Refining a Prostate Cancer Survivor's Toolkit.

Men who have undergone radical prostatectomy for the treatment of prostate cancer often lack knowledge about post-surgical care to bridge this gap in knowledge. Thus, we developed, refined, and validated a prostate cancer survivor's toolkit, which provides these men in the care required after this procedure.

The role of resilience and social support in predicting postdeployment adjustment in otherwise healthy Navy personnel.

The purpose of this study was to determine if resilience, social support, and exposure to combat, stressful deployment environments, and additional stressful life events predicted short-term (12 months or less) postdeployment adjustment in a relatively healthy subset of Navy service members. One hundred and thirty-two service members between 3 and 6 months postdeployment completed anonymous surveys at a deployment health center. Service members with probable post-traumatic stress disorder and those who were at risk for harm to self or others were excluded. There was relatively low variance in exposure to combat, stressful deployment environments, and additional stressful life events for this convenience sample. Although the sample was a relatively healthy subset of service members and conclusions may not be generalizable to larger populations, 56% endorsed considerable adjustment difficulties. Results of logistic regression indicated that greater resilience, greater postdeployment social support, and less stressful deployment environments predicted greater postdeployment adjustment. Resilience and postdeployment social support remained significant predictors of postdeployment adjustment when controlling for covariates. Results also suggest that individual augmentee experience may be a protective factor against postdeployment adjustment difficulties-at least in otherwise healthy service members.

Psychometric properties of the Task Self-Efficacy Scale for everyday activities in older adults.

Physical and cognitive factors contribute to independence in daily activities, but the confidence to perform an activity (self-efficacy) also contributes to it. The purpose of this study was to assess the psychometric properties of the Task Self-efficacy Scale (TSE) for confidence in performing daily activities, Validity and reliability were assessed in 278 older adults with scores on all items on the TSE for analysis. Factor analysis revealed two factors (self-care and mobility) explaining 72.42% of the variance in the items. Moderate to large correlations were found between the TSE for Self-Care and TSE for Mobility to exertion (.90 to .93, respectively) and fatigue (-.79 to -.84, respectively) associated with activities assessed in the TSE. The expected differences in TSE were found between those with and without mobility difficulties, fear of falls, and shortness of breath with activity. Cronbach's alpha was .96.

Educating patients to evaluate web-based health care information: the GATOR approach to healthy surfing.

AIMS AND OBJECTIVES: Teaching patients to assess web resources effectively has become an important need in primary care. The acronym GATOR (genuine, accurate, trustworthy, origin and readability), an easily memorized strategy for assessing web-based health information, is presented in this paper. BACKGROUND: Despite the fact that many patients consult the World-Wide Web (or Internet) daily to find information related to health concerns, a lack of experience, knowledge, or education may limit ability to accurately evaluate health-related sites and the information they contain. Health information on the Web is not subject to regulation, oversight, or mandatory updates and sites are often transient due to ever changing budget priorities. This makes it difficult, if not impossible, for patients to develop a list of stable sites containing current, reliable information. DESIGN: Commentary aimed at improving patient's use of web based health care information. CONCLUSIONS: The GATOR acronym is easy to remember and understand and may assist patients in making knowledgeable decisions as they traverse through the sometimes misleading and often overwhelming amount of health information on the Web. RELEVANCE TO CLINICAL PRACTICE: The GATOR acronym provides a mechanism that can be used to structure frank discussion with patients and assist in health promotion through education. When properly educated about how to find and evaluate Web-based health information, patients may avoid negative consequences that result from trying unsafe recommendations drawn from untrustworthy sites. They may also be empowered to not only seek more information about their health conditions, treatment and available alternatives, but also to discuss their feelings, ideas and concerns with their healthcare providers.

Physical and emotional predictors of depression after radical prostatectomy.

Radical prostatectomy commonly results in urinary, sexual, and bowel dysfunction that bothers men and may lead to depressive symptomatology (hereafter depression) that occurs at a rate 4 times greater for men with prostate cancer than healthy counterparts. The purpose of this study was to assess depressive symptoms in men shortly after radical prostatectomy and to identify associated risk factors. Seventy-two men were interviewed 6 weeks after surgery. Measured were depression (Geriatric Depression Scale), self-efficacy (Stanford Inventory of Cancer Patient Adjustment), social support (Modified Inventory of Socially Supportive Behaviors), physical and emotional factors (UCLA Prostate Cancer Index), and social function (SF-36 subscale). Results indicate that men with high self-efficacy and less sexual bother were 45% and 55% less likely to have depressive symptoms, respectively. Findings from this study add to the limited amount of information on the complex relationship between prostate cancer treatment and depression in men.

Dyadic support and quality-of-life after radical prostatectomy.

BACKGROUND: Treatment side effects after radical prostatectomy include urinary, sexual, and bowel dysfunction. These functional declines, coupled with the bother associated with these dysfunctions, lead to a complicated pattern of change in quality-of-life and decreased self-efficacy. METHODS: In this study, 72 men who underwent radical prostatectomy 6-weeks prior were randomly assigned to usual health care control group or peer-to-peer support (dyadic support) group. The dyadic meetings were held once a week for 8 weeks. Measured pre- and post-test was general health-related quality-of-life (SF-36), prostate cancer-specific quality-of-life (UCLA Prostate Cancer Index), and self-efficacy (Stanford Inventory of Cancer Patient Adjustment). RESULTS: By 8 weeks, self-efficacy significantly improved for men in the experimental group, but not for men in the control group. A series of logistic regression analyses showed that the dyadic intervention significantly accounted for changes in physical role functioning, bowel function, mental health, and social function. Age, education, and self-efficacy had significant interaction effects and increased the effects of the dyadic intervention on several outcomes. CONCLUSIONS: The intervention had a significant impact on how men react socially and emotionally to the side effects of radical prostatectomy.

The impact of dyadic social support on self-efficacy and depression after radical prostatectomy.

OBJECTIVE: To assess the effect of one-on-one peer support at enhancing self-efficacy and decreasing depression in older men treated by radical prostatectomy for prostate cancer. METHODS: Six weeks after surgery, 72 men (M(age) = 60) were randomly assigned to a treatment (n = 37) or control group ( n = 35). Treatment group participants were paired to form dyads with a trained support partner who had similar treatment and related side effects; control group participants received usual health care. Dyads met 8 times over 8 weeks to discuss concerns and coping strategies. RESULTS: At posttest, the treatment group had significantly higher self-efficacy than the controls (M = 328.89 and M = 304.54, respectively) and significantly less depression (M = 0.92 and M = 2.49, respectively). Depression outcomes remained significant when controlling baseline self-efficacy and social support (F = 4.845, p = .032). DISCUSSION: Findings confirm pilot study results and are theoretically consistent with the self-efficacy enhancing nature of vicarious experience described by Bandura in self-efficacy theory.

Urinary, sexual, and bowel dysfunction and bother after radical prostatectomy.

INTRODUCTION: Radical prostatectomy results in greater persistence of urinary and sexual dysfunction (and to a minor degree, bowel dysfunction) than other forms of prostate cancer treatment. These physical side effects create bother, which is the degree of annoyance, dysfunction, or discomfort associated with treatment aftermath. OBJECTIVE: The purpose of this study was to assess the relationships between post-radical prostatectomy urinary, sexual, and bowel dysfunction, and the resultant bother to determine which of the physical dysfunctions bothers men the most. METHOD: Seventy-two men were recruited and surveyed 6 weeks after radical prostatectomy. Outcome measures included self-efficacy (Stanford Inventory of Cancer Patient Adjustment), social support (Modified Inventory of Socially Supportive Behaviors), uncertainty (Uncertainty in Illness Scale), and physical function and bother (UCLA Prostate Cancer Index). RESULTS: Sexual dysfunction had the highest prevalence among treatment side effects caused by radical prostatectomy. However, it was urinary dysfunction in terms of incontinence that was the most bothersome. CONCLUSIONS: Given various treatment options for prostate cancer, men who undergo radical prostatectomy initially decide that the physical dysfunction is worth the benefits of improved likelihood of survival; however, they do so without firsthand knowledge of the associated bother. Patients should be informed of the transient and unrelenting physical symptoms and associated bother that are produced after radical prostatectomy.

A comparison study: paper-based versus web-based data collection and management.

The purpose of this pilot study was to compare the cost, accuracy, and efficiency of a web-enhanced handheld computer data collection system with those of the traditional paper-based data collection and management system and to increase awareness/knowledge of researchers on these two data collection and management methods. This is an important topic because funding resources are diminishing and high startup costs associated with automated data collection systems may give researchers pause when faced with these financial expenditures. Hence, this information will position grant writers and funders to make intelligent decisions regarding the feasibility and advantage of web-enhanced electronic data collection strategies.

Psychosocial consequences of prostate cancer: 30 years of research.

Carcinoma of the prostate is the leading source of solid-organ cancer in U.S. men. When the disease is discovered early, survival rates are high; survivorship, however, is commonly complicated by disease-specific treatment side effects that challenge a man's physical, mental, and social well-being and life satisfaction. This review comprises a search of scientific literature published between 1970 and March 2004 with the aims of 1) identifying the terms used to define the psychosocial consequences unique to men treated for prostate cancer and 2) describing the research aimed at improving the lives of survivors through psychosocial interventions.

The effect of dyadic intervention on self-efficacy, social support, and depression for men with prostate cancer.

Urinary and sexual dysfunctions are side effects of radical prostatectomy (RP) for prostate cancer (PC) that contribute to depression. Despite the effectiveness of support groups at reducing depression in cancer patients, men typically do not participate in them. The purpose of this pilot study was to test the effects of a dyadic intervention (one-to-one support) on social support (Modified Inventory of Socially Supportive Behaviors), self-efficacy (Stanford Inventory of Cancer Patient Adjustment), and depression (Geriatric Depression Scale). Subjects were randomized to group. Controls (N=15; Mage=59.7) received usual care. Experimentals were paired with long-term survivors (LTS) who had RP and who had treatment side effects in common. Experimentals (N=15; Mage=57.5) met with a LTS 8 times in 8 weeks to discuss concerns associated with survivorship. No significant differences were detected on social support, but after 4 weeks, significant differences were present on depression between controls and experimentals, however these differences were not seen at 8 weeks. After 8 weeks, there were also significant differences on self-efficacy between controls and experimentals. Weekly anecdotal data supported the feasibility and acceptance of the intervention that was a low cost strategy effective at reducing depression and increasing self-efficacy in men treated by RP. Future research directions and clinical application is presented.