Improving the quality of life of patients with prostate carcinoma: a randomized trial testing the efficacy of a nurse-driven intervention.
BACKGROUND
Treatments for clinically 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.


METHODS
Within 6 weeks after completing treatment, 99 patients, along with their partners, were enrolled into a prospective, controlled trial and were randomized to receive the cancer care intervention or to receive standard care. Participants in the intervention arm met once each month for 6 months with an oncology nurse intervenor, who helped patients identify their quality-of-life needs using an interactive computer program. The intervener then provided education and support tailored to participants' needs. Primary outcome variables included 1) disease-specific quality of life, including sexual, urinary, and bowel outcomes and cancer worry; 2) depression; 3) dyadic adjustment; and 4) general quality of life. Outcomes data were collected prior to randomization and again at 4 months, 7 months, and 12 months posttreatment.


RESULTS
Patients in the intervention arm experienced long-term improvements in quality-of-life outcomes related to sexual functioning and cancer worry compared with patients who received standard care. Baseline depression moderated the impact of the intervention on several other quality-of-life outcomes.


CONCLUSIONS
The findings of the current study indicated that a computer-assisted, nurse-driven intervention was capable of providing durable improvements in the quality of life of men who underwent treatment for clinically localized prostate carcinoma.
Giesler
R Brian
RB
School of Nursing, Indiana University, Indianapolis, Indiana, USA. bgiesler@iupui.edu
Given
Barbara
B
Given
Charles W
CW
Rawl
Susan
S
Monahan
Patrick
P
Burns
Debra
D
Azzouz
Faouzi
F
Reuille
Kristina M
KM
Weinrich
Sally
S
Koch
Michael
M
Champion
Victoria
V
D000368:Aged; D015928:Cognitive Behavioral Therapy; D004066:Digestive System Diseases / Q000209:etiology / Q000523:psychology; D006801:Humans; D008297:Male; D052801:Male Urogenital Diseases / Q000209:etiology / Q000523:psychology; D008875:Middle Aged; D009726:Nurses; D010353:Patient Education as Topic; D011471:Prostatic Neoplasms / Q000150:complications / Q000523:psychology* / Q000628:therapy*; D011788:Quality of Life / Q000523:psychology*; D012735:Sexual Dysfunction, Physiological / Q000209:etiology / Q000523:psychology; D012984:Software; D018454:Spouses; D011795:Surveys and Questionnaires