title: Patient experiences at diagnosis and psychological well-being in prostate cancer: A Finnish national survey.
abstract: OBJECTIVE
  Most cases of prostate cancer are diagnosed at an early stage, and men live for many years after diagnosis. Thus, their well-being and quality of life are of great importance. This study investigated patient experiences and psychological well-being in a Finnish national sample of prostate cancer patients who received various types of treatment.
  
  
  METHODS
  In a national sample (50%) of prostate cancer patients diagnosed in Finland in 2004, information was collected on the patients' experiences at diagnosis and choice of treatment (e.g. treatment selection, patient satisfaction with care and information, psychological reactions). In 2009, participants were asked about their experiences, and psychological well-being (psychological symptoms, satisfaction with life) was measured. In total, 1239 completed questionnaires (73%) were accepted for the study. Differences between treatments and predictors of psychological well-being were investigated using descriptive statistics and regression analysis.
  
  
  RESULTS
  Half of the respondents were satisfied with the care and information they received about the cancer and side effects of treatment. Experiences and psychological well-being were most positive among patients who received brachytherapy and poorest among patients who received hormonal therapy. Patients who underwent prostatectomy or brachytherapy were most likely to have been involved in treatment selection. Negative experiences, such as learning of the diagnosis in an impersonal way and dissatisfaction with the information and care received, were predictive of poorer well-being.
  
  
  CONCLUSIONS
  Unmet supportive care and informational needs were common. Experiences and well-being varied between treatments. Patients tended to prefer prostatectomy and brachytherapy. Unmet needs, which would probably be reduced by improvements in care, appear to have a long-lasting impact on patients' psychological well-being.
authors.affiliation: Population Health Unit, National Institute for Health and Welfare, Helsinki, Finland. Electronic address: ulla-sisko.lehto@thl.fi.
authors.forename: Ulla-Sisko
authors.initials: US
authors.lastname: Lehto
authors.affiliation: Finnish Cancer Registry, Helsinki, Finland.
authors.forename: Sanni
authors.initials: S
authors.lastname: Helander
authors.affiliation: Department of Urology, Helsinki University Central Hospital, Helsinki, Finland; Department of Surgery, University of Helsinki, Helsinki, Finland.
authors.forename: Kimmo
authors.initials: K
authors.lastname: Taari
authors.affiliation: National Institute for Health and Welfare, Helsinki, Finland.
authors.forename: Arpo
authors.initials: A
authors.lastname: Aromaa
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D018931:Antineoplastic Agents, Hormonal / Q000627:therapeutic use*; D001007:Anxiety; D001294:Attitude to Health; D001918:Brachytherapy / Q000523:psychology*; D064420:Drug-Related Side Effects and Adverse Reactions / Q000523:psychology; D005387:Finland; D006801:Humans; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D010361:Patients / Q000523:psychology*; D011468:Prostatectomy / Q000523:psychology*; D011471:Prostatic Neoplasms / Q000175:diagnosis / Q000523:psychology* / Q000628:therapy*; D011788:Quality of Life
chemical_list: D018931:Antineoplastic Agents, Hormonal
keywords: Patient experiences; Patient outcomes; Patient satisfaction; Population study; Prostate cancer patients; Prostate cancer survivors; Psychological well-being; Quality of care; Quality of life; Supportive care needs