Acceptance and Commitment Therapy for Erectile Dysfunction Following Radical Pros

接受和承诺治疗勃起功能障碍的激进专家

• 批准号: 7871955
• 负责人: Christian J Nelson
• 金额: $ 24.91万
• 依托单位: SLOAN-KETTERING INST CAN RESEARCH
• 依托单位国家: 美国
• 财政年份: 2010
• 资助国家: 美国
• 起止时间: 2010-04-12 至 2012-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7871955
• 关键词: Address; Adverse effects; Atrophic; Bayer brand of vardenafil hydrochloride; Behavior Therapy; Blood; Cancer Survivor; Chronic; Cialis; Cognitive; Commit; Continuance of life; Data; Diagnosis; Diagnostic Neoplasm Staging; Early Diagnosis; Erectile dysfunction; Exploratory/Developmental Grant; Female; Frustration; Gold; Happiness; Healed; Health; Injection of therapeutic agent; Institute of Medicine (U.S.); Intervention; Lead; Life; Malignant Neoplasms; Malignant neoplasm of prostate; Medical; Medicine; Names; Nerve; Nitric Oxide; Operative Surgical Procedures; Oral; Oxygen; Persons; Pharmaceutical Preparations; Prostate; Psychosocial Influences; Psychotherapy; Public Health; Qualifying; Quality of life; Radical Prostatectomy; Recovery; Rehabilitation therapy; Relative (related person); Reporting; Research; Running; Self Perception; Sex Functioning; Sexual Dysfunction; Sexual Health; Shame; Staging; Stress; Survival Rate; Survivors; Telephone; Therapeutic; Time; Tissues; Viagra; Woman; brief intervention; cancer diagnosis; cancer therapy; cancer type; compliance behavior; cost; depressive symptoms; design; erection; healing; improved; innovation; intimate behavior; malignant breast neoplasm; men; novel; novel strategies; programs; psychologic; public health relevance; satisfaction; self esteem; standard care

DESCRIPTION (provided by applicant): The Institute of Medicine's recent report highlights the distinct need to address sexual dysfunction in cancer survivors. Prostate cancer is the most common cancer in men in the US; 90 percent of all prostate cancers are diagnosed in the early stage, and the relative 5 and 10 year survival rates are over 90 percent. A primary side-effect of prostate cancer treatment is erectile dysfunction (ED), with as many as 85 percent of men reporting problems with erections more than 4 years after early stage treatment. ED can have negative quality of life implications. Men who have ED report significant frustration, increased depressive symptoms, and reduced general happiness with life. ED can also have deleterious effects on men's intimate relationships, often times causing relationship stress, a reduction in intimacy, and sexual dysfunctions in female partners. Radical prostatectomy (RP) is one of the gold standard treatments for early stage prostate cancer, and the medical field has made important advances in understanding ED after RP. The current best practices treatment for ED after RP is the concept of "erectile rehabilitation." Despite these medical advances, frustration, shame, and disappointment often lead men to avoid seeking and sustaining treatment for ED. This delay in pursuing and difficulty sustaining treatment can be especially damaging in men following RP since it is imperative for erectile rehabilitation that treatment start immediately after RP and continue for 2 years post RP. We propose an innovative psychological intervention that will be integrated with an erectile rehabilitation program. This treatment will consist of 7 sessions (4 sessions in person, 3 over the phone) that will help men accept the need for ED treatment, identify and overcome the barriers to this treatment, and then commit to an erectile rehabilitation program. This novel intervention will utilize therapeutic concepts from the cognitive-behavioral treatment Acceptance and Commitment Therapy (ACT), and apply these concepts to ED after RP (i.e., intervention name, ACT-ED). The innovativeness of this intervention lies in 1) the shift to a proactive focus on erectile rehabilitation, increasing the chance of erectile recovery and avoiding the psychosocial issues related to chronic ED, and 2) the novel approach of applying ACT concepts to sexual medicine. Our research group is uniquely situated and qualified to run this type of intervention. This proposal is relevant to the PA-09-130 R21 mechanism as it will assess the feasibility and initial efficacy of applying this innovative intervention to a novel setting, with high significance for hundreds of thousands of prostate cancer survivors. The primary aim of the study is to investigate the feasibility, tolerability, and acceptability of a psychotherapy treatment integrated into an erectile rehabilitation program (i.e., ACT-ED). The secondary aim is to investigate the impact of ACT-ED on penile injection compliance, ED treatment satisfaction, sexual functioning, sexual self-esteem, ED bother, depression symptoms, acceptance and self-awareness. PUBLIC HEALTH RELEVANCE: Although life saving, prostate cancer treatment can have a high cost to survivors in regard to their sexual health. Prostate cancer is the most common type of cancer in men in the US; over 90 percent of men are diagnosed in the early stage, and the 5 and 10 year survivor rates are over 90 percent. Since 85 percent of men treated for early stage cancer report difficulties with erections, sexual functioning after early stage treatment for prostate cancer impacts hundreds of thousands of prostate cancer survivors. ACT-ED is designed to address this significant survivorship issues by providing a brief intervention to promote acceptance of ED and a commitment to an erectile rehabilitation program after radical prostatectomy to improve sexual functioning.

描述（由申请人提供）：医学研究所的最新报告强调了解决癌症幸存者性功能障碍的明显需求。前列腺癌是美国男性最常见的癌症。所有前列腺癌中有90％在早期被诊断出，相对5年和10年的生存率超过90％。前列腺癌治疗的主要副作用是勃起功能障碍（ED），在早期治疗后4年以上，有多达85％的男性报告勃起问题。 ED可能具有负面的生活质量。 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。埃德（Ed）也会对男人的亲密关系产生有害影响，通常会导致关系压力，亲密关系减少以及女性伴侣的性功能障碍。根治性前列腺切除术（RP）是早期前列腺癌的黄金标准治疗方法之一，医学领域在RP后理解ED方面已取得了重要进步。 RP后ED的当前最佳实践治疗是“勃起康复”的概念。尽管有这些医学进展，挫败感，羞耻和失望通常会导致男性避免寻求和维持ED的治疗。在RP之后，追求和难以维持治疗的这种延迟可能会造成尤其损害，因为勃起康复必须立即在RP之后开始治疗，并在RP后持续2年。我们提出了一种创新的心理干预措施，该干预将与勃起的康复计划融为一体。这种治疗方法将包括7次会议（亲自进行4次课程，3次会议），这将帮助男性接受ED治疗，识别和克服这种治疗的障碍，然后承诺进行勃起的康复计划。这种新颖的干预措施将利用认知行为治疗接受和承诺疗法（ACT）的治疗概念，并将这些概念应用于RP之后的ED（即干预名称，ACT-ED）。这种干预的创新性在于1）主动地关注勃起康复的转变，增加了勃起恢复的机会，并避免了与长期以来有关的社会心理问题，以及2）将ACT ACT概念应用于性医学的新方法。我们的研究小组的位置独特，有资格进行此类干预措施。该提案与PA-09-130 R21机制有关，因为它将评估将这种创新干预措施应用于新型环境的可行性和初始功效，对于成千上万的前列腺癌幸存者具有很高的意义。该研究的主要目的是研究整合到勃起康复计划（即ACT-ED）中的心理治疗治疗的可行性，耐受性和可接受性。第二个目的是研究ACT-ED对阴茎注射依从性，ED治疗满意度，性功能，性自尊，ED困扰，抑郁症状，接受和自我意识的影响。 公共卫生相关性：尽管挽救生命，前列腺癌的治疗可能对幸存者的性健康造成高昂的成本。前列腺癌是美国男性最常见的癌症类型。超过90％的男性在早期被诊断出，5年和10年的幸存者率超过90％。由于有85％接受早期癌症治疗的男性报告了勃起的困难，因此早期治疗后，针对前列腺癌的性功能会影响成千上万的前列腺癌幸存者。 ACT-ED旨在通过提供简短的干预措施来促进ED接受以及对勃起的康复计划的承诺，以解决这一重大的生存问题，以改善性功能。