Table 3 Self-care psychological interventions targeting prostate cancer patients
Author(s) | Mode of delivery | Intervention description | Intervention components | Results/effectiveness/points of interest | Implications for PROACTIVE |
|---|---|---|---|---|---|
Parker et al. (2009) [25] | Group-based environment | Pre-surgical stress management programme for men undergoing radical prostatectomy | 2 × 90-min sessions that involved: • Learning relaxation skills • Guided imaginary rehearsals of surgery day • Discussion about fears and implementation of coping strategies 2 × booster sessions: on the morning of surgery; and 48 h post-surgery | Significantly less mood disturbance, cancer-related worries and physical side effects than controls. Effects maintained at 12 months 221 potential participants approached, 159 took part | Level of uptake suggests PCa patients are willing to take part in self-care interventions to improve psychological wellbeing |
Group-based environment | Cognitive behavioural stress management intervention with men who had received either radical prostatectomy or radiotherapy for PCa | 10 week intervention with 2 h weekly sessions involving: • Implementing relaxation techniques • Utilising techniques such as identifying distorted thoughts • Goal setting • Utilising social support | Significant improvements in both general and PCa specific quality of life compared to controls | In PCa patients relaxation interventions are both well received and clinically effective | |
Group-based environment | Standardised Mindfulness Based Stress Reduction (MBSR) course | 8 weekly sessions incorporating: • Relaxation • Meditation • Gently yoga • Daily home practice (Note: Recruits not exclusively PCa) | Significant improvements in sleep, stress, anxiety, mood and fatigue | Results were not stratified by disease type, so hard to draw any strong implications for PROACTIVE; however, the study findings do support the notion of group-based support for cancer patients | |
Templeton and Coates (2004) [30] | Group based environment | Educational intervention | Brief, group-based, nurse-led single session for men being treated with hormone therapy for PCa. Participants were provided with an information booklet | Compared to controls, significant improvements in general and PCa-specific quality of life, PCa knowledge and satisfaction with care | Intervention effectiveness may not be dose related, and short interventions may be as effective as more time consuming programmes Information provision is valued by PCa patients The participants in this trial were receiving hormone treatment and those on AS may feel differently |
Berglund et al. (2007) [31] | Group based environment | Psychosocial rehabilitation | 7-week group based intervention 3 arms; information arm, physical activity arm, combined arm, plus a control group • Information arm led by PCa nurse and participants received information about what PCa is, treatment options, side effects and methods of dealing with urinary and erectile dysfunction • Physical activity arm led by physiotherapist and focussed on increasing daily exercise • Combined arm received both | No significant improvements in anxiety, depression or quality of life | Unclear why the intervention was unsuccessful, perhaps information needs to be combined with relaxation/stress management techniques |
Lepore et al. (2003) [32] | Group based environment | Educational intervention | 3 groups, intervention, intervention plus discussion, control group Intervention involved 6 1-h weekly group sessions involving: • Prostate cancer biology information • Treatment options • Managing side effects • Diet and nutrition • Stress, coping and relaxation | Both intervention arms showed significant improvements in PCa knowledge and experienced less sexual dysfunction compared to the control group. No significant improvements in depression | Depression baseline taken after treatment, low levels to start with so hard to draw conclusions for PROACTIVE from this |
Bailey et al. (2004) [33] | Telephone | Intervention to manage uncertainty | This was designed for men on watchful waiting. 5 brief telephone consultations with a male PCa nurse, with week-long intervals. Telephone consultations around: • Re-framing negative thoughts • Managing uncertainty • Accepting watchful waiting | Significant improvements in quality of life and uncertainty management compare to controls | This study limited by high homogeneity in the sample, and watchful waiting patients may be different to AS patients |
Chambers et al. (2013) [34] | Telephone | Psycho-educational intervention | 5 brief telephone consultations with PCa patients around: • Cognitive reframing • PCa education • Management of side effects • Management of stress • Developing problem solving skills | Significant improvements in mental health and cancer related distress in younger patients with higher levels of education and income, but not in the rest of the sample | Heterogeneous sample compared to Bailey et al. (2004), and large sample recruited from multiple centres. Indicates telephone support may not be effective for some groups of PCa patients |
Kazer et al. (2011) [35] | Internet | Intervention to manage uncertainty | 5-week online intervention named “Alive and Well” for men on AS. Components included: • Cognitive reframing of negative thoughts • PCa and AS information • Lifestyle advice • Tailored emails | Significant improvement in 8 of the 12 quality of life subscales measured at the end of the intervention | An online-only intervention improve quality of life in men on AS |
Osei et al. (2013) [36] | Internet | Intervention to improve quality of life | 6-week online intervention for men radically treated for PCa involving: • Online support forum • PCa information • Support managing side effects | Significant improvements in quality of life, but not maintained at follow-up | Support may need to be more long term to improve outcomes beyond the study timeframe |
Weber et al. (2004) [37] | Other—dyadic support | Social support intervention | Post-radical prostatectomy patients paired with men who had the same surgery 5 years previously. Men in the intervention arm met with long term survivors once a week for 8 weeks | Men in intervention arm reported significantly lower levels of depression and significantly higher levels of self-efficacy compared to controls. High attrition rate – all 8 sessions attended by every intervention arm participant | Dyadic support well adhered to Support from men who have had similar experiences can be effective in improving psychological outcomes |