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Objective: Cancer patients and partners often report inadequate communication about illness-related issues, although it is essential for mutual support and informal caregiving. This study examined the patterns of change in dyadic communication between patients with prostate cancer and their partners, and also determined if certain factors affected their communication over time. Method: Using multilevel modeling, this study analyzed longitudinal data obtained from a randomized clinical trial with prostate cancer patients and their partners, to examine their communication over time. Patients and partners ( N=134 pairs) from the usual-care control group independently completed baseline demographic assessment and measures of social support, uncertainty, symptom distress, and dyadic communication at baseline, and 4-, 8-, and 12-month follow-ups. Results: The results indicated that (1) patients and partners reported similar levels of open communication at the time of diagnosis. Communication reported by patients and partners decreased over time in a similar trend, regardless of phase of illness; (2) phase of illness affected couples' open communication at diagnosis but not patterns of change over time; and (3) couples' perceived communication increased as they reported more social support, less uncertainty, and fewer hormonal symptoms in patients. Couples' demographic factors and general symptoms, and patients' prostate cancer-specific symptoms did not affect their levels of open communication. Conclusions: Perceived open communication between prostate cancer patients and partners over time is affected by certain baseline and time-varying psychosocial and cancer-related factors. The results provide empirical evidence that may guide the development of strategies to facilitate couples' interaction and mutual support during survivorship. Copyright © 2010 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Using Orem’s theory as the framework, two purposes guided the study: (a) to test the effectiveness of an audio-visual education program and behavioral contracting to promote self-care behaviors in managing radiation side effects and (b) to determine the extent to which low literacy affects self-care abilities. Seventy men diagnosed with prostate cancer participated in this experimental study. The nursing interventions of education and behavioral contracting significantly increased the self-care behaviors of men in managing radiation side effects. An increase in self-care behaviors was especially shown in men with low-literacy skills. [ABSTRACT FROM PUBLISHER]

Background: Few intervention studies have been conducted to help couples manage the effects of prostate cancer and maintain their quality of life. The objective of this study was to determine whether a family-based intervention could improve appraisal variables (appraisal of illness or caregiving, uncertainty, hopelessness), coping resources (coping strategies, self-efficacy, communication), symptom distress, and quality of life in men with prostate cancer and their spouses.Methods: For this clinical trial, 263 patient-spouse dyads were stratified by research site, phase of illness, and treatment; then, they were randomized to the control group (standard care) or the experimental group (standard care plus a 5-session family intervention). The intervention targeted couples' communication, hope, coping, uncertainty, and symptom management. The final sample consisted of 235 couples: 123 couples in the control group and 112 couples in the experimental group. Data collection occurred at baseline before randomization and at 4 months, 8 months, and 12 months.Results: At 4-month follow-up, intervention patients reported less uncertainty and better communication with spouses than control patients, but they reported no other effects. Intervention spouses reported higher quality of life, more self-efficacy, better communication, and less negative appraisal of caregiving, uncertainty, hopelessness, and symptom distress at 4 months compared with controls, and some effects were sustained to 8 months and 12 months.Conclusions: Men with prostate cancer and their spouses reported positive outcomes from a family intervention that offered them information and support. Programs of care need to be extended to spouses who likely will experience multiple benefits from intervention. [ABSTRACT FROM AUTHOR]

The purposes of this article are: (a) to describe and analyze the accrual and retention patterns in a longitudinal randomized clinical trial with prostate cancer patients and their partners, and (b) to discuss strategies that were used to overcome challenges in conducting this family-based study. Initially, 429 dyads were referred to the study. Of these, 166 were not enrolled due to refusal (n = 120) or ineligibility (n = 46), 21 of whom did not meet one or more of the inclusion criteria, and 25 of whom could not be reached within the 2-month window of eligibility. Of the 383 eligible dyads, 263 dyads were enrolled (enrollment rate of 68.7%). Accrual and retention patterns differed by research site, referral procedures, and phase of prostate cancer. The retention rate was very good with the majority of dyads (n = 218) completing all three follow-up assessments at 4, 8, and 12 months (82.9%). © 2006 Wiley Periodicals, Inc. Res Nurs Health 29:199–211, 2006 [ABSTRACT FROM AUTHOR]

Prostate cancer is the most common cancer among men in the United States and is accompanied by devastating treatment-related sequelae (incontinence, sexual dysfunction) that can negatively affect the quality of life of men and their spouses. To date, few intervention studies have been conducted to help men and spouses manage the effects of illness and maintain their quality of life. The purpose of this study was to determine if a family intervention could improve several proximal outcomes (appraisal of illness or caregiving, hopelessness, uncertainty, self-efficacy, coping, family communication, and symptom bother) and the distal outcome of quality of life in men with prostate cancer and their spouses. This study was guided by a stress-coping framework. A randomized clinical trial was used with a sample of men with prostate cancer and their spouses. Men were in one of three phases of illness: newly diagnosed, post-treatment biochemical recurrence, or advanced. Dyads were referred to the study by clinic staff. Of those referred, 263 dyads completed baseline assessments were randomly assigned to treatment (129 dyads) or control group (134 dyads), and completed a follow-up assessment at 4 months (236 dyads). The intervention was a five session, family program that consisted of three home visits and two follow-up phone calls by masters- prepared nurses. Several instruments with established reliability and validity were administered: Appraisal of Illness/Caregiving Scales, Beck Hopelessness Scale, Mishel Uncertainty Scale, Lewis Self-efficacy Scale, Brief COPE, Lewis MIS scale, Symptoms Scale, and FACT-G. Descriptive statistics and repeated measures ANOVA were used for data analyses. Findings indicated that patients in the intervention group reported significantly less uncertainty (p=.06), better communication (p=.06), and higher quality of life (p=.07) than control patients. Spouses in the intervention group reported significantly less negative appraisal of caregiving (p=.004), less hopelessness (p=.04), less uncertainty (p=.007), more self-efficacy (p=.05), better communication (p=.002), and higher quality of life (p=.003) than control spouses. Findings suggest that the family intervention produced beneficial outcomes for patients and spouses and is relevant for clinical practice. Funding Sources: National Cancer Institute (R01CA90739) [ABSTRACT FROM AUTHOR]

Purpose/Objectives: To explore the experiences of couples living with prostate cancer, the impact of the illness on their quality of life, their ability to manage symptoms, and their suggestions for interventions that would help them to improve their daily experiences. Design: Descriptive, qualitative. Setting: Six focus groups were used to obtain the data; two were patient-only groups, two were spouse-caregiver groups, and two were dyad groups. The focus groups were conducted at two comprehensive cancer centers in the midwestern region of the United States. Sample: 42 participants: 22 men with prostate cancer and 20 spouse-caregivers. Methods: Focus group discussions were tape-recorded, and the content was analyzed. Main Research Variables: Quality of life, symptom experience, and areas for intervention. Findings: Four major themes emerged from the data: enduring uncertainty, living with treatment effects, coping with changes, and needing help. Conclusions: Participants had a need for information and support. Both men and spouse-caregivers felt unprepared to manage treatment effects. Symptoms had a broad effect on couples, not just men. Positive effects of the illness, as well as negative effects, emerged from the themes. Implications for Nursing: Attention needs to be given to methods of providing information and support to couples coping with prostate cancer. Both patients and partners need to be included in discussions about the effect of the illness and treatments so that both can feel more prepared to manage them. [ABSTRACT FROM AUTHOR]