title: Nurse-led group consultation intervention reduces depressive symptoms in men with localised prostate cancer: a cluster randomised controlled trial.
abstract: Radiotherapy for localised prostate cancer has many known and distressing side effects. The efficacy of group interventions for reducing psychological morbidity is lacking. This study investigated the relative benefits of a group nurse-led intervention on psychological morbidity, unmet needs, treatment-related concerns and prostate cancer-specific quality of life in men receiving curative intent radiotherapy for prostate cancer.
  
  
  
  This phase III, two-arm cluster randomised controlled trial included 331 men (consent rate: 72 %; attrition: 5 %) randomised to the intervention (n = 166) or usual care (n = 165). The intervention comprised four group and one individual consultation all delivered by specialist uro-oncology nurses. Primary outcomes were anxious and depressive symptoms as assessed by the Hospital Anxiety and Depression Scale. Unmet needs were assessed with the Supportive Care Needs Survey-SF34 Revised, treatment-related concerns with the Cancer Treatment Scale and quality of life with the Expanded Prostate Cancer Index -26. Assessments occurred before, at the end of and 6 months post-radiotherapy. Primary outcome analysis was by intention-to-treat and performed by fitting a linear mixed model to each outcome separately using all observed data.
  
  
  
  Mixed models analysis indicated that group consultations had a significant beneficial effect on one of two primary endpoints, depressive symptoms (p = 0.009), and one of twelve secondary endpoints, procedural concerns related to cancer treatment (p = 0.049). Group consultations did not have a significant beneficial effect on generalised anxiety, unmet needs and prostate cancer-specific quality of life.
  
  
  
  Compared with individual consultations offered as part of usual care, the intervention provides a means of delivering patient education and is associated with modest reductions in depressive symptoms and procedural concerns. Future work should seek to confirm the clinical feasibility and cost-effectiveness of group interventions.
  
  
  
  Australian and New Zealand Clinical Trials Registry ANZCTRN012606000184572 . 1 March 2006.
authors.affiliation: Department of Psychology, Swinburne University of Technology, Hawthorn, Australia. penelope.schofield@petermac.org.|Department of Cancer Experiences Research, Peter MacCallum Cancer Centre, 2 St Andrews Place, East Melbourne, Australia. penelope.schofield@petermac.org.|Sir Peter MacCallum Department of Oncology, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Parkville, Australia. penelope.schofield@petermac.org.|School of Health Sciences, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Parkville, Australia. penelope.schofield@petermac.org.
authors.forename: Penelope
authors.initials: P
authors.lastname: Schofield
authors.affiliation: Department of Cancer Experiences Research, Peter MacCallum Cancer Centre, 2 St Andrews Place, East Melbourne, Australia.|School of Health Sciences, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Parkville, Australia.
authors.forename: Karla
authors.initials: K
authors.lastname: Gough
authors.affiliation: School of Health Sciences, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Parkville, Australia.
authors.forename: Kerryann
authors.initials: K
authors.lastname: Lotfi-Jam
authors.affiliation: Department of Cancer Experiences Research, Peter MacCallum Cancer Centre, 2 St Andrews Place, East Melbourne, Australia.
authors.forename: Rebecca
authors.initials: R
authors.lastname: Bergin
authors.affiliation: Deakin University, Faculty of Health, 221 Burwood Highway, Burwood, Australia.|Cancer Council Victoria, Cancer Information and Support Services, 615 St Kilda Rd, Melbourne, Australia.
authors.forename: Anna
authors.initials: A
authors.lastname: Ugalde
authors.affiliation: School of Behavioural Science, University of Melbourne, Parkville, Australia.
authors.forename: Paul
authors.initials: P
authors.lastname: Dudgeon
authors.affiliation: Department of Cancer Experiences Research, Peter MacCallum Cancer Centre, 2 St Andrews Place, East Melbourne, Australia.
authors.forename: Wallace
authors.initials: W
authors.lastname: Crellin
authors.affiliation: Radiation Oncology and Cancer Imaging, Peter MacCallum Cancer Centre, 2 St Andrews Place, East Melbourne, Australia.
authors.forename: Kathryn
authors.initials: K
authors.lastname: Schubach
authors.affiliation: Sir Peter MacCallum Department of Oncology, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Parkville, Australia.|Radiation Oncology and Cancer Imaging, Peter MacCallum Cancer Centre, 2 St Andrews Place, East Melbourne, Australia.
authors.forename: Farshard
authors.initials: F
authors.lastname: Foroudi
authors.affiliation: Sir Peter MacCallum Department of Oncology, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Parkville, Australia.|Radiation Oncology and Cancer Imaging, Peter MacCallum Cancer Centre, 2 St Andrews Place, East Melbourne, Australia.
authors.forename: Keen Hun
authors.initials: KH
authors.lastname: Tai
authors.affiliation: Sir Peter MacCallum Department of Oncology, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Parkville, Australia.|Radiation Oncology and Cancer Imaging, Peter MacCallum Cancer Centre, 2 St Andrews Place, East Melbourne, Australia.
authors.forename: Gillian
authors.initials: G
authors.lastname: Duchesne
authors.affiliation: School of Medicine and Public Health, The University of Newcastle, University Drive, Callaghan, Australia.
authors.forename: Rob
authors.initials: R
authors.lastname: Sanson-Fisher
authors.affiliation: Department of Cancer Experiences Research, Peter MacCallum Cancer Centre, 2 St Andrews Place, East Melbourne, Australia.|Sir Peter MacCallum Department of Oncology, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Parkville, Australia.|Cancer Council Australia, Sydney, NSW, Australia.
authors.forename: Sanchia
authors.initials: S
authors.lastname: Aranda
mesh_terms: D000223:Adaptation, Psychological; D000368:Aged; D000369:Aged, 80 and over; D001007:Anxiety / Q000453:epidemiology* / Q000523:psychology / Q000628:therapy; D001315:Australia; D003376:Counseling / Q000379:methods*; D003863:Depression / Q000453:epidemiology* / Q000523:psychology / Q000628:therapy; D017144:Focus Groups; D006801:Humans; D008297:Male; D008875:Middle Aged; D009520:New Zealand; D024802:Nurse's Role; D011471:Prostatic Neoplasms / Q000523:psychology / Q000532:radiotherapy*; D011788:Quality of Life / Q000523:psychology; D011795:Surveys and Questionnaires; D016896:Treatment Outcome
keywords: Intervention; Prostate cancer; Psychological morbidity; Quality of life; Radiotherapy; Unmet needs; Uro-oncology nurses