title: Care-related predictors for negative intrusive thoughts after prostate cancer diagnosis-data from the prospective LAPPRO trial.
abstract: OBJECTIVE
  Negative intrusive thoughts about one's prostate cancer have been associated with depressive mood and impaired quality of life among prostate cancer patients. However, little is known about possible predictors for negative intrusive thoughts among this group. We aimed to identify health- and care-related predictors for such thoughts among a population of men newly diagnosed with prostate cancer and undergoing radical prostatectomy.
  
  
  METHODS
  In the LAPPRO-trial, 3154 men (80%) answered study-specific questionnaires at admission and 3 months after surgery. Questions concerned socio-demographics, health, uncertainty, preparedness for symptoms, and the outcome-negative intrusive thoughts. Associations between variables were analyzed by log-binominal and multivariable approach.
  
  
  RESULTS
  The strongest predictor of negative intrusive thoughts at admission to surgery was uncertainty of cure, followed by binge drinking, poor physical health, antidepressant medication, not being prepared for urinary symptoms, age under 55, and physical pain. Reporting it not probable to obtain urinary symptoms after surgery lowered the odds. Negative intrusive thoughts before surgery were the strongest predictor for such thoughts 3 months later followed by uncertainty of cure, physical pain, younger age, living alone, and poor self-reported physical health.
  
  
  CONCLUSIONS
  Our findings showed an association of preoperative uncertainty of cure as well as low preparedness for well-known surgery-induced symptoms with higher occurrence of negative intrusive thoughts about prostate cancer. Future studies should examine if interventions designed to have healthcare professionals inform patients about their upcoming prostatectomy reduce patients' negative intrusive thoughts and thereby, improve their psychological well-being.
authors.affiliation: Division of Clinical Cancer Epidemiology, Department of Oncology, Institute of Clinical Sciences, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden.|Faculty of Nursing, School of Health Sciences, University of Iceland, Reykjavík, Iceland.|Research Institute in Emergency Care, Landspitali University Hospital, Reykjavík, Iceland.
authors.forename: Thordis
authors.identifier: http://orcid.org/0000-0002-3585-006X
authors.initials: T
authors.lastname: Thorsteinsdottir
authors.affiliation: Department of Oncological Sciences, Mount Sinai School of Medicine, New York, NY, USA.|Department of Psychology, Reykjavik University, Reykjavik, Iceland.
authors.forename: Heiddis
authors.initials: H
authors.lastname: Valdimarsdottir
authors.affiliation: Center for Public Health Sciences, School of Health Sciences, University of Iceland, Reykjavik, Iceland.
authors.forename: Arna
authors.initials: A
authors.lastname: Hauksdottir
authors.affiliation: Department of Urology, Sahlgrenska University Hospital, Gothenburg, Sweden.
authors.forename: Johan
authors.initials: J
authors.lastname: Stranne
authors.affiliation: Division of Clinical Cancer Epidemiology, Department of Oncology, Institute of Clinical Sciences, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden.
authors.forename: Ulrica
authors.initials: U
authors.lastname: Wilderäng
authors.affiliation: Department of Surgery, Institute of Clinical Sciences, Sahlgrenska Academy at University of Gothenburg, SSORG - Scandinavian Surgical Outcomes Research Group, Sahlgrenska University Hospital/Östra, Gothenburg, Sweden.
authors.forename: Eva
authors.initials: E
authors.lastname: Haglind
authors.affiliation: Division of Clinical Cancer Epidemiology, Department of Oncology, Institute of Clinical Sciences, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden.|Division of Clinical Cancer Epidemiology, Department of Oncology-Pathology, Karolinska Institutet, Stockholm, Sweden.
authors.forename: Gunnar
authors.initials: G
authors.lastname: Steineck
mesh_terms: D000328:Adult; D000339:Affect; D000368:Aged; D006801:Humans; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000523:psychology; D011446:Prospective Studies; D011468:Prostatectomy; D011471:Prostatic Neoplasms / Q000175:diagnosis* / Q000523:psychology / Q000601:surgery; D011788:Quality of Life / Q000523:psychology*; D011795:Surveys and Questionnaires; D035501:Uncertainty
keywords: clinical trial; intrusive thoughts; oncological sugery; prostate cancer; psychological well-being