The diagnosis and treatment of localized prostate cancer can reduce the quality of life for both patient and partner. Our preliminary studies as well as the work of others suggest that couples' communication and intimacy play a role in the psychological and relationship functioning of both patient and partner. These results suggest that enhancing intimacy via improvements in the communication strategies couples utilize may be a prime target for psychological intervention. We have developed an Intimacy- Enhancing Couples' Intervention (IEC) and tested it against a Usual care control (UC) in a small randomized clinical trial. The primary goal of IEC is to teach couples relationship-enhancing communication skills and bolster relationship intimacy. Preliminary results suggested that IEC reduced patient and partner distress and improved communication and intimacy. The goal of the proposed study is to conduct a larger scale trial to evaluate IEC's efficacy against an attention control (a General Health and Wellness Intervention; GHW) and to evaluate moderators and mechanisms for the treatment's effects. 469 men diagnosed with localized prostate cancer and their partners will be randomly assigned to IEC, GHW, or UC. Participants will complete surveys pre-intervention, 5 weeks, 12 weeks, and six months post-baseline.
The aims are: 1) To evaluate the impact of an IEC versus a GHW and UCl on patient and partner psychological and relationship outcomes. 2) To determine whether relationship length, pre-intervention marital satisfaction, and men's pre-intervention traditional masculinity moderate the effects of IEC on couples' psychological and relationship outcomes. IEC will have a stronger impact on patient and partner psychological and relationship functioning among patients and partners married a longer period of time, patients and partners reporting lower pre-intervention levels of marital satisfaction, and among patients reporting higher levels of traditional masculinity; 3) To evaluate whether IEC has an effect on couples' communication and intimacy when compared with GHW and UC, and to determine whether changes in relationship communication and intimacy mediate changes in couples' psychological and relationship outcomes.
Our prior research has indicated that relationship communication and intimacy are related to psychological distress and relationship satisfaction of men diagnosed with early stage prostate cancer and their partners. We have developed and conducted a pilot study to evaluate the efficacy of a new intimacy-enhancing couples' intervention for this population. In the proposed study, we seek to evaluate the intervention in a large randomized clinical trial, identify characteristics of patients and partners who may benefit the most from this intervention, and evaluate possible mechanisms of change
