What it would take for men to attend and benefit from support groups after prostatectomy for prostate cancer: a problem-solving approach.

Twenty-nine incontinent prostate cancer patients learned Pelvic Floor Muscle Exercises through biofeedback and were randomly assigned to a control group or a support group entailing six meetings over 3 months. The obtained consent rate (50%) is much higher than the previously reported rate for men (13%). The reasons for refusal were mainly due to actual barriers (48%) and less frequently due to psychological concerns (10.3%). Most support group participants (71.5%) attended five to six group meetings. The findings suggest that men are willing to attend support groups that focus on solving problems and that social supports help men improve continence and quality of life.

Shared medical appointments for patients with diabetes: glycemic reduction in high-risk patients.

PURPOSE: To assess the impact on glycemic control (A1c, %) in a primary care urban Veterans Affairs (VA) shared medical appointments (SMAs). DATA SOURCES: A retrospective pretest/posttest study included all patients who had attended ≥1 SMA from 4/06 to 12/10. A1cs 810 days pre- and postinitial SMA were obtained from 90-day time periods. A1c levels were averaged within patient in these 90-day intervals and data were aggregated based upon corresponding time intervals. CONCLUSIONS: Of 1290 individuals seen in SMAs, 1288 (99.8%) had ≥1 A1c levels and 1170 (90.7%) individuals had ≥1 level collected both before and after attendance. The sample was predominantly (96%) male and middle aged or older (mean [±1 SD] age of 62.6 + 9.09 years) with a mean Diabetes Severity Index 3.01 (2.34). There were significant A1c reductions (∼1%) in A1c overall (n = 1170) and for patients with ≥1 measurement in the 180-day periods preceding and following their first SMA appointment (n = 815). Linear regression analysis showed a significant (p < .001) pre-SMA positive trend (r(2) = 0.90). IMPLICATIONS FOR PRACTICE: Limitations notwithstanding (single site and design lacking a control group), the large number of patients demonstrates SMA clinical effectiveness in improving A1c for high-risk patients with diabetes.

Effects of combined pelvic floor muscle exercise and a support group on urinary incontinence and quality of life of postprostatectomy patients.

PURPOSE/OBJECTIVES: To examine the effect of combined pelvic floor muscle exercise (PFME) and a support group on postprostatectomy urinary incontinence and quality of life. DESIGN: Pilot study of a randomized, controlled clinical trial. SETTING: Two metropolitan hospitals in northeastern Ohio. SAMPLE: 29 men with postprostatectomy urinary incontinence. METHODS: The participants learned PFME through biofeedback and were randomized to the control group (n = 15) or the support group (n = 14). The control group practiced PFME at home, whereas the support group attended six biweekly group meetings facilitated by a health psychologist. Assessment of urinary incontinence and quality of life was conducted at baseline and three months. MAIN RESEARCH VARIABLES: Urinary incontinence and disease-specific quality of life. FINDINGS: Eighty-six percent of the support group participants versus 46% of the control group participants practiced PFME four to seven days per week. The support group had a lower rating of urinary incontinence based on a 0- to 10-point visual analog rating scale than the control group (X = 3.2 versus 4.7), and fewer support group participants used pads (50%) than control group participants (85%) at three months. The support group also scored significantly lower on the severity of incontinence problems than the control group at three months, especially in relationship with spouse and social outing, despite no group difference in these areas at baseline. CONCLUSIONS: The study provided promising evidence regarding the effect of the proposed intervention on adherence to PFME, urinary incontinence, and quality of life. IMPLICATIONS FOR NURSING: Reports regarding nursing practice are lacking with respect to PFME. This study suggests that practicing PFME in a group with patients with incontinence who have undergone prostatectomy can be a useful nursing intervention.

Intervention of urinary incontinence and quality of life outcome in prostate cancer patients.

This study examined the effect of combined Pelvic Floor Muscle Exercises (PFME) and support group on quality of life of postprostatectomy patients. Twenty-nine participants learned PFME through biofeedback and were randomized to the control group (n = 15) and support group (n = 14). Assessment of quality of life was conducted at baseline and 3-month follow-up. The findings indicated a trend of increased functioning and reduced perception of illness intrusiveness in the support group, compared with the control group. Improved urinary continence was significantly associated with reduced depression and symptom distress over time. The findings suggest that an intervention focusing on urinary continence improves quality of life in these patients.