Examining the impact of androgen deprivation therapy, masculine self-esteem, and psychological flexibility on distress and quality of life in men with prostate cancer.

OBJECTIVE: Studies suggest that androgen deprivation therapy (ADT) exacerbates psychological and quality of life (QoL) issues associated with prostate cancer (PCa). However, quantitative research examining underlying psychosocial mechanisms for this is limited. We examined the association of PCa symptoms with distress and QoL in ADT-treated and ADT-naïve patients, and the influence of masculine self-esteem and psychological flexibility (PF) on these relationships. METHODS: Secondary analysis of a quantitative, cross-sectional survey of 286 PCa patients. Independent samples t-tests, moderation, and conditional process analysis were used to assess relationships between predictor, mediator, moderator, and outcome variables. RESULTS: ADT was associated with greater PCa symptomology, lower masculine self-esteem, and lower QoL. Moderation analysis showed that ADT potentiated adverse impacts of PCa symptomology on distress and QoL. High PF attenuated these relationships, though less so for ADT-treated participants. Conditional process analysis showed that masculine self-esteem mediated the predictive effect of symptoms on distress across treatments. However, ADT did not moderate this indirect effect, nor was moderation conditional on PF. CONCLUSION: PF appears to: (1) attenuate psychological distress in ADT patients; and (2) improve distress, QoL, and masculine self-esteem in ADT-naïve patients. Interventions targeting PF may thus be a viable adjunct to established approaches. However, their effects may be comparatively limited in ADT patients, who may benefit from more intensive and tailored treatment.

Investigating the role of psychological flexibility, masculine self-esteem and stoicism as predictors of psychological distress and quality of life in men living with prostate cancer.

OBJECTIVE: This study examined the predictive power of psychological flexibility, masculine self-esteem and stoicism in influencing psychological distress and quality of life in men diagnosed with prostate cancer. It explores relationships between these theorised predictors and prostate cancer physical symptoms, an established predictor of psychological distress and reduced quality of life. METHOD: A quantitative cross-sectional survey was undertaken with 286 men previously diagnosed with prostate cancer. Correlation, hierarchical multiple regression and conditional process analysis were used to explore relationships between variables. RESULTS: Psychological flexibility and masculine self-esteem predicted outcomes of distress (ß = -0.41, p < 0.001; ß = -0.27, p < 0.001, respectively) and quality of life (ß = -0.28, p < 0.001; ß = -0.28, p < 0.001, respectively), beyond the impact of physical symptoms. Stoicism showed only low correlations with other predictor and outcome variables (r < 0.1). Conditional process analysis showed psychological flexibility moderated the predictive effect of both prostate cancer physical symptoms and masculine self-esteem in predicting distress, but did not moderate these predictors on quality of life. CONCLUSIONS: Interventions targeted at raising psychological flexibility, particularly those that encourage adaptive masculine values, may be effective in reducing psychological distress in prostate cancer patients.

Public Preferences regarding Data Linkage for Health Research: A Discrete Choice Experiment.

The potential for data collected in the public and private sector to be linked and used in research has led to increasing interest in public acceptability of data sharing and data linkage. The literature has identified a range of factors that are important for shaping public responses and in particular has noted that public support for research conducted through data linkage or data sharing is contingent on a number of conditions being met. In order to examine the relative importance of these conditions a Discrete Choice Experiment (DCE) was conducted via an online questionnaire among members of Ipsos MORI's online panel in Scotland. The survey was completed by 1,004 respondents. Overall the two most influential factors shaping respondents' preferences are: the type of data being linked; and, how profits are managed and shared. The type of data being linked is roughly twice as important as who the researchers are. There were slight differences across age groups and between genders and slight differences when comparing respondents with and without long term health conditions. The most notable differences between respondents were found when comparing respondents according to employment and working sector. This study provides much needed evidence regarding the relative importance of various conditions which may be essential for securing and sustaining public support for data-linkage in health research. This may be useful for indicating which factors to focus on in future public engagement and has important implications for the design and delivery of research and public engagement activities. The continuously evolving nature of the field means it will be necessary to revisit the key conditions for public support on an ongoing basis and to examine the contexts and circumstances in which these might change.