Living with prostate cancer: patients' and spouses' psychosocial status and quality of life.
OBJECTIVE
Despite the high prevalence of prostate cancer, little information is available on the quality of life of men and their spouses during the phases of illness. This study assessed patients' and spouses' quality of life, appraisal of illness, resources, symptoms, and risk for distress across three phases of prostate cancer: newly diagnosed, biochemical recurrence, and advanced.


METHODS
The sample consisted of 263 patient/spouse dyads. A stress-appraisal conceptual model guided the selection of variables which were then assessed with established instruments. Study variables were examined for phase effects (differences in dyads across three phases), role effects (patients v spouses), and phase-by-role interactions (differences within dyads across phases) using analysis of variance (ANOVA).


RESULTS
More phase effects than role effects were found, indicating that the psychosocial experiences of patients and their spouses were similar, but differed from dyads in other phases. Dyads in the advanced phase were at highest risk for distress. These patients had the lowest physical quality of life, and their spouses had the lowest emotional quality of life of all participants. Dyads in the biochemical recurrence and advanced phases had more negative appraisals of illness and caregiving, greater uncertainty, and more hopelessness compared with dyads in the newly diagnosed phase. Spouses, in contrast to patients, had less confidence in their ability to manage the illness and perceived less support across all phases of illness.


CONCLUSIONS
Phase-specific programs of care are needed to assist both men with prostate cancer and their spouses to manage the effects of illness.
Northouse
Laurel L
LL
School of Nursing and the Division of Hematology/Oncology, Department of Urology, University of Michigan, Ann Arbor 48109-0482, USA. lnortho@umich.edu
Mood
Darlene W
DW
Montie
James E
JE
Sandler
Howard M
HM
Forman
Jeffrey D
JD
Hussain
Maha
M
Pienta
Kenneth J
KJ
Smith
David C
DC
Sanda
Martin G
MG
Kershaw
Trace
T
D000368:Aged; D017028:Caregivers; D005192:Family Health; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011471:Prostatic Neoplasms / Q000473:pathology / Q000523:psychology* / Q000628:therapy*; D011788:Quality of Life; D012923:Social Class; D012944:Social Support; D018454:Spouses; D016896:Treatment Outcome