Prostate Cancer: Family Care for Patients and Spouses Prostate cancer is the most common cancer among men in the United States. Treatments for prostate cancer are often accompanied by devastating complications such as sexual impotence, urinary incontinence, and bowel dysfunction that can severely affect the quality of life of men and their spouses. The purpose of this study is to determine if a family-based intervention (The FOCUS Program) can improve the long-term quality of life of men with prostate cancer and their spouses. There are two specific aims for this study.
The first aim i s to determine if the family-based intervention can improve proximal clinical outcomes (better family communication, higher self-efficacy, more problem-focused coping, and less threat, uncertainty, and hopelessness) and improve the distal clinical outcome, better quality of life, in a culturally and socioeconomically diverse sample of men with prostate cancer and their spouses.
The second aim i s to test a stress-coping model designed to predict which prostate cancer patients and their spouses are at increased risk of poorer long-term quality of life. The model includes antecedent, mediating, and outcome variables.
The specific aims will be accomplished with a longitudinal, randomized-block clinical trial in which a cohort of men with prostate cancer and their spouses (N=222 dyads) will be followed over a 12 month period of time. Dyads will be stratified by three phases of illness: 1) newly diagnosed-localized phase, following prostatectomy or radiation therapy, 2) post-primary treatment phase with rising PSA (biochemical recurrence), and 3) advanced/metastatic phase with evidence of disease progression; and by type of treatment received. Following stratification, dyads will be randomized to the control (standard care) or experimental group (standard care plus FOCUS Program). The FOCUS Program is administered in three face-to-face home visits and two follow-up phone calls and provides core content in five areas: Family involvement, Optimistic attitude, Coping effectiveness, Uncertainty reduction, and Symptom management. The program also has tailored content related to phase of illness and treatment received. Data will be collected four times: baseline, prior to the intervention (Time 1); 4 months, shortly after the completion of the intervention (Time 2); 8 months (Time 3); and 12 months (Time 4) with a set of established standardized instruments. The main analysis to meet Aim 1(test of the intervention) will be the MANOVA approach to repeated measures ANOVA (intervention x time), and the main analysis for Aim 2 will use manifest variable structural equation modeling. Overall, this study will test the effectiveness of a family-based program of care in improving clinical outcomes, and test the ability of a model to predict which patients and spouses are at increased risk of poorer quality of life.

Agency
National Institute of Health (NIH)
Institute
National Cancer Institute (NCI)
Type
Research Project (R01)
Project #
5R01CA090739-03
Application #
6634010
Study Section
Nursing Research Study Section (NURS)
Program Officer
Aziz, Noreen M
Project Start
2001-04-01
Project End
2006-03-31
Budget Start
2003-04-01
Budget End
2004-03-31
Support Year
3
Fiscal Year
2003
Total Cost
$482,340
Indirect Cost
Name
University of Michigan Ann Arbor
Department
Type
Schools of Nursing
DUNS #
073133571
City
Ann Arbor
State
MI
Country
United States
Zip Code
48109
Song, Lixin; Northouse, Laurel L; Zhang, Lingling et al. (2012) Study of dyadic communication in couples managing prostate cancer: a longitudinal perspective. Psychooncology 21:72-81
Song, Lixin; Northouse, Laurel L; Braun, Thomas M et al. (2011) Assessing longitudinal quality of life in prostate cancer patients and their spouses: a multilevel modeling approach. Qual Life Res 20:371-81
Northouse, Laurel L; Katapodi, Maria C; Song, Lixin et al. (2010) Interventions with family caregivers of cancer patients: meta-analysis of randomized trials. CA Cancer J Clin 60:317-39
Harden, Janet; Falahee, Margaret; Bickes, Joan et al. (2009) Factors associated with prostate cancer patients' and their spouses' satisfaction with a family-based intervention. Cancer Nurs 32:482-92
Harden, Janet; Northouse, Laurel; Cimprich, Bernadine et al. (2008) The influence of developmental life stage on quality of life in survivors of prostate cancer and their partners. J Cancer Surviv 2:84-94
Kershaw, Trace S; Mood, Darlene W; Newth, Gail et al. (2008) Longitudinal analysis of a model to predict quality of life in prostate cancer patients and their spouses. Ann Behav Med 36:117-28
Northouse, Laurel L; Mood, Darlene W; Schafenacker, Ann et al. (2007) Randomized clinical trial of a family intervention for prostate cancer patients and their spouses. Cancer 110:2809-18
Northouse, Laurel L; Mood, Darlene W; Montie, James E et al. (2007) Living with prostate cancer: patients'and spouses'psychosocial status and quality of life. J Clin Oncol 25:4171-7
Northouse, Laurel L; Rosset, Tansey; Phillips, Laurel et al. (2006) Research with families facing cancer: the challenges of accrual and retention. Res Nurs Health 29:199-211