; P > 0.2 ) . CONCLUSIONS Male veterans are poorly informed about the potential benefits and risks of prostate cancer screening . Although our mailed educational pamphlet enhanced knowledge only modestly , it was an inexpensive and easily implemented intervention BACKGROUND The purpose of this investigation was to systematic ally examine the efficacy of providing men with prostate cancer with an audiotape of their primary treatment consultation . METHOD Participants included 425 men newly diagnosed with prostate cancer and 15 radiation oncologists from 4 cancer centers in Canada . Patients were block r and omized to one of four consultation groups : 1 . St and ard care control -- not audio-taped ; 2 . Audio-taped -- no audiotape given ; 3 . Audio-taped -- patient given audiotape ; and 4 . Audio-taped -- patient offered choice of receiving audiotape or not ( 4 patients declined ; 94 accepted ) . Patient outcomes were measured at 12 weeks post-consultation : perceived degree of information provision ; audiotape satisfaction and use ; communication satisfaction with oncologist ; mood state ; and cancer-specific quality of life . RESULTS Patients receiving the consultation audiotape reported having been provided with significantly more disease and treatment information in general ( p=0.04 ) , and more information about treatment alternatives ( p=0.04 ) and treatment side effects ( p=0.01 ) in particular , than patients who did not receive the audiotape . Audiotape benefit was not significantly related to patient satisfaction with communication , mood state or quality of life at 12 weeks post-consultation , and was not significantly affected by choice of receiving the audiotape . Patients rated the audiotape intervention positively , with an average score of 83.0 out of 100 . CONCLUSION Consultation audiotapes are rated highly by men with prostate cancer , and these audiotapes help to enhance their perception of having been provided with critical disease- and treatment-related information The aim of this study was to evaluate the effect of an individual support ( IS ) intervention including intensified primary healthcare on the utilisation of specialist care among cancer patients , and to investigate if such an effect was modified by the patient 's age ( less than 70 years or 70 years and more ) . Newly diagnosed cancer patients ( n=416 ) were r and omised between the intervention and a control condition  , and data were collected on the utilisation of specialist care within 3 months from inclusion . Intensified primary healthcare comprised extended information from the specialist clinics , and education and supervision in cancer care for general practitioners ( GPs ) and home-care nurses . The support given also included interventions design ed to diminish problems of weight loss and psychological distress . The intervention reduced the number of admissions ( NoA ) and the days of hospitalisation ( DoH ) after adjustment for weight loss and psychological distress , but only for older patients . Older patients r and omised to the intervention ( n=82 ) experienced 393 fewer DoH than the older control patients ( n=79 ) . In addition , the proportion of older patients in the IS group who utilised acute specialist care was smaller compared with older control patients group . The conclusion is that older cancer patients '  utilisation of specialist care may be reduced by intensified primary healthcare services Watchful waiting is a reasonable alternative to treatment for some older men with localized prostate cancer , but it inevitably brings uncertainty . This study tested the effectiveness of the watchful waiting intervention ( WWI ) in helping men cognitively reframe and manage the uncertainty of watchful waiting . Based on Mishel 's Reconceptualized Uncertainty in Illness Theory ( Image . 1990 ; 256–262 ) , the WWI was tested with a convenience sample of 41 men . Experimental subjects received 5 weekly intervention calls from a nurse . Control subjects received usual care . Outcomes were new view of life , mood state , quality of life , and cognitive reframing . Repeated measures of analysis of variance were used to test the effectiveness of the WWI . The sample was 86 % Caucasian and 14 % African American , with an average age of 75.4 years . Intervention subjects were significantly more likely than controls to view their lives in a new light ( P = .02 ) and experience a decrease in confusion ( P = .04 ) following the intervention . Additionally , intervention subjects reported greater improvement in their quality of life than did controls ( P = .01 ) and believed their quality of life in the future would be better than did controls ( P = .01 ) . This study 's findings document the benefits of the WWI for patients living with uncertainty PURPOSE To estimate prevalence and severity of patients ' self-perceived supportive care needs in the immediate post-treatment phase and identify predictors of unmet need . PATIENTS AND METHODS A multicenter , prospect i ve , longitudinal survey was conducted . Sixty-six centers recruited patients for 12 weeks . Patients receiving treatment for the following cancers were recruited : breast , prostate , colorectal , and gynecologic cancer and non-Hodgkin 's lymphoma . Measures of supportive care needs , anxiety and depression , fear of recurrence , and positive and negative affect were completed at the end of treatment ( T0 ) and 6 months later ( T1 ) . RESULTS Of 1,850 patients given question naire packs , 1,425 ( 79 % ) returned question naires at T0 , and 1,152 ( 62 % ) returned question naires at T1 . Mean age was 61 years ; and most respondents were female ( 69 % ) and had breast cancer ( 57 % ) . Most patients had no or few moderate or severe unmet supportive care needs . However , 30 % reported more than five unmet needs at baseline , and for 60 % of these patients , the situation did not improve . At both assessment s , the most frequently endorsed unmet needs were psychological needs and fear of recurrence . Logistic regression revealed several statistically significant predictors of unmet need , including receipt of hormone treatment , negative affect , and experiencing an unrelated significant event between assessment s. CONCLUSION Most patients do not express unmet needs for supportive care after treatment . Thirty percent reported more than five moderate or severe unmet needs at both assessment s. Unmet needs were predicted by hormone treatment , negative mood , and experiencing a significant event . Our results suggest that there is a proportion of survivors with unmet needs who might benefit from the targeted application of psychosocial re sources Men who were recently treated for prostate cancer ( N=250 ) were r and omly assigned to a control group , a group education intervention ( GE ) , or a group education-plus- discussion intervention ( GED ) . Both GE and GED  increased prostate cancer knowledge . In the year postintervention , men in the GED condition were less bothered by sexual problems than men in the control condition , and they were more likely to remain steadily employed ( 93.0 % ) than men in the GE ( 75.6 % ) or control ( 72.5 % ) conditions . Among noncollege graduates , GED and GE result ed in better physical functioning than the control condition , and GED result ed in more positive health behaviors than the control or GE condition . Among college graduates , controls were comparable with the GE and GED groups in physical functioning and positive health behaviors CONTEXT Five-year survival rates for early stage colorectal , breast , and prostate cancer currently exceed 90 % and are increasing . Cancer survivors are at greater risk for second malignancies , other comorbidities , and accelerated functional decline . Lifestyle interventions may provide benefit , but it is unknown whether long-term cancer survivors can modify their lifestyle behaviors sufficiently to improve functional status . OBJECTIVE To determine whether a telephone counseling and mailed print material -based diet and exercise intervention is effective in reorienting functional decline in older , overweight cancer survivors . DESIGN , SETTING , AND PARTICIPANTS R and omized controlled trial of 641 overweight ( body mass index > or = 25 and < 40 ) , long-term ( > or = 5 years ) survivors ( aged 65 - 91 years ) of colorectal , breast , and prostate cancer , who were r and omly assigned to an intervention group ( n = 319 ) or delayed intervention ( control ) group ( n = 322 ) in Canada , the United Kingdom , and 21 US states . Individuals were recruited for the Reach out to Enhance Wellness ( RENEW ) trial from July 1 , 2005 , through May 17 , 2007 . INTERVENTION A 12-month , home-based tailored program of telephone counseling and mailed material s promoting exercise , improved diet quality , and modest weight loss . The control group was wait-listed for 12 months . MAIN OUTCOME MEASURES Change in self-reported physical function on the Short-Form 36 physical function subscale ( score range , 0 - 100 ; a high score indicates better functioning ) from baseline to 12 months was the primary end point . Secondary outcomes included changes in function on the basic and advanced lower extremity function subscales of the Late Life Function and Disability Index ( score range , 0 - 100 ) , physical activity , body mass index , and overall health-related quality of life . RESULTS The mean baseline Short-Form 36 physical function score was 75.7 . At the 12-month follow-up , the mean function scores declined less rapidly in the intervention group ( -2.15 ; 95 % confidence interval [ CI ] , -0.36 to -3.93 ) compared with the control group ( -4.84 ; 95 % CI , -3.04 to -6.63 ) ( P = .03 ) . The mean baseline basic lower extremity function score was 78.2 . The mean changes in basic lower extremity function were 0.34 ( 95 % CI , -0.84 to 1.52 ) in the intervention group compared with -1.89 ( 95 % CI , -0.70 to -3.09 ) in the control group ( P = .005 ) . Physical activity , dietary behaviors , and overall quality of life increased significantly in the intervention group compared with the control group , and weight loss also was greater ( 2.06 kg [ 95 % CI , 1.69 to 2.43 kg ] vs 0.92 kg [ 95 % CI , 0.51 to 1.33 kg ] , respectively ; P < .001 ) . CONCLUSION Among older , long-term survivors of colorectal , breast , and prostate cancer , a diet and exercise intervention reduced the rate of self-reported functional decline compared with no intervention . TRIAL REGISTRATION clinical trials.gov Identifier : NCT00303875 OBJECTIVE The purpose of this study was to examine the effects of a theory-based decision-making uncertainty management intervention ( DMUMI ) providing newly diagnosed prostate cancer patients with information , communication skills and personally design ed prompts . METHODS A r and omized clinical trial was conducted using a 3x2 design with intervention and control groups including both Caucasian and African-American men . General linear mixed models were used to compare intervention groups over time . RESULTS Significant main effects for the treatment groups were found for uncertainty management ( cancer knowledge , problem-solving , and patient-provider communication ) , medical communication competence , number and helpfulness of re sources for information , and decisional regret . CONCLUSION The intervention was effective in uncertainty management for Caucasian and African-American men , specifically in preparing competent patients with improved knowledge , problem-solving skills , information re sources , and communication skills . Using the Uncertainty in Illness Theory , specific skills were selected with a focus on the antecedents of uncertainty . PRACTICE IMPLICATION S In the treatment decision-making context , patients and supportive others need information about disease , treatment options and side effects but they also need communication skills training prior to the treatment decision consultation OBJECTIVE Rehabilitation programmes are intended to help cancer patients achieve optimal functioning and live independently . We evaluated whether a psychosocial rehabilitation course was effective in relieving  cancer patients '  distress and improving their well-being . METHODS Patients with breast , prostate or colorectal cancer diagnosed within 2 years who had finished primary treatment were  r and omised to usual care or a 6-day residential course of lectures , discussion s and peer groups on issues related to treatment and living with cancer . Changes in self-reported distress ( POMS-Sf ) and quality of life ( EORTC QLQ-C30 ) from baseline to 1 and 6 months ' follow-up were measured . Analyses were adjusted for baseline scores of outcome , cancer site , time since diagnosis , gender , age and education . RESULTS Of 507 patients , 452 were included in the analyses , 404 completed the 1-month and 394 the 6-month assessment . Patients in the control group showed greater decreases in total mood disturbance and subscales of the POMS-Sf and showed more improvement in emotional , cognitive and social functioning at both 1 and 6 months and in role functioning at 6 months than the intervention group . A similar pattern was observed in analyses of breast cancer patients only . CONCLUSION A 6-day residential rehabilitation course did not relieve cancer patients '  distress or improve their well-being Many studies have reported that cancer patients who show difficulties maintaining perceptions of control report more psychological distress than patients who are higher in control . Besides perceptions of control , feelings of illness uncertainty have also been regarded as a predictor of psychological distress . Given these strong relationships between perceptions of low control and high illness uncertainty and psychological distress , the present study examined whether an informational self-management intervention ( booklet ) could moderate this relationship . The booklet contained general and specific information about cancer and cancer treatment , information about possible coping strategies , and social comparison information , which consisted of short stories of other patients . Prior to radiotherapy  , 209 patients with cancer completed baseline measures , including control and illness uncertainty . After completing radiotherapy , patients were r and omly allocated to receive either a booklet ( experimental group ; N=103 ) or no booklet ( control group ; N=106 ) . Three months after the intervention , aspects of psychological distress were assessed , including tension , anger , depression , fatigue and vigour . The results supported our hypotheses and suggested that a self-management intervention is relevant in reducing the relationship between control and illness uncertainty before radiotherapy and psychological distress after radiotherapy . This seems important , especially for high-risk patients who perceive little control and much illness uncertainty Abstract This study examined the effect of combined Pelvic Floor Muscle Exercises ( PFME ) and support group on quality of life of postprostatectomy patients . Twenty — nine participants learned PFME through biofeedback and were r and omized to the control group ( n = 15 ) and support group ( n = 14 ) . Assessment of quality of life was conducted at baseline and 3-month follow — up . The findings indicated a trend of increased functioning and reduced perception of illness intrusiveness in the support group , compared with the control group . Improved urinary continence was significantly associated with reduced depression and symptom distress over time . The findings suggest that an intervention focusing on urinary continence improves quality of life in these patients INTRODUCTION Few couple-focused interventions have been developed to improve distress and relationship outcomes among men diagnosed with localized prostate cancer and their partners . AIMS We examined the effects of a five-session Intimacy-Enhancing Therapy ( IET ) vs. Usual Care ( UC ) on the psychological and relationship functioning of men diagnosed with localized prostate cancer and their partners . Pre-intervention levels of psychological and relationship functioning were evaluated as moderators of intervention effects . METHODS Seventy-one survivors and their partners completed a baseline survey and were subsequently r and omly assigned to receive five sessions of IET or UC ( no treatment ) . Eight weeks after the baseline assessment , a follow-up survey was administered to survivor and partner . MAIN OUTCOME MEASURES Distress , well-being , relationship satisfaction , relationship intimacy , and communication were investigated as the main outcomes . RESULTS IET effects were largely moderated by pre-intervention psychosocial and relationship factors . Those survivors who had higher levels of cancer concerns at pretreatment had significantly reduced concerns following IET . Similar moderating effects for pre-intervention levels were reported for the effects of IET on self-disclosure , perceived partner disclosure , and perceived partner responsiveness . Among partners beginning the intervention with higher cancer-specific distress , lower marital satisfaction , lower intimacy , and poorer communication , IET improved these outcomes . CONCLUSIONS IET had a marginally significant main effect upon survivor well-being but was effective among couples with fewer personal and relationship re sources . Subsequent research is needed to replicate these findings with a larger sample and a longer follow-up Treatments for clinical ly localized prostate carcinoma are accompanied by sexual , urinary , and bowel dysfunction and other sequelae that can result in significant distress and reduced well being . Methods capable of improving quality of life are needed that can be integrated into clinical practice . To address this need , a nurse‐driven , cancer care intervention was developed and tested BACKGROUND Patients with cancer have relatively high rates of anxiety and distress , adversely affecting their well-being and quality of life . Recent studies indicate that addressing these symptoms could result in better response to cancer treatment . Research ers have found that interventions that focus on increasing mental awareness and the frequency of positive experiences may have a greater impact on reducing psychological morbidity and increasing quality of life than interventions that target relief of psychological symptoms . AIM To develop and test a brief , easy to use intervention that could improve well-being and quality of life in cancer patients . METHODS We developed a simple well-being intervention that made few dem and s on patient time and required little training re source . Participants were r and omly assigned to an intervention group or a deferred entry group .  Measures of anxiety , depression , well-being and quality of life were administered at baseline and at follow-ups . RESULTS Twenty-two women with metastatic breast cancer and 24 men with metastatic prostate cancer were recruited from oncology clinics . Thirteen women and 14 men completed the study . Both qualitative and quantitative data showed that the intervention was acceptable to users . There was statistically significant improvement in quality of life scores on WHOQOL-BREF post-intervention ( p=0.046 ) . Compliance with the intervention was good . CONCLUSIONS This brief well-being intervention appears to be a promising technique for improving quality of life of cancer patients , without making undue dem and s on staff re sources or patient time . If further studies confirm its effectiveness , it could prove to be a cost-effective intervention A r and omized study was conducted to compare a generic and individualized approach to providing decisional support to men newly diagnosed with localized prostate cancer . Patients ( N = 324 ) were referred by community urologists to a patient education center where they were r and omly assigned to receive either an individualized or generic information intervention . Men assigned to the generic group viewed a video on the various treatments available for localized prostate cancer . Men in the individualized information group used a computer program to identify their information preferences . Computer printouts on top information preferences were individualized according to patient 's specific disease characteristics , followed by a discussion of the pros and cons of each recommended treatment option . Both groups received a st and ardized package of written information . Men completed measures of decision control , satisfaction , and decision conflict at baseline and after a definitive treatment decision was made . Results demonstrated that overall both groups reported increased levels of decision control and lower levels of decision conflict after their treatment decision . All men reported being satisfied with their preparation to make a treatment decision . Compared to the generic information group , men who received the individualized information were more satisfied with the type , amount and method of providing information , and role played in treatment decision making with their physician ( P < .002 ) . Both information interventions seem to be similar in providing decisional support to this group of men at the time of diagnosis . Further research is required to determine how to identify men who may benefit from a more individualized approach OBJECTIVE The effects of a 6-week psychoeducational group intervention on the distress , coping , personal growth , and marital communication of wives of men diagnosed with prostate cancer were evaluated using a r and omized clinical trial . METHODS Sixty wives completed measures prior to r and om assignment to either the psychoeducational group intervention or a no-treatment control group , and 1 month after completion of the group . RESULTS No differences with regard to wives ' general distress or cancer-specific distress were noted . In comparison with the control group , participants receiving the intervention perceived that having a spouse with prostate cancer had made positive contributions to their lives , reported gains in the use of positive re appraisal coping and reductions in denial coping . CONCLUSION Although the psychoeducational intervention did not result in changes in psychological distress , improvements in adaptive coping and indicators of psychological growth were found . The utility of group interventions for spouses of men with prostate cancer is discussed OBJECTIVES To investigate the clinical effect of electroacupuncture ( EA ) for chronic prostatitis/chronic pelvic pain syndrome ( CP/CPPS ) . METHODS We recruited 63 participants meeting the U.S. National Institutes of Health ( NIH ) consensus criteria for CP/CPPS . After the inclusion /exclusion criteria were applied , 39 men were r and omized to 3 treatment groups : group 1 , advice and exercise plus 12 sessions of EA ; group 2 , advice and exercise plus 12 sessions of sham EA ( SEA ) ; and group 3 , advice and exercise alone ( A&E ) for 6 weeks . A total of 6 acupuncture points were used to stimulate the sacral nerve and release the piriformis muscle using an electrical pulse generator . Symptoms related to CP/CPPS were assessed using the NIH-Chronic Prostatitis Symptom Index ( NIH-CPSI ) . Prostagl and in E(2 ) and beta-endorphin levels in postmassage urine sample s were measured using an enzyme-linked immunosorbent assay . RESULTS At 6 weeks , the NIH-CPSI total score had decreased significantly in the EA group compared with the SEA and A&E groups ( P < .001 ) . On a subscale analysis of the NIH-CPSI , the EA group showed significant decreases in pain-related symptoms compared with the SEA and A&E groups ( P < .01 ) . All 12 EA participants experienced at least a 6-point decrease in the NIH-CPSI total score compared with 2 of 12 SEA participants ( 16.7 % ) and 3 of 12 A&E participants ( 25.0 % ; P < .0001 ) . The mean prostagl and in E(2 ) level in the postmassage urine sample s had significantly decreased in the EA group ( P = .023 ) . In contrast , it had increased in the other 2 groups . CONCLUSIONS In a 3-arm r and omized trial investigating the clinical effects of EA on CP/CPPS , EA therapy proved to have independent therapeutic effects , particularly for pain relief superior to SEA or A&E therapy CONTEXT Although behavioral therapy has been shown to improve postoperative recovery of continence , there have been no controlled trials of behavioral therapy for postprostatectomy incontinence persisting more than 1 year . OBJECTIVE To evaluate the effectiveness of behavioral therapy for reducing persistent postprostatectomy incontinence and to determine whether the technologies of biofeedback and pelvic floor electrical stimulation enhance the effectiveness of behavioral therapy . DESIGN , SETTING , AND PARTICIPANTS A prospect i ve r and omized controlled trial involving 208 community-dwelling men aged 51 through 84 years with incontinence persisting 1 to 17 years after radical prostatectomy was conducted at a university and 2 Veterans Affairs continence clinics ( 2003 - 2008 ) and included a 1-year follow-up after active treatment . Twenty-four percent of the men were African American ; 75 % , white . INTERVENTIONS After stratification by type and frequency of incontinence , participants were r and omized to 1 of 3 groups : 8 weeks of behavioral therapy ( pelvic floor muscle training and bladder control strategies ) ; behavioral therapy plus in-office , dual-channel electromyograph biofeedback and daily home pelvic floor electrical stimulation at 20 Hz , current up to 100 mA ( behavior plus ) ; or delayed treatment , which served as the control group . MAIN OUTCOME MEASURE Percentage reduction in mean number of incontinence episodes after 8 weeks of treatment as documented in 7-day bladder diaries . RESULTS Mean incontinence episodes decreased from 28 to 13 per week ( 55 % reduction ; 95 % confidence interval [ CI ] , 44%-66 % ) after behavioral therapy and from 26 to 12 ( 51 % reduction ; 95 % CI , 37%-65 % ) after behavior plus therapy . Both reductions were significantly greater than the reduction from 25 to 21 ( 24 % reduction ; 95 % CI , 10%-39 % ) observed among controls ( P = .001 for both treatment groups ) . However , there was no significant difference in incontinence reduction between the treatment groups ( P = .69 ) . Improvements were durable to 12 months in the active treatment groups : 50 % reduction ( 95 % CI , 39.8%-61.1 % ; 13.5 episodes per week ) in the behavioral group and 59 % reduction ( 95 % CI , 45.0%-73.1 % ; 9.1 episodes per week ) in the behavior plus group ( P = .32 ) . CONCLUSIONS Among patients with postprostatectomy incontinence for at least 1 year , 8 weeks of behavioral therapy , compared with a delayed-treatment control , result ed in fewer incontinence episodes . The addition of biofeedback and pelvic floor electrical stimulation did not result in greater effectiveness . TRIAL REGISTRATION clinical trials.gov Identifier : NCT00212264
BACKGROUND As the incidence and prevalence of prostate cancer continue to rise , the number of men needing help and support to assist them in coping with disease and treatment-related symptoms and their psychosocial effects is likely to increase .
OBJECTIVES To evaluate the effectiveness of psychosocial interventions for men with prostate cancer in improving quality of life ( QoL ) , self-efficacy and knowledge and in reducing distress , uncertainty and depression .