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- Title
Nurse-led group consultation intervention reduces depressive symptoms in men with localised prostate cancer: a cluster randomised controlled trial.
- Authors
Schofield, Penelope; Gough, Karla; Lotfi-Jam, Kerryann; Bergin, Rebecca; Ugalde, Anna; Dudgeon, Paul; Crellin, Wallace; Schubach, Kathryn; Foroudi, Farshard; Keen Hun Tai; Duchesne, Gillian; Sanson-Fisher, Rob; Aranda, Sanchia; Tai, Keen Hun
- Abstract
<bold>Background: </bold>Radiotherapy for localised prostate cancer has many known and distressing side effects. The efficacy of group interventions for reducing psychological morbidity is lacking. This study investigated the relative benefits of a group nurse-led intervention on psychological morbidity, unmet needs, treatment-related concerns and prostate cancer-specific quality of life in men receiving curative intent radiotherapy for prostate cancer.<bold>Methods: </bold>This phase III, two-arm cluster randomised controlled trial included 331 men (consent rate: 72 %; attrition: 5 %) randomised to the intervention (n = 166) or usual care (n = 165). The intervention comprised four group and one individual consultation all delivered by specialist uro-oncology nurses. Primary outcomes were anxious and depressive symptoms as assessed by the Hospital Anxiety and Depression Scale. Unmet needs were assessed with the Supportive Care Needs Survey-SF34 Revised, treatment-related concerns with the Cancer Treatment Scale and quality of life with the Expanded Prostate Cancer Index -26. Assessments occurred before, at the end of and 6 months post-radiotherapy. Primary outcome analysis was by intention-to-treat and performed by fitting a linear mixed model to each outcome separately using all observed data.<bold>Results: </bold>Mixed models analysis indicated that group consultations had a significant beneficial effect on one of two primary endpoints, depressive symptoms (p = 0.009), and one of twelve secondary endpoints, procedural concerns related to cancer treatment (p = 0.049). Group consultations did not have a significant beneficial effect on generalised anxiety, unmet needs and prostate cancer-specific quality of life.<bold>Conclusions: </bold>Compared with individual consultations offered as part of usual care, the intervention provides a means of delivering patient education and is associated with modest reductions in depressive symptoms and procedural concerns. Future work should seek to confirm the clinical feasibility and cost-effectiveness of group interventions.<bold>Trial Registration: </bold>Australian and New Zealand Clinical Trials Registry ANZCTRN012606000184572 . 1 March 2006.
- Subjects
AUSTRALIA; NEW Zealand; NURSE-led clinics; CANCER radiotherapy; PROSTATE cancer patients; DRUG side effects; ANXIETY; QUALITY of life; ANXIETY treatment; THERAPEUTICS; MENTAL health; ADAPTABILITY (Personality); COMPARATIVE studies; COUNSELING; MENTAL depression; FOCUS groups; RESEARCH methodology; MEDICAL cooperation; NURSES; PROSTATE tumors; PSYCHOLOGICAL tests; RESEARCH; OCCUPATIONAL roles; EVALUATION research; RANDOMIZED controlled trials; TREATMENT effectiveness; PSYCHOLOGY
- Publication
BMC Cancer, 2016, Vol 16, p1
- ISSN
1471-2407
- Publication type
journal article
- DOI
10.1186/s12885-016-2687-1