title: Prostate cancer patients gradually advance goals for rehabilitation after radical prostatectomy: applying a lines-of-defense model to rehabilitation.
abstract: Following tumor surgery, urinary incontinence challenges prostate cancer patients' functional health. Adjustments of functional goals (lines of defense [LoDs]) were examined during rehabilitation from incontinence. A conceptual model proposing stepwise and distinct upward adjustments of LoDs, ranging from minimizing discomfort (lowest LoD) to protecting self-reliance (highest LoD), was investigated. Within 7 months following the onset of incontinence, 175 patients completed questionnaires at 4 occasions. A theory-based hierarchy was imposed on time-invariant latent classes of LoD-endorsements. As incontinence receded, patients transitioned upward through the hierarchy of LoD-classes, matched LoDs to concurrent incontinence levels, and thus promptly claimed independent functioning with physical improvements.
authors.affiliation: Division of Health Psychology, Department of Educational Sciences and Psychology, Freie Universität Berlin.
authors.forename: Nina
authors.initials: N
authors.lastname: Knoll
authors.affiliation: Division of Health Psychology, Department of Educational Sciences and Psychology, Freie Universität Berlin.
authors.forename: Amelie U
authors.initials: AU
authors.lastname: Wiedemann
authors.affiliation: Division of Methods and Evaluation, Department of Educational Sciences and Psychology, Freie Universität Berlin.
authors.forename: Martin
authors.initials: M
authors.lastname: Schultze
authors.affiliation: Department of Urology, Universitätsklinikum Ulm.
authors.forename: Mark
authors.initials: M
authors.lastname: Schrader
authors.affiliation: Department of Psychology and Social Behavior, University of California.
authors.forename: Jutta
authors.initials: J
authors.lastname: Heckhausen
mesh_terms: D000203:Activities of Daily Living / Q000523:psychology*; D000368:Aged; D006040:Goals; D006801:Humans; D008297:Male; D008875:Middle Aged; D008960:Models, Psychological; D011468:Prostatectomy; D011471:Prostatic Neoplasms / Q000150:complications / Q000523:psychology / Q000534:rehabilitation* / Q000601:surgery*; D011795:Surveys and Questionnaires; D013997:Time Factors; D014549:Urinary Incontinence / Q000150:complications / Q000209:etiology / Q000534:rehabilitation*