Distress among Prostate Cancer Patients and Spouses is Associated with Hormone Treatment and Participation in Decision-Making

2007 ◽  
Vol 1 ◽  
pp. 117955490700100
Author(s):  
E.K. Salminen ◽  
R. Portin ◽  
M.J. Nurmi

Background The aim of this study was to chart cancer experience and distress shared between prostate cancer (PC) patients and their spouses, focusing on effects of hormone treatment and treatment decision-making. Patients and methods This observational prospective study involved 203 PC patients and 194 spouses surveyed within 5 years from being diagnosed with PC. Fifty percent of the patients had received hormone treatment. Results Younger (<65 years) patients and spouses were significantly more distressed than the older. Patients receiving hormone treatment tended to be more distressed than those not treated (sum of scores, 5.6 vs 4.3, p = 0.017), and the same trend was seen in their spouses (p = 0.08). The spouse experienced difficulties in concentration and decision-making (Chi-squared test, p = 0.012) and somatic symptoms (p = 0.049) more often if the patient suffered the same problems. Use of alcohol/drugs was significantly more common among younger (<65 years) spouses (27.8% vs 7.2%, p < 0.001) and in those with higher level of education (26.1% vs 12.2%, p = 0.015). Conclusions Significant associations were observed in distress variables between prostate cancer patients and spouses, especially among younger patients and when hormone treatment was used. Distress among patients was associated with participation in treatment-decision making, and among spouses with age and educational level.

2006 ◽  
Vol 63 (3) ◽  
pp. 308-313 ◽  
Author(s):  
Maarten Fischer ◽  
Adriaan Visser ◽  
Bert Voerman ◽  
Bert Garssen ◽  
George van Andel ◽  
...  

Author(s):  
Andreas Ihrig ◽  
I. Maatouk ◽  
H. C. Friederich ◽  
M. Baunacke ◽  
C. Groeben ◽  
...  

Abstract Different patients want to take different roles in the treatment decision-making process; these roles can be classified as passive, collaborative, and active. The aim of this study was to investigate the correlation between decision-making preferences among patients with prostate cancer and personal, disease-related, and structural factors. In four survey studies, we asked 7169 prostate cancer patients about their decision-making preferences using the Control Preferences Scale (CPS) and collected clinical, psychological, and quality-of-life measures. Most patients (62.2%) preferred collaborative decision-making, while 2322 (32.4%) preferred an active role, and only 391 (5.5%) preferred a passive role. Age (p < 0.001), data collection mode (p < 0.001), peer-to-peer support (p = 0.018), treatment status (p < 0.001), performed or planned radical prostatectomy (p < 0.001), metastatic disease (p = 0.001), and quality of life (p < 0.001) showed significant associations with patients’ preferred decision-making roles. Oncologic risk group, anxiety, and depression were not significant in the model. In particular, younger prostate cancer patients with higher quality of life completing an online survey want to play a more active role in treatment decision-making. Before treatment has started, patients tend to prefer collaborative decision-making. Few prostate cancer patients in Germany prefer a passive role. These patients are mostly older patients, patients with a metastatic disease, and patients who have opted for prostatectomy. Whether this finding reflects a generational effect or a tendency by age group and disease phase should be investigated. Further research is also needed to describe the causalities of these relationships. The CPS offers valuable information for personal counselling and should be applied in clinical routine. In a large group of patients with prostate cancer, we found that there is a strong desire for joint decision-making with the physician before the actual treatment. Especially younger men, men with active online behaviour, and men with a high quality of life want to be actively involved in therapy decision-making processes.


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