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Preliminary Results of a Randomised Controlled Trial of an Online Psychological Intervention to Reduce Distress in Men Treated for Localised Prostate Cancer

医学 社会心理的 背景(考古学) 苦恼 焦虑 随机对照试验 物理疗法 心理干预 干预(咨询) 医院焦虑抑郁量表 生活质量(医疗保健) 临床心理学 精神科 护理部 内科学 古生物学 生物
作者
Addie Wootten,Jo Abbott,Denny Meyer,Katherine C. Horton,David Austin,Britt Klein,Marita P. McCabe,Declan G. Murphy,Anthony J. Costello
出处
期刊:European Urology [Elsevier BV]
卷期号:68 (3): 471-479 被引量:71
标识
DOI:10.1016/j.eururo.2014.10.024
摘要

Prostate cancer (PCa) poses many emotional and physical challenges for men following treatment. The unmet support needs of these men are well documented, and access to psychosocial support remains problematic. To assess the efficacy of an online psychological intervention for men who have localised PCa. We undertook a randomised controlled trial to evaluate the intervention. Participants were randomly allocated to one of three conditions: My Road Ahead (MRA) alone (MRA Only), MRA plus access to an online forum (MRA + Forum), and access to the forum alone (Forum). The intervention was a 10-week self-guided online psychological intervention called My Road Ahead that consisted of six themed modules designed to facilitate improved emotional well-being in the context of PCa as well as a moderated peer forum. Pre- and postintervention assessments of psychological distress (the 21-question Depression, Anxiety and Stress Scale) [1] and the Prostate Cancer–related Quality of Life scale [2] were conducted. Multivariate analysis of variance, regression, and structural equation modelling were used to analyse the data. In total, 142 participants were randomly allocated to one of the three intervention arms. The mean age of participants was 61 yr of age (standard deviation: 7), and 88% had undergone radical prostatectomy. A significant improvement in psychological distress was observed for participants who had access to the combined condition (MRA + Forum) with a moderate effect size (p = 0.02; partial η2 = 0.07). In particular, the decline in the mean level of psychological distress was 8.8 units larger for the MRA + Forum group than the Forum group (95% confidence interval [CI], 0.9–16.7). Although the decline in the mean level of psychological distress was 7.0 units larger for the MRA + Forum group than for the MRA Only group, this difference was not significant (95% CI, 1.1–15.1). Structural equation modelling indicated that reductions in health worry and regret contributed significantly to the reductions in psychological distress for the MRA + Forum condition. This study is the first, to our knowledge, that has evaluated a self-guided online psychological intervention tailored to the specific needs of men who have PCa. The findings of this study indicate the potential for this programme to deliver support that men may not otherwise receive. This study found that men who have localised prostate cancer who received access to the online psychological intervention called My Road Ahead combined with the online peer discussion forum had significantly improved reductions in distress compared with those who received access to the online intervention alone or the forum alone.
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