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Erschienen in: International Journal of Behavioral Medicine 5/2020

01.10.2020 | Full length manuscript

Technology-Based Psychosocial Intervention to Improve Quality of Life and Reduce Symptom Burden in Men with Advanced Prostate Cancer: Results from a Randomized Controlled Trial

verfasst von: Frank J. Penedo, Rina S. Fox, Laura B. Oswald, Patricia I. Moreno, Cody L. Boland, Ryne Estabrook, Heather L. McGinty, David C. Mohr, Mark J. Begale, Jason R. Dahn, Sarah C. Flury, Kent T. Perry, Shilajit D. Kundu, Betina Yanez

Erschienen in: International Journal of Behavioral Medicine | Ausgabe 5/2020

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Abstract

Background

Men with advanced prostate cancer (APC) face multiple challenges including poor prognosis, poor health-related quality of life (HRQOL), and elevated symptom burden. This study sought to establish the efficacy of a tablet-delivered, group-based psychosocial intervention for improving HRQOL and reducing symptom burden in men with APC. We hypothesized that men randomized to cognitive-behavioral stress management (CBSM) would report improved HRQOL and reduced symptom burden relative to men randomized to an active control health promotion (HP) condition. Condition effects on intervention targets and moderators of these effects were explored.

Methods

Men with APC (N = 192) were randomized (1:1) to 10-week tablet-delivered CBSM or HP, and followed for 1 year. Multilevel modeling was used to evaluate condition effects over time.

Results

Changes in HRQOL and symptom burden did not differ between groups. Men in both groups improved across several intervention targets; men in the CBSM condition reported greater increases in self-reported ability to relax, and both conditions showed improvements in cancer-related anxiety, cancer-related distress, and feelings of cohesiveness with other patients over time. Moderating factors included baseline interpersonal disruption, fatigue, and sexual functioning.

Conclusions

Tablet-delivered CBSM and HP were well received by men with APC. The hypothesized effects of CBSM on HRQOL and symptom burden were not supported, though improvements in intervention targets were observed across conditions. Participants reported high-baseline HRQOL relative to cancer and general population norms, possibly limiting intervention effects. The identified moderating factors should be considered in the development and implementation of interventions targeting HRQOL and symptom burden.

Trial Registration

ClinicalTrials.gov Identifier: NCT03149185
Literatur
1.
Zurück zum Zitat American Cancer Society. Cancer Facts & Figures 2018. Atlanta: American Cancer Society; 2018. American Cancer Society. Cancer Facts & Figures 2018. Atlanta: American Cancer Society; 2018.
2.
Zurück zum Zitat Chen RC, Chang P, Vetter RJ, et al. Recommended patient-reported core set of symptoms to measure in prostate cancer treatment trials. J Natl Cancer Inst. 2014;106:dju132.PubMedPubMedCentral Chen RC, Chang P, Vetter RJ, et al. Recommended patient-reported core set of symptoms to measure in prostate cancer treatment trials. J Natl Cancer Inst. 2014;106:dju132.PubMedPubMedCentral
3.
Zurück zum Zitat Sonn GA, Sadetsky N, Presti JC, Litwin MS. Differing perceptions of quality of life in patients with prostate cancer and their doctors. J Urol. 2013;189:S59–65.PubMed Sonn GA, Sadetsky N, Presti JC, Litwin MS. Differing perceptions of quality of life in patients with prostate cancer and their doctors. J Urol. 2013;189:S59–65.PubMed
4.
Zurück zum Zitat Warde P, Mason M, Ding K, et al. Combined androgen deprivation therapy and radiation therapy for locally advanced prostate cancer: a randomised, phase 3 trial. Lancet. 2011;378:2104–11.PubMedPubMedCentral Warde P, Mason M, Ding K, et al. Combined androgen deprivation therapy and radiation therapy for locally advanced prostate cancer: a randomised, phase 3 trial. Lancet. 2011;378:2104–11.PubMedPubMedCentral
5.
Zurück zum Zitat Zajdlewicz L, Hyde MK, Lepore SJ, Gardiner RA, Chambers SK. Health-related quality of life after the diagnosis of locally advanced or advanced prostate cancer: a longitudinal study. Cancer Nurs. 2017;40:412–9.PubMed Zajdlewicz L, Hyde MK, Lepore SJ, Gardiner RA, Chambers SK. Health-related quality of life after the diagnosis of locally advanced or advanced prostate cancer: a longitudinal study. Cancer Nurs. 2017;40:412–9.PubMed
6.
Zurück zum Zitat Perlmutter MA, Lepor H. Androgen deprivation therapy in the treatment of advanced prostate cancer. Rev Urol. 2007;9(Suppl 1):S3–8.PubMedPubMedCentral Perlmutter MA, Lepor H. Androgen deprivation therapy in the treatment of advanced prostate cancer. Rev Urol. 2007;9(Suppl 1):S3–8.PubMedPubMedCentral
7.
Zurück zum Zitat Potosky AL, Reeve BB, Clegg LX, Hoffman RM, Stephenson RA, Albertsen PC, et al. Quality of life following localized prostate cancer treated initially with androgen deprivation therapy or no therapy. J Natl Cancer Inst. 2002;94(6):430–7.PubMed Potosky AL, Reeve BB, Clegg LX, Hoffman RM, Stephenson RA, Albertsen PC, et al. Quality of life following localized prostate cancer treated initially with androgen deprivation therapy or no therapy. J Natl Cancer Inst. 2002;94(6):430–7.PubMed
8.
Zurück zum Zitat Sheinfeld Gorin S, Krebs P, Gadr H. Meta-analysis of psychosocial interventions to reduce pain in patients with cancer. J Clin Oncol. 2012;30:539–47.PubMedPubMedCentral Sheinfeld Gorin S, Krebs P, Gadr H. Meta-analysis of psychosocial interventions to reduce pain in patients with cancer. J Clin Oncol. 2012;30:539–47.PubMedPubMedCentral
9.
Zurück zum Zitat de la Torre-Luque A, Gambara H, López E, Cruzado JA. Psychological treatments to improve quality of life in cancer contexts: a meta-analysis. Int J Clin Health Psychol. 2016;16:211–9.PubMed de la Torre-Luque A, Gambara H, López E, Cruzado JA. Psychological treatments to improve quality of life in cancer contexts: a meta-analysis. Int J Clin Health Psychol. 2016;16:211–9.PubMed
10.
Zurück zum Zitat Penedo FJ, Dahn JR, Molton I, Gonzalez JS, Kinsinger D, Roos BA, et al. Cognitive-behavioral stress management improves stress-management skills and quality of life in men recovering from treatment of prostate carcinoma. Cancer. 2004;100:192–200.PubMed Penedo FJ, Dahn JR, Molton I, Gonzalez JS, Kinsinger D, Roos BA, et al. Cognitive-behavioral stress management improves stress-management skills and quality of life in men recovering from treatment of prostate carcinoma. Cancer. 2004;100:192–200.PubMed
11.
Zurück zum Zitat Traeger L, Penedo FJ, Gonzalez JS, Dahn JR, Lechner SC, Schneiderman N, et al. Illness perceptions and emotional well-being in men treated for localized prostate cancer. J Psychosom Res. 2009;67:389–97.PubMed Traeger L, Penedo FJ, Gonzalez JS, Dahn JR, Lechner SC, Schneiderman N, et al. Illness perceptions and emotional well-being in men treated for localized prostate cancer. J Psychosom Res. 2009;67:389–97.PubMed
12.
Zurück zum Zitat Parahoo K, McDonough S, McCaughan E. Psychosocial interventions for men with prostate cancer: a Cochrane systematic review. BJU Int. 2015;116:174–83.PubMed Parahoo K, McDonough S, McCaughan E. Psychosocial interventions for men with prostate cancer: a Cochrane systematic review. BJU Int. 2015;116:174–83.PubMed
13.
Zurück zum Zitat Folstein MF, Folstein SE, McHugh PR. “Mini-mental state”. A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res. 1975;12:189–98.PubMed Folstein MF, Folstein SE, McHugh PR. “Mini-mental state”. A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res. 1975;12:189–98.PubMed
14.
Zurück zum Zitat Penedo FJ, Antoni MH, Schneiderman N. Cognitive-behavioral stress management for prostate cancer recovery facilitator guide. New York: Oxford University Press; 2008. Penedo FJ, Antoni MH, Schneiderman N. Cognitive-behavioral stress management for prostate cancer recovery facilitator guide. New York: Oxford University Press; 2008.
15.
Zurück zum Zitat Fox RS, Moreno PI, Yanez B, et al. Integrating PROMIS® computerized adaptive tests into a web-based intervention for prostate cancer. Health Psychol. 2019;38:403–9.PubMedPubMedCentral Fox RS, Moreno PI, Yanez B, et al. Integrating PROMIS® computerized adaptive tests into a web-based intervention for prostate cancer. Health Psychol. 2019;38:403–9.PubMedPubMedCentral
16.
Zurück zum Zitat Schueller SM, Begale M, Penedo FJ, Mohr DC. Purple: a modular system for developing and deploying behavioral intervention technologies. J Med Internet Res. 2014;16:e181.PubMedPubMedCentral Schueller SM, Begale M, Penedo FJ, Mohr DC. Purple: a modular system for developing and deploying behavioral intervention technologies. J Med Internet Res. 2014;16:e181.PubMedPubMedCentral
17.
Zurück zum Zitat Cella DF, Tulsky DS, Gray G, Sarafian B, Linn E, Bonomi A, et al. The functional assessment of cancer therapy scale: development and validation of the general measure. J Clin Oncol. 1993;11:570–9.PubMed Cella DF, Tulsky DS, Gray G, Sarafian B, Linn E, Bonomi A, et al. The functional assessment of cancer therapy scale: development and validation of the general measure. J Clin Oncol. 1993;11:570–9.PubMed
18.
Zurück zum Zitat Brucker PS, Yost K, Cashy J, Webster K, Cella D. General population and cancer patient norms for the functional assessment of cancer therapy-general (FACT-G). Eval Health Prof. 2005;28:192–211.PubMed Brucker PS, Yost K, Cashy J, Webster K, Cella D. General population and cancer patient norms for the functional assessment of cancer therapy-general (FACT-G). Eval Health Prof. 2005;28:192–211.PubMed
19.
Zurück zum Zitat Wei JR, Dunn RL, Litwin MS, Sandler HM, Sanda MG. Development and validation of the expanded prostate cancer index composite (EPIC) for comprehensive assessment of health-related quality of life in men with prostate cancer. Urology. 2000;56:899–905.PubMed Wei JR, Dunn RL, Litwin MS, Sandler HM, Sanda MG. Development and validation of the expanded prostate cancer index composite (EPIC) for comprehensive assessment of health-related quality of life in men with prostate cancer. Urology. 2000;56:899–905.PubMed
20.
Zurück zum Zitat Ader DN. Developing the Patient-Reported Outcomes Measurement Information System (PROMIS). Med Care. 2007;45:S1–2. Ader DN. Developing the Patient-Reported Outcomes Measurement Information System (PROMIS). Med Care. 2007;45:S1–2.
21.
Zurück zum Zitat Schalet BD, Pilkonis PA, Yu L, et al. Clinical validity of PROMIS depression, anxiety, and anger across diverse clinical samples. J Clin Epidemiol. 2016;73:119–27.PubMedPubMedCentral Schalet BD, Pilkonis PA, Yu L, et al. Clinical validity of PROMIS depression, anxiety, and anger across diverse clinical samples. J Clin Epidemiol. 2016;73:119–27.PubMedPubMedCentral
22.
Zurück zum Zitat Clover K, Lambert SD, Oldmeadow C, et al. PROMIS depression measures perform similarly to legacy measures relative to a structured diagnostic interview for depression in cancer patients. Qual Life Res. 2018;27:1357–67.PubMed Clover K, Lambert SD, Oldmeadow C, et al. PROMIS depression measures perform similarly to legacy measures relative to a structured diagnostic interview for depression in cancer patients. Qual Life Res. 2018;27:1357–67.PubMed
23.
Zurück zum Zitat Hann DM, Jacobsen PB, Azzarello LM, Martin SC, Curran SL, Fields KK, et al. Measurement of fatigue in cancer patients: development and validation of the Fatigue Symptom Inventory. Qual Life Res. 1998;7:301–10.PubMed Hann DM, Jacobsen PB, Azzarello LM, Martin SC, Curran SL, Fields KK, et al. Measurement of fatigue in cancer patients: development and validation of the Fatigue Symptom Inventory. Qual Life Res. 1998;7:301–10.PubMed
24.
Zurück zum Zitat Donovan KA, Jacobsen PB. The fatigue symptom inventory: a systematic review of its psychometric properties. Support Care Cancer. 2011;19:169–85. Donovan KA, Jacobsen PB. The fatigue symptom inventory: a systematic review of its psychometric properties. Support Care Cancer. 2011;19:169–85.
25.
Zurück zum Zitat Melzack R. The short-form McGill Pain Questionnaire. Pain. 1987;30:191–7.PubMed Melzack R. The short-form McGill Pain Questionnaire. Pain. 1987;30:191–7.PubMed
26.
Zurück zum Zitat Kahl C, Cleland JA. Visual analogue scale, numeric pain rating scale and the McGill Pain Questionnaire: an overview of psychometric properties. Phys Ther Rev. 2005;10:123–8. Kahl C, Cleland JA. Visual analogue scale, numeric pain rating scale and the McGill Pain Questionnaire: an overview of psychometric properties. Phys Ther Rev. 2005;10:123–8.
27.
Zurück zum Zitat Antoni MH, Lechner SC, Kazi A, Wimberly SR, Sifre T, Urcuyo KR, et al. How stress management improves quality of life after treatment for breast cancer. J Consult Clin Psychol. 2006;74:1143–52. Antoni MH, Lechner SC, Kazi A, Wimberly SR, Sifre T, Urcuyo KR, et al. How stress management improves quality of life after treatment for breast cancer. J Consult Clin Psychol. 2006;74:1143–52.
28.
Zurück zum Zitat Roth AJ, Rosenfield B, Kornblith AB, et al. The Memorial Anxiety Scale for Prostate Cancer: validation of a new scale to measure anxiety in men with with prostate cancer. Cancer. 2003;97:2910–8.PubMed Roth AJ, Rosenfield B, Kornblith AB, et al. The Memorial Anxiety Scale for Prostate Cancer: validation of a new scale to measure anxiety in men with with prostate cancer. Cancer. 2003;97:2910–8.PubMed
29.
Zurück zum Zitat Bradburn N. The structure of psychological well-being. Chicago: Aldine; 1969. Bradburn N. The structure of psychological well-being. Chicago: Aldine; 1969.
30.
Zurück zum Zitat Bergner M, Bobbitt RA, Carter WB, Gilson BS. The sickness impact profile: development and final revision of a health status measure. Med Care. 1981;19:787–805. Bergner M, Bobbitt RA, Carter WB, Gilson BS. The sickness impact profile: development and final revision of a health status measure. Med Care. 1981;19:787–805.
31.
Zurück zum Zitat Cohen S, Kamarck T, Mermelstein R. A global measure of perceived stress. J Health Soc Behav. 1983;24:385–96. Cohen S, Kamarck T, Mermelstein R. A global measure of perceived stress. J Health Soc Behav. 1983;24:385–96.
32.
Zurück zum Zitat Weiss DS, Marmar CR. The impact of event scale – revised. In: Wilson JP, Tang CS, editors. Psychological trauma and PTSD. New York: Guilford Press; 1997. p. 399–411. Weiss DS, Marmar CR. The impact of event scale – revised. In: Wilson JP, Tang CS, editors. Psychological trauma and PTSD. New York: Guilford Press; 1997. p. 399–411.
33.
Zurück zum Zitat Stanton AL, Ganz PA, Kwan L, Meyerowitz BE, Bower JE, Krupnick JL, et al. Outcomes from the moving beyond cancer psychoeducational, randomized, controlled trial with breast cancer patients. J Clin Oncol. 2005;23:6009–18.PubMed Stanton AL, Ganz PA, Kwan L, Meyerowitz BE, Bower JE, Krupnick JL, et al. Outcomes from the moving beyond cancer psychoeducational, randomized, controlled trial with breast cancer patients. J Clin Oncol. 2005;23:6009–18.PubMed
34.
Zurück zum Zitat Derogatis LR. The psychosocial adjustment to illness scale (PAIS). J Psychosom Res. 1986;30:77–91.PubMed Derogatis LR. The psychosocial adjustment to illness scale (PAIS). J Psychosom Res. 1986;30:77–91.PubMed
35.
Zurück zum Zitat Charlson M, Szatrowski TP, Peterson J, Gold J. Validation of a combined comorbidity index. J Clin Epidemiol. 1994;47:1245–51. Charlson M, Szatrowski TP, Peterson J, Gold J. Validation of a combined comorbidity index. J Clin Epidemiol. 1994;47:1245–51.
36.
Zurück zum Zitat Preacher KJ, Curran PJ, Bauer DJ. Computational tools for probing interactions in multiple linear regression, multilevel modeling, and latent curve analysis. J Educ Behav Stat. 2006;31:437–48. Preacher KJ, Curran PJ, Bauer DJ. Computational tools for probing interactions in multiple linear regression, multilevel modeling, and latent curve analysis. J Educ Behav Stat. 2006;31:437–48.
37.
Zurück zum Zitat Pearman T, Yanez B, Peipert J, Wortman K, Beaumont J, Cella D. Ambulatory cancer and US general population reference values and cutoff scores for the functional assessment of cancer therapy. Cancer. 2014;120:2902–9.PubMed Pearman T, Yanez B, Peipert J, Wortman K, Beaumont J, Cella D. Ambulatory cancer and US general population reference values and cutoff scores for the functional assessment of cancer therapy. Cancer. 2014;120:2902–9.PubMed
38.
Zurück zum Zitat Penedo FJ, Molton I, Dahn JR, Shen BJ, Kinsinger D, Traeger L, et al. A randomized clinical trial of group-based cognitive-behavioral stress management in localized prostate cancer: development of stress management skills improves quality of life and benefit finding. Ann Behav Med. 2006;31:261–70.PubMed Penedo FJ, Molton I, Dahn JR, Shen BJ, Kinsinger D, Traeger L, et al. A randomized clinical trial of group-based cognitive-behavioral stress management in localized prostate cancer: development of stress management skills improves quality of life and benefit finding. Ann Behav Med. 2006;31:261–70.PubMed
39.
Zurück zum Zitat Greer JA, Jacobs J, Pensak N, MacDonald J, Fuh CX, Perez GK, et al. Randomzied trial of a tailored cognitive-behavioral therapy mobile application for anxiety in patients with incurable cancer. Oncologist. 2019;24:1111–20.PubMedPubMedCentral Greer JA, Jacobs J, Pensak N, MacDonald J, Fuh CX, Perez GK, et al. Randomzied trial of a tailored cognitive-behavioral therapy mobile application for anxiety in patients with incurable cancer. Oncologist. 2019;24:1111–20.PubMedPubMedCentral
40.
Zurück zum Zitat Huang GJ, Sadetsky N, Penson DF. Health related quality of life for men treated for localized prostate cancer with long-term follow-up. J Urol. 2010;183:2206–12.PubMedPubMedCentral Huang GJ, Sadetsky N, Penson DF. Health related quality of life for men treated for localized prostate cancer with long-term follow-up. J Urol. 2010;183:2206–12.PubMedPubMedCentral
41.
Zurück zum Zitat Antoni MH. Stress management effects on psychological, endocrinological, and immune functioning in men with HIV infection: empirical support for a psychoneuroimmunological model. Stress. 2003;6:173–88.PubMed Antoni MH. Stress management effects on psychological, endocrinological, and immune functioning in men with HIV infection: empirical support for a psychoneuroimmunological model. Stress. 2003;6:173–88.PubMed
42.
Zurück zum Zitat Antoni MH, Lechner S, Diaz A, et al. Cognitive behavioral stress management effects on psychosocial and physiological adaptation in women undergoing treatment for breast cancer. Brain Behav Immun. 2009;23:580–91.PubMed Antoni MH, Lechner S, Diaz A, et al. Cognitive behavioral stress management effects on psychosocial and physiological adaptation in women undergoing treatment for breast cancer. Brain Behav Immun. 2009;23:580–91.PubMed
43.
Zurück zum Zitat Walker LM, Tran S, Wassersug RJ, Thomas B, Robinson JW. Patients and partners lack knowledge of androgen deprivation therapy side effects. Urol Oncol. 2013;31:1098–105.PubMed Walker LM, Tran S, Wassersug RJ, Thomas B, Robinson JW. Patients and partners lack knowledge of androgen deprivation therapy side effects. Urol Oncol. 2013;31:1098–105.PubMed
44.
Zurück zum Zitat Wu PH, Chen SW, Huang WT, Chang SC, Hsu MC. Effects of a psychoeducational intervention in patients with breast cancer undergoing chemotherapy. J Nurs Res. 2018;26:266–79.PubMed Wu PH, Chen SW, Huang WT, Chang SC, Hsu MC. Effects of a psychoeducational intervention in patients with breast cancer undergoing chemotherapy. J Nurs Res. 2018;26:266–79.PubMed
45.
Zurück zum Zitat Karnell LH, Christensen AJ, Rosenthal EL, Magnuson JS, Funk GF. Influence of social support on health-related quality of life outcomes in head and neck cancer. Head Neck. 2007;29:143–6.PubMed Karnell LH, Christensen AJ, Rosenthal EL, Magnuson JS, Funk GF. Influence of social support on health-related quality of life outcomes in head and neck cancer. Head Neck. 2007;29:143–6.PubMed
46.
Zurück zum Zitat Filazoglu G, Griva K. Coping and social support and health related quality of life in women with breast cancer in Turkey. Psychol Health Med. 2008;13:559–73.PubMed Filazoglu G, Griva K. Coping and social support and health related quality of life in women with breast cancer in Turkey. Psychol Health Med. 2008;13:559–73.PubMed
47.
Zurück zum Zitat Leung J, Pachana NA, McLaughlin D. Social support and health-related quality of life in women with breast cancer: a longitudinal study. Psychooncology. 2014;23:1014–20.PubMed Leung J, Pachana NA, McLaughlin D. Social support and health-related quality of life in women with breast cancer: a longitudinal study. Psychooncology. 2014;23:1014–20.PubMed
48.
Zurück zum Zitat Bouchard LC, Yanez B, Dahn JR, et al. Brief report of a tablet-delivered psychosocial intervention for men with advanced prostate cancer: acceptability and efficacy by race. Transl Behav Med. 2019;9:629–37.PubMed Bouchard LC, Yanez B, Dahn JR, et al. Brief report of a tablet-delivered psychosocial intervention for men with advanced prostate cancer: acceptability and efficacy by race. Transl Behav Med. 2019;9:629–37.PubMed
Metadaten
Titel
Technology-Based Psychosocial Intervention to Improve Quality of Life and Reduce Symptom Burden in Men with Advanced Prostate Cancer: Results from a Randomized Controlled Trial
verfasst von
Frank J. Penedo
Rina S. Fox
Laura B. Oswald
Patricia I. Moreno
Cody L. Boland
Ryne Estabrook
Heather L. McGinty
David C. Mohr
Mark J. Begale
Jason R. Dahn
Sarah C. Flury
Kent T. Perry
Shilajit D. Kundu
Betina Yanez
Publikationsdatum
01.10.2020
Verlag
Springer US
Erschienen in
International Journal of Behavioral Medicine / Ausgabe 5/2020
Print ISSN: 1070-5503
Elektronische ISSN: 1532-7558
DOI
https://doi.org/10.1007/s12529-019-09839-7

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