Helping Men Adhere to Sexual Rehabilitation Following Prostate Cancer Surgery

帮助男性在前列腺癌手术后坚持性康复

• 批准号: 10058812
• 负责人: Christian J Nelson
• 金额: $ 38.85万
• 依托单位: SLOAN-KETTERING INST CAN RESEARCH
• 依托单位国家: 美国
• 财政年份: 2015
• 资助国家: 美国
• 起止时间: 2015-12-01 至 2023-11-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10058812
• 关键词: Address; Adherence; Aftercare; Anxiety; Cancer Survivor; Cialis; Continuance of life; Data; Diagnosis; Early Diagnosis; Early treatment; Education; Erectile dysfunction; Female; Frustration; Goals; Gold; Happiness; Injections; Institute of Medicine (U.S.); Intervention; Lead; Life; Malignant Neoplasms; Malignant neoplasm of prostate; Mediating; Medical; Monitor; Nature; Nerve; Nitric Oxide; Nurse Practitioners; Operative Surgical Procedures; Oral; Outcome; Pattern; Pharmaceutical Preparations; Pilot Projects; Prostate Cancer therapy; Quality of life; Radical Prostatectomy; Randomized; Recovery; Regrets; Rehabilitation therapy; Reporting; Research; Sex Functioning; Sexual Dysfunction; Sexual Health; Stress; Survival Rate; Survivors; Telephone; Therapeutic Intervention; Tissues; Viagra; Work; anxiety treatment; arm; base; brief intervention; cancer diagnosis; cancer surgery; cancer type; cost; depressive symptoms; design; erection; experience; follow-up; group intervention; healing; improved; innovation; intimate behavior; men; mindfulness; novel; penis; preservation; programs; prostate cancer survivors; psychologic; psychosocial; public health relevance; satisfaction; self esteem; side effect; standard care; therapy design; treatment arm; vardenafil; willingness

 DESCRIPTION (provided by applicant) The Institute of Medicine highlights the distinct need to address sexual dysfunction in cancer survivors. Sexual dysfunction is especially prominent in prostate cancer. Prostate cancer is the most common cancer in men, with approximately 233,000 new cases diagnosed in 2014. A primary side effect of prostate cancer treatment is erectile dysfunction (ED), with as many as 85% of men reporting problems with erections. Men who have ED report significant frustration, increased depressive symptoms, and reduced general happiness with life. Surgery (radical prostatectomy) is a gold standard treatment for early stage prostate cancer, and the medical field has made important advances in treating ED following surgery. The current best practice is the concept of "erectile rehabilitation," which helps increase the chance of recovering erections following surgery. However, men have difficulty complying with these programs. Our data suggest that only 10% of men who receive proactive nurse practitioner phone calls are compliant with erectile rehabilitation. We developed a novel intervention designed to increase compliance with an erectile rehabilitation program. This intervention uses Acceptance and Commitment Therapy (ACT) and helps men focus on the long-term goals of rehabilitation, accept the frustration related to ED, identify and overcome barriers, and commit to an erectile rehabilitation program. In our pilot work, a greater percentage of men in the intervention group, compared to a nurse practitioner enhanced monitoring control, adhered to the erectile rehabilitation program (44% vs.10%, p = 0.02). We propose a larger, two arm, RCT to determine if increased compliance in the intervention leads to improved erectile function at 24 months following surgery. One hundred and fifty-five subjects will be randomized to each arm: Arm 1- Standard care plus the ACT intervention; Arm 2 - Standard care plus nurse practitioner enhanced monitoring and education (EME). We believe this intervention is innovative as it: 1) describes a conceptual framework for avoidance of rehabilitation and outlines how this leads to poor compliance, 2) shifts the primary treatment focus from increasing education to reducing avoidance, 3) applies ACT concepts to a sexual-based intervention, 4) integrates a psychological intervention into an erectile rehabilitation program, and 5) proactively focuses on rehabilitation, increasing the chance of recovery and reducing the negative quality-of-life issues related to ED.

 描述（由适用提供）医学研究所强调了解决癌症生存中性功能障碍的明显需求。性功能障碍在前列腺癌中特别突出。前列腺癌是男性最常见的癌症，2014年诊断出大约233,000例新病例。前列腺癌治疗的主要副作用是勃起功能障碍（ED），其中多达85％的男性报告勃起问题。 ED报告的男性报告了严重的挫败感，增加了抑郁症状，并减少了生活中的一般幸福感。手术（根治性前列腺切除术）是早期前列腺癌的金标准治疗方法，并且医学领域在手术后治疗ED方面已取得了重要进步。当前的最佳实践是“勃起康复”的概念，这有助于增加手术后恢复勃起的机会。但是，男人很难遵守这些计划。我们的数据表明，只有10％的男性接受主动护士从业人员电话符合勃起的康复。我们开发了一种新颖的干预措施，旨在提高对勃起康复计划的依从性。该干预措施使用接受和承诺疗法（ACT），并帮助男性专注于康复的长期目标，接受与ED相关的挫败感，识别和克服障碍，并致力于勃起的康复计划。在我们的飞行员工作中，更大的比例 与护士从业人员增强的监测控制相比，干预组中的男性（44％vs.10％，p = 0.02）相比。我们提出了一个较大的两个臂RCT，以确定干预措施中的依从性是否提高导致手术后24个月的勃起功能提高。一百五十五名受试者将被随机分配到每个手臂：ARM 1-标准护理以及ACT干预； ARM 2-标准护理以及护士从业者增强监测和教育（EME）。我们认为，这种干预具有创新性：1）描述避免康复的概念框架，并概述这如何导致依从性不佳，2）将主要治疗的重点从增加教育转变为减少避免的避免，3）将ACT概念应用于性干预，4）将心理干预纳入勃起的Repligity repripation and 5） 专注于康复，增加恢复的机会并减少与ED相关的负面生活质量问题。

项目成果

Couples-based interventions following prostate cancer treatment: a narrative review.

• DOI: 10.3978/j.issn.2223-4683.2015.04.04
• 发表时间: 2015-04
• 期刊: Translational andrology and urology
• 影响因子: 2
• 作者: Nelson CJ;Emanu JC;Avildsen I
• 通讯作者: Avildsen I

Erectile dysfunction after radical prostatectomy: prevalence, medical treatments, and psychosocial interventions.

• DOI: 10.1097/spc.0000000000000195
• 发表时间: 2016-03
• 期刊: Current opinion in supportive and palliative care
• 影响因子: 2.1
• 作者: Emanu JC;Avildsen IK;Nelson CJ
• 通讯作者: Nelson CJ

Medical Help-Seeking for Sexual Concerns in Prostate Cancer Survivors.

• DOI: 10.1016/j.esxm.2015.12.004
• 发表时间: 2016-03
• 期刊: Sexual medicine
• 影响因子: 2.6
• 作者: Hyde MK;Zajdlewicz L;Wootten AC;Nelson CJ;Lowe A;Dunn J;Chambers SK
• 通讯作者: Chambers SK

Guidelines for Sexual Health Care for Prostate Cancer Patients: Recommendations of an International Panel.

前列腺癌患者性保健指南：国际专家组的建议。

• DOI: 10.1016/j.jsxm.2022.08.197
• 发表时间: 2022
• 期刊: The journal of sexual medicine
• 作者: Wittmann,Daniela;Mehta,Akanksha;McCaughan,Eilis;Faraday,Martha;Duby,Ashley;Matthew,Andrew;Incrocci,Luca;Burnett,Arthur;Nelson,ChristianJ;Elliott,Stacy;Koontz,BridgetF;Bober,SharonL;McLeod,Deborah;Capogrosso,Paolo;Yap,Tet;H
• 通讯作者: H