The association between patient characteristics, psychological distress, and coping in the diagnostic phase of prostate cancer - A cross-sectional multicenter study.

PURPOSE: This study aims to investigate the associations between patient characteristics, psychological distress, and coping in the diagnostic phase of prostate cancer. METHODS: A cross-sectional multicentre study was conducted from 2017 to 2019. A total of 250 patients were recruited from three hospitals in western Norway. The patients completed a questionnaire while awaiting their prostate biopsy. Patient characteristics were collected, and the Hospital Anxiety and Depression Scale and the Revised Ways of Coping Checklist were used to measure psychological distress and evaluate coping strategies and primary appraisal, respectively. RESULTS: Approximately 15% and 5% of the patients experienced symptoms of anxiety and depression, respectively. Younger age and poorer self-reported health were associated with higher anxiety levels. Anxiety was associated with all five coping strategies but showed the strongest correlation with wishful thinking. The patients who appraised their situation as a threat experienced more symptoms of both anxiety and depression and used more wishful thinking and avoidance than did the patients who appraised their situation as a challenge or benign. CONCLUSION: A subgroup of patients experiences psychological distress during diagnostic evaluation of prostate cancer. Age, self-reported health, and primary appraisal may contribute to the development of psychological distress. Identification of patient characteristics associated with higher levels of psychological distress may guide nurses in implementing early interventions aimed at supporting beneficial coping and enhancing well-being.

Men's perception of information and psychological distress in the diagnostic phase of prostate cancer: a comparative mixed methods study.

BACKGROUND: Previous studies indicate that men experience frustration and uncertainty when confronted with an elevated prostate specific antigen (PSA) test and during further diagnostics for prostate cancer. The novel Stockholm3 test is an algorithm-based test that combines plasma protein biomarkers, genetic markers and clinical variables in predicting the risk of PCa. The test was introduced in a western part of Norway as a new tool for detecting prostate cancer. This study aimed to explore and compare men's perception of information and possible experience of distress between a PSA group and a Stockholm3 group during the diagnostic phase of prostate cancer. METHODS: This study is a part of the trailing research evaluating the impact of the change from PSA to Stockholm3. It is a multicenter study using a comparative mixed method design. Data were collected in a PSA group (n = 130) and a Stockholm3 group (n = 120) between 2017 and 2019. Quantitative data were collected using questionnaires and qualitative data were collected using semi-structured interviews (n = 20). The quantitative and qualitative data were analysed and compared separately and then merged in a side-by-side discussion. The study adheres to the GRAMMS guidelines for reporting mixed-methods research. RESULTS: Compared with the PSA group, men in the Stockholm3 group reported that the information from the general practitioners was better. Similarly, men in the Stockholm3 group were more likely to indicate that they had received sufficient information regarding how examinations would be conducted. No differences were found between the groups regarding waiting time and distress. Three themes emerged from the qualitative analysis of the two groups: "Information affects the experience of comprehension", "Stepping into the world of the healthcare system", and "Periodically feelings of distress". CONCLUSION: The Stockholm3 test may facilitate the provision of information to patients. However, some patients in both groups experienced distress and would benefit from more information and additional support from healthcare professionals. Routines that ensure sufficient information from the interdisciplinary healthcare team should be of priority during the diagnostic phase of prostate cancer in order to provide patients with predictability and to avoid unnecessary distress.