title: Couple-Based Psychosexual Support Following Prostate Cancer Surgery: Results of a Feasibility Pilot Randomized Control Trial.
abstract: Surgery for prostate cancer can result in distressing side effects such as sexual difficulties, which are associated with lower levels of dyadic functioning. The study developed and tested an intervention to address sexual, relational, and emotional aspects of the relationship after prostate cancer by incorporating elements of family systems theory and sex therapy.
  
  
  
  To develop and test the feasibility and acceptability of relational psychosexual treatment for couples with prostate cancer, determine whether a relational-psychosexual intervention is feasible and acceptable for couples affected by prostate cancer, and determine the parameters for a full-scale trial.
  
  
  
  Forty-three couples were recruited for this pilot randomized controlled trial and received a six-session manual-based psychosexual intervention or usual care. Outcomes were measured before, after, and 6 months after the intervention. Acceptability and feasibility were established from recruitment and retention rates and adherence to the manual.
  
  
  
  The primary outcome measurement was the sexual bother subdomain of the Expanded Prostate Cancer Index Composite. The Hospital Anxiety and Depression Scale and the 15-item Systemic Clinical Outcome and Routine Evaluation (SCORE-15) were used to measure emotional and relational functioning, respectively.
  
  
  
  The intervention was feasible and acceptable. The trial achieved adequate recruitment (38%) and retention (74%) rates. The intervention had a clinically and statistically significant effect on sexual bother immediately after the intervention. Small decreases in anxiety and depression were observed for the intervention couples, although these were not statistically significant. Practitioners reported high levels of adherence to the manual.
  
  
  
  The clinically significant impact on sexual bother and positive feedback on the study's feasibility and acceptability indicate that the intervention should be tested in a multicenter trial. The SCORE-15 lacked specificity for this intervention, and future trials would benefit from a couple-focused measurement.
authors.affiliation: School of Social Science, University of Stirling, Stirling, UK.
authors.forename: Jane
authors.initials: J
authors.lastname: Robertson
authors.affiliation: Institute for Women's Health, University College London, London, UK.
authors.forename: Phillip
authors.initials: P
authors.lastname: McNamee
authors.affiliation: School of Psychology, NUI Galway, Galway, Eire.
authors.forename: Gerry
authors.initials: G
authors.lastname: Molloy
authors.affiliation: School of Health, University of Stirling, Inverness, UK.
authors.forename: Gill
authors.initials: G
authors.lastname: Hubbard
authors.affiliation: Department of Urology, Lothian University Hospitals, Edinburgh, UK.
authors.forename: Alan
authors.initials: A
authors.lastname: McNeill
authors.affiliation: Department of Urology, Lothian University Hospitals, Edinburgh, UK.
authors.forename: Prasad
authors.initials: P
authors.lastname: Bollina
authors.affiliation: Cardiff University, Cardiff, UK.
authors.forename: Daniel
authors.initials: D
authors.lastname: Kelly
authors.affiliation: Faculty of Health Sciences, Australian Catholic University and Calvary Health Care Bruce, Canberra, Australia. Electronic address: elizabeth.forbat@acu.edu.au.
authors.forename: Liz
authors.initials: L
authors.lastname: Forbat
mesh_terms: D000368:Aged; D001007:Anxiety / Q000209:etiology; D019546:Couples Therapy / Q000379:methods*; D003863:Depression / Q000209:etiology; D005191:Family Characteristics; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D011182:Postoperative Care / Q000379:methods; D011183:Postoperative Complications / Q000517:prevention & control; D011468:Prostatectomy / Q000009:adverse effects; D011471:Prostatic Neoplasms / Q000601:surgery*; D012725:Sexual Behavior; D012735:Sexual Dysfunction, Physiological / Q000517:prevention & control*; D020018:Sexual Dysfunctions, Psychological / Q000517:prevention & control*; D012747:Sexual Partners; D012944:Social Support
keywords: Couple Therapy; Family Systems; Intimacy; Prostate Cancer; Psychosexual Support; Relationships; Sex Therapy; Sexual Function; Treatment