- Wootten, Addie C, Meyer, Denny, Abbott, Jo-Anne, Chisholm, Katherine, Austin, David, Klein, Britt, McCabe, Marita, Murphy, Declan, Costello, Anthony
- Authors: Wootten, Addie C , Meyer, Denny , Abbott, Jo-Anne , Chisholm, Katherine , Austin, David , Klein, Britt , McCabe, Marita , Murphy, Declan , Costello, Anthony
- Date: 2016
- Type: Text , Journal article
- Relation: Psycho-Oncology Vol. 26, no. 7 (2016), p. 975-981
- Full Text: false
- Reviewed:
- Description: BACKGROUND: Prostate cancer treatment often results in significant psycho-sexual challenges for men following treatment; however, many men report difficulty in accessing appropriate care. METHODS: A randomized controlled trial was undertaken to assess the efficacy of a 10-week self-guided online psychological intervention called My Road Ahead (MRA) for men with localized prostate cancer in improving sexual satisfaction. Participants were randomized to 1 of 3 conditions MRA alone or MRA plus online forum, or forum access alone. Pre, post, and follow-up assessments of overall sexual satisfaction were conducted. Mixed models and structural equation modeling were used to analyze the data. RESULTS: One hundred forty-two men (mean age 61 y; SD = 7) participated. The majority of participants had undergone radical prostatectomy (88%) and all men had received treatment for localized prostate cancer. Significant differences were obtained for the 3 groups (P = .026) and a significant improvement in total sexual satisfaction was observed only for participants who were allocated to MRA + forum with a large effect size (P = .004, partial eta2 = 0.256). Structural equation modeling indicated that increases in sexual function, masculine self-esteem, and sexual confidence contributed significantly to overall sexual satisfaction for the MRA + forum plus forum condition. CONCLUSIONS: This study is the first, to our knowledge, that has evaluated a self-guided online psychological intervention tailored to the specific needs of men with prostate cancer. The findings indicate the potential for MRA to deliver support that men may not otherwise receive and also highlight the importance of psychological intervention to facilitate improved sexual outcomes.
Development, feasibility and usability of an online psychological intervention for men with prostate cancer : My road ahead
- Wootten, Addie, Abbott, Jo-Anne, Chisholm, Katherine, Austin, David, Klein, Britt, McCabe, Marita, Murphy, Declan, Costello, Anthony
- Authors: Wootten, Addie , Abbott, Jo-Anne , Chisholm, Katherine , Austin, David , Klein, Britt , McCabe, Marita , Murphy, Declan , Costello, Anthony
- Date: 2014
- Type: Text , Journal article
- Relation: Internet Interventions Vol. 1, no. 4 (2014), p. 188-195
- Full Text:
- Reviewed:
- Description: Men with prostate cancer are not routinely offered psychosocial support despite strong evidence that being diagnosed with prostate cancer poses significant quality of life concerns and places the patient at elevated risk of developing a range of mental health disorders. The objective of this study was to develop an online psychological intervention for men with prostate cancer and to pilot test the feasibility and acceptability of the intervention. Development of the intervention involved a multidisciplinary collaboration, adapting face-to-face and group intervention strategies for an online format. The full online intervention and moderated forum were pilot tested with 64 participants who were recruited from urology practices in Melbourne, Victoria, Australia. After consenting to participate and creating a personal account in the online programme, participants completed baseline demographic questionnaires. Participants were provided access to the programme for 6-12. weeks. After completing the programme participants completed an online survey to assess intervention and forum utilisation and satisfaction, as well as suggest intervention refinements following their use of the intervention. Patient satisfaction was calculated using mean responses to the satisfaction questionnaire. The intervention was received positively with 47.82% of participants highly satisfied with the programme, and 78.26% said they would recommend it to a friend. Participants' qualitative feedback indicated good acceptability of the online intervention. A number of technical and participant engagement issues were identified and changes recommended as a result of the feasibility testing. © 2014 .
- Authors: Wootten, Addie , Abbott, Jo-Anne , Chisholm, Katherine , Austin, David , Klein, Britt , McCabe, Marita , Murphy, Declan , Costello, Anthony
- Date: 2014
- Type: Text , Journal article
- Relation: Internet Interventions Vol. 1, no. 4 (2014), p. 188-195
- Full Text:
- Reviewed:
- Description: Men with prostate cancer are not routinely offered psychosocial support despite strong evidence that being diagnosed with prostate cancer poses significant quality of life concerns and places the patient at elevated risk of developing a range of mental health disorders. The objective of this study was to develop an online psychological intervention for men with prostate cancer and to pilot test the feasibility and acceptability of the intervention. Development of the intervention involved a multidisciplinary collaboration, adapting face-to-face and group intervention strategies for an online format. The full online intervention and moderated forum were pilot tested with 64 participants who were recruited from urology practices in Melbourne, Victoria, Australia. After consenting to participate and creating a personal account in the online programme, participants completed baseline demographic questionnaires. Participants were provided access to the programme for 6-12. weeks. After completing the programme participants completed an online survey to assess intervention and forum utilisation and satisfaction, as well as suggest intervention refinements following their use of the intervention. Patient satisfaction was calculated using mean responses to the satisfaction questionnaire. The intervention was received positively with 47.82% of participants highly satisfied with the programme, and 78.26% said they would recommend it to a friend. Participants' qualitative feedback indicated good acceptability of the online intervention. A number of technical and participant engagement issues were identified and changes recommended as a result of the feasibility testing. © 2014 .
My Road Ahead study protocol: A randomised controlled trial of an online psychological intervention for men following treatment for localised prostate cancer
- Wootten, Addie, Abbott, Jo-Anne, Chisholm, Katherine, Austin, David, Klein, Britt, McCabe, Marita, Meyer, Denny, Costello, Anthony, Murphy, Declan
- Authors: Wootten, Addie , Abbott, Jo-Anne , Chisholm, Katherine , Austin, David , Klein, Britt , McCabe, Marita , Meyer, Denny , Costello, Anthony , Murphy, Declan
- Date: 2014
- Type: Text , Journal article
- Relation: BMC Cancer Vol. 14, no. 1 (2014), p.83
- Full Text:
- Reviewed:
- Description: Background: There is a need for psychosocial interventions for men with prostate cancer to promote adaptive coping with the challenges and distress associated with diagnosis, treatment and recovery. In addition, interventions are needed that help to overcome barriers to psychosocial treatment such as limited face-to-face psychosocial support services, a shortage of adequately trained professionals, geographical distance, perceived and personal stigma and a preference for consumer-centric and self-directed learning. My Road Ahead is an online cognitive behaviour therapy (CBT) intervention for prostate cancer. This protocol describes a randomised controlled trial (RCT) that will evaluate the efficacy of this online intervention alone, the intervention in combination with a moderated online forum, and the moderated online forum alone. Methods/design: This study utilises a RCT design with three groups receiving: 1) the 6-module My Road Ahead intervention alone; 2) the My Road Ahead intervention plus a moderated online forum; and 3) the moderated online forum alone. It is expected that 150 men with localised prostate cancer will be recruited into the RCT. Online measures will assess men's psychological distress as well as sexual and relationship adjustment at baseline, post-intervention, 3 month follow-up and 6 month follow-up. The study is being conducted in Australia and participants will be recruited from April 2012 to Feb 2014. The primary aim of this study is to evaluate the efficacy of My Road Ahead in reducing psychological distress. Discussion: To our knowledge, My Road Ahead is the first self-directed online psychological intervention developed for men who have been treated for localised prostate cancer. The RCT will assess the efficacy of this intervention in improving psychological well-being, sexual satisfaction, relationship satisfaction and overall quality of life. If successful, this intervention could provide much needed support to men receiving treatment for localised prostate cancer in a highly accessible manner. Trial registration: Australian New Zealand Clinical Trials Registry Identifier: ACTRN12611000278932. © 2014 Wootten et al.; licensee BioMed Central Ltd.
- Authors: Wootten, Addie , Abbott, Jo-Anne , Chisholm, Katherine , Austin, David , Klein, Britt , McCabe, Marita , Meyer, Denny , Costello, Anthony , Murphy, Declan
- Date: 2014
- Type: Text , Journal article
- Relation: BMC Cancer Vol. 14, no. 1 (2014), p.83
- Full Text:
- Reviewed:
- Description: Background: There is a need for psychosocial interventions for men with prostate cancer to promote adaptive coping with the challenges and distress associated with diagnosis, treatment and recovery. In addition, interventions are needed that help to overcome barriers to psychosocial treatment such as limited face-to-face psychosocial support services, a shortage of adequately trained professionals, geographical distance, perceived and personal stigma and a preference for consumer-centric and self-directed learning. My Road Ahead is an online cognitive behaviour therapy (CBT) intervention for prostate cancer. This protocol describes a randomised controlled trial (RCT) that will evaluate the efficacy of this online intervention alone, the intervention in combination with a moderated online forum, and the moderated online forum alone. Methods/design: This study utilises a RCT design with three groups receiving: 1) the 6-module My Road Ahead intervention alone; 2) the My Road Ahead intervention plus a moderated online forum; and 3) the moderated online forum alone. It is expected that 150 men with localised prostate cancer will be recruited into the RCT. Online measures will assess men's psychological distress as well as sexual and relationship adjustment at baseline, post-intervention, 3 month follow-up and 6 month follow-up. The study is being conducted in Australia and participants will be recruited from April 2012 to Feb 2014. The primary aim of this study is to evaluate the efficacy of My Road Ahead in reducing psychological distress. Discussion: To our knowledge, My Road Ahead is the first self-directed online psychological intervention developed for men who have been treated for localised prostate cancer. The RCT will assess the efficacy of this intervention in improving psychological well-being, sexual satisfaction, relationship satisfaction and overall quality of life. If successful, this intervention could provide much needed support to men receiving treatment for localised prostate cancer in a highly accessible manner. Trial registration: Australian New Zealand Clinical Trials Registry Identifier: ACTRN12611000278932. © 2014 Wootten et al.; licensee BioMed Central Ltd.
- Couper, Jeremy, Love, Anthony, Duchesne, Gillian, Bloch, Sidney, MacVean, Michelle, Dunai, Judy, Scealy, Marita, Costello, Anthony, Kissane, David
- Authors: Couper, Jeremy , Love, Anthony , Duchesne, Gillian , Bloch, Sidney , MacVean, Michelle , Dunai, Judy , Scealy, Marita , Costello, Anthony , Kissane, David
- Date: 2010
- Type: Text , Journal article
- Relation: Medical Journal of Australia Vol. 193, no. 5 (2010), p. S58-S61
- Full Text: false
- Reviewed:
- Description: Objective: To assess psychosocial distress in patients with early (localised) and advanced (metastatic) prostate cancer (PCA) at diagnosis (Time 1) and 12 months later (Time 2), and identify psychosocial factors predictive of later distress. Design, participants and setting: Observational, prospective study of 367 men with early (211) or advanced (156) PCA recruited as consecutive attendees at clinics at seven public hospitals and practices in metropolitan Melbourne between 1 April 2001 and 30 December 2005. Both groups completed questionnaires at Time 1 and Time 2. Main outcome measures: Health-related quality of life as assessed by the Short Form 36-item Health Survey; psychological distress, including depression and anxiety as assessed by the Brief Symptom Inventory; and coping patterns as assessed by the Mini-Mental Adjustment to Cancer scale. Results: Over the 12 months, both the early and advanced RCA group showed reduced vitality and increased depression and anxiety; this effect was greater in the advanced PCA group. Mental health, social functioning and role-emotional functioning also deteriorated in the advanced group. Predictors of depression at Time 2 for the early PCA group were depression, vitality and a fatalistic coping pattern at Time 1; anxiety at Time 2 was predicted by anxiety and vitality at Time 1. In the advanced PCA group, depression at Time 2 was predicted by depression and mental health at Time 1; anxiety at Time 2 was predicted by anxiety, mental health, cognitive avoidance and lower anxious preoccupation at Time 1. Conclusions: Men with early PCA experience decreasing vitality and increasing psychological distress over the 12 months following diagnosis; this trend is accelerated after diagnosis with advanced RCA. A fatalistic coping pattern at diagnosis of early PCA predicts later depression while cognitive avoidance and lower anxious preoccupation at diagnosis of advanced PCA predict later anxiety.
- Wootten, Addie, Abbott, Jo-Anne, Meyer, Denny, Chisholm, Katherine, Austin, David, Klein, Britt, McCabe, Marita, Murphy, Declan, Costello, Anthony
- Authors: Wootten, Addie , Abbott, Jo-Anne , Meyer, Denny , Chisholm, Katherine , Austin, David , Klein, Britt , McCabe, Marita , Murphy, Declan , Costello, Anthony
- Date: 2015
- Type: Text , Journal article
- Relation: European Urology Vol. 68, no. 3 (2015), p. 471-479
- Full Text: false
- Reviewed:
- Description: Background Prostate cancer (PCa) poses many emotional and physical challenges for men following treatment. The unmet support needs of these men are well documented, and access to psychosocial support remains problematic. Objectives To assess the efficacy of an online psychological intervention for men who have localised PCa. Design, setting, and participants We undertook a randomised controlled trial to evaluate the intervention. Participants were randomly allocated to one of three conditions: My Road Ahead (MRA) alone (MRA Only), MRA plus access to an online forum (MRA + Forum), and access to the forum alone (Forum). Intervention The intervention was a 10-week self-guided online psychological intervention called My Road Ahead that consisted of six themed modules designed to facilitate improved emotional well-being in the context of PCa as well as a moderated peer forum. Outcome measurements and statistical analysis Pre- and postintervention assessments of psychological distress (the 21-question Depression, Anxiety and Stress Scale) [1] and the Prostate Cancer-related Quality of Life scale [2] were conducted. Multivariate analysis of variance, regression, and structural equation modelling were used to analyse the data. Results and limitations In total, 142 participants were randomly allocated to one of the three intervention arms. The mean age of participants was 61 yr of age (standard deviation: 7), and 88% had undergone radical prostatectomy. A significant improvement in psychological distress was observed for participants who had access to the combined condition (MRA + Forum) with a moderate effect size (p = 0.02; partial η2 = 0.07). In particular, the decline in the mean level of psychological distress was 8.8 units larger for the MRA + Forum group than the Forum group (95% confidence interval [CI], 0.9-16.7). Although the decline in the mean level of psychological distress was 7.0 units larger for the MRA + Forum group than for the MRA Only group, this difference was not significant (95% CI, 1.1-15.1). Structural equation modelling indicated that reductions in health worry and regret contributed significantly to the reductions in psychological distress for the MRA + Forum condition. Conclusions This study is the first, to our knowledge, that has evaluated a self-guided online psychological intervention tailored to the specific needs of men who have PCa. The findings of this study indicate the potential for this programme to deliver support that men may not otherwise receive. Patient summary This study found that men who have localised prostate cancer who received access to the online psychological intervention called My Road Ahead combined with the online peer discussion forum had significantly improved reductions in distress compared with those who received access to the online intervention alone or the forum alone. © 2014 European Association of Urology.
Psychosocial adjustment in newly diagnosed prostate cancer
- Love, Anthony, Scealy, Marita, Bloch, Sidney, Duchesne, Gillian, Couper, Jeremy, MacVean, Michelle, Costello, Anthony, Kissane, David
- Authors: Love, Anthony , Scealy, Marita , Bloch, Sidney , Duchesne, Gillian , Couper, Jeremy , MacVean, Michelle , Costello, Anthony , Kissane, David
- Date: 2008
- Type: Text , Journal article
- Relation: Australian and New Zealand Journal of Psychiatry Vol. 42, no. 5 (2008), p. 423-429
- Full Text: false
- Reviewed:
- Description: Objective: To examine the psychological and social adjustment of men with early or advanced stage prostate cancer and to compare them with a matched group of cancer-free community volunteers. Methods: A longitudinal observational study in which 367 men recently diagnosed with early (n =211) or advanced stage (n = 156), prostate cancer were compared to 169 cancer-free men from the community, of similar age and residential area, using self-report measures of psychosocial adjustment. Results: On the mental health subscales of the Short-Form 36-item Health Survey, men with advanced disease had lower vitality and social functioning than the other two groups, and lower mental health scores than the comparison group. Both patient groups had lower role-emotional scores than the comparison group. With regard to the Brief Symptom Inventory, the advanced disease group had higher somatization scores, and lower interpersonal sensitivity and paranoid ideation scores than the early stage group and the community comparison group. In terms of psychiatric morbidity, there were higher rates of anxiety disorders but not depressive disorders in both patient groups although overall diagnosis rates were low. No differences were found in terms of couple or family functioning. Conclusions: There is impairment in psychosocial function in men with prostate cancer, particularly those with advanced disease, but no increase in the rate of formal psychiatric disorder or adverse effects on the couples and families. This suggests directions for psychosocial interventions with these patient groups
The impact of prostate cancer on partners: A qualitative exploration
- Wootten, Addie, Abbott, Jo-Anne, Osborne, Dawn, Austin, David, Klein, Britt, Costello, Anthony, Murphy, Declan
- Authors: Wootten, Addie , Abbott, Jo-Anne , Osborne, Dawn , Austin, David , Klein, Britt , Costello, Anthony , Murphy, Declan
- Date: 2014
- Type: Text , Journal article
- Relation: Psycho-Oncology Vol. 23, no. 11 (2014), p. 1252-1258
- Full Text: false
- Reviewed:
- Description: Objective: Prostate cancer and its treatment can result in numerous physical and psychological morbidities for the patient as well as his partner. This qualitative study aimed to explore the experiences of intimate spouses or partners of men diagnosed and/or treated for prostate cancer to better understand the personal impact of prostate cancer on the partner. Methods: Twenty-seven partners participated in this study. Six focus groups were convened, and one in-depth interview was undertaken to explore the practical impact of prostate cancer on the intimate spouse/partner. All discussions were audio-recorded and transcribed and then coded using a thematic approach. Results: Six themes emerged: (a) The influence of the man's response to prostate cancer on the partner, (b) The need to be involved in treatment and medical decision making, (c) Supporting a man who is experiencing a loss of masculinity, (d) Degree of congruence between each partner's coping responses, (e) Constrained communication, and (f) Changed roles and increased practical management. Conclusions: It is clear that prostate cancer impacts substantially on many areas of partner well-being. An effective intervention provided to this population seems warranted and may lead to improvements in partner well-being, assist the couple in lessening the impact of prostate cancer and its treatment on their relationship, and assist in the man's recovery. © 2014 John Wiley & Sons, Ltd.
The psychological aftermath of prostate cancer treatment choices : A comparison of depression, anxiety and quality of life outcomes over the 12 months following diagnosis
- Couper, Jeremy, Love, Anthony, Dunai, Judy, Duchesne, G. M., Bloch, Sidney, Costello, Anthony, Kissane, David
- Authors: Couper, Jeremy , Love, Anthony , Dunai, Judy , Duchesne, G. M. , Bloch, Sidney , Costello, Anthony , Kissane, David
- Date: 2009
- Type: Text , Journal article
- Relation: Medical Journal of Australia Vol. 190, no. 7 SUPPL. (2009), p. S86-S89
- Full Text:
- Reviewed:
- Description: Objective: To assess the psychological impact of the different treatments for localised prostate cancer (PCA). Design, participants and setting: Observational, prospective study of consecutive patients with PCA attending clinics in public hospitals and private practices in metropolitan Melbourne between 1 April 2001 and 30 December 2005. Data were collected at initial diagnosis of histologically confirmed localised PCA, and close to the commencement of definitive treatment (Time 1), and 12 months later (Time 2). Patients were stratified according to treatment type (radical prostatectomy [RP], hormone therapy [HT] or other early treatment including radiation therapies [OET]). Patients who elected to undergo active surveillance/ watchful waiting (WW) rather than active treatment were treated as a naturalistic control group. Main outcome measures: Levels of depression and anxiety were assessed by the Brief Symptom Inventory, and physical and psychosocial aspects of health-related quality of life (HRQOL) were assessed by the 36-item Short-Form Health Survey. Results: 211 patients with PCA were recruited; 193 completed the Time 1 questionnaires (38 RP, 56 HT, 38 OET and 61 WW); and 172 completed the Time 2 questionnaires (33 RP, 51 HT, 33 OET and 55 WW). At Time 1, the three active treatment groups all reported greater dysfunction in work role and daily activities compared with the WW group. The RP group also reported worse social and emotional role functioning, while the HT and OET groups reported poorer vitality levels. The HT group reported significantly higher depression scores. At Time 2, the RP and OET groups did not differ from the WW group on either HRQOL or psychological status. By contrast, the HT group reported significantly worse HRQOL (physical functioning, role-physical and vitality domains) and greater psychological distress compared with the WW group. Conclusions: Compared with the other active treatments for localised PCA, HT appears to be associated with poorer HRQOL and greater psychological distress 12 months after commencing treatment.
- Authors: Couper, Jeremy , Love, Anthony , Dunai, Judy , Duchesne, G. M. , Bloch, Sidney , Costello, Anthony , Kissane, David
- Date: 2009
- Type: Text , Journal article
- Relation: Medical Journal of Australia Vol. 190, no. 7 SUPPL. (2009), p. S86-S89
- Full Text:
- Reviewed:
- Description: Objective: To assess the psychological impact of the different treatments for localised prostate cancer (PCA). Design, participants and setting: Observational, prospective study of consecutive patients with PCA attending clinics in public hospitals and private practices in metropolitan Melbourne between 1 April 2001 and 30 December 2005. Data were collected at initial diagnosis of histologically confirmed localised PCA, and close to the commencement of definitive treatment (Time 1), and 12 months later (Time 2). Patients were stratified according to treatment type (radical prostatectomy [RP], hormone therapy [HT] or other early treatment including radiation therapies [OET]). Patients who elected to undergo active surveillance/ watchful waiting (WW) rather than active treatment were treated as a naturalistic control group. Main outcome measures: Levels of depression and anxiety were assessed by the Brief Symptom Inventory, and physical and psychosocial aspects of health-related quality of life (HRQOL) were assessed by the 36-item Short-Form Health Survey. Results: 211 patients with PCA were recruited; 193 completed the Time 1 questionnaires (38 RP, 56 HT, 38 OET and 61 WW); and 172 completed the Time 2 questionnaires (33 RP, 51 HT, 33 OET and 55 WW). At Time 1, the three active treatment groups all reported greater dysfunction in work role and daily activities compared with the WW group. The RP group also reported worse social and emotional role functioning, while the HT and OET groups reported poorer vitality levels. The HT group reported significantly higher depression scores. At Time 2, the RP and OET groups did not differ from the WW group on either HRQOL or psychological status. By contrast, the HT group reported significantly worse HRQOL (physical functioning, role-physical and vitality domains) and greater psychological distress compared with the WW group. Conclusions: Compared with the other active treatments for localised PCA, HT appears to be associated with poorer HRQOL and greater psychological distress 12 months after commencing treatment.
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