Measuring patients' perceptions of the outcomes of treatment for early prostate cancer

被引:112
作者
Clark, JA
Bokhour, BG
Inui, TS
Silliman, RA
Talcott, JA
机构
[1] Boston Univ, Sch Publ Hlth, Dept Hlth Serv, Boston, MA 02118 USA
[2] Edith Nourse Rogers Mem Vet Adm Hosp, Ctr Hlth Qual Outcomes & Econ Res, Bedford, MA 01730 USA
[3] Indiana Univ, Sch Med, Indianapolis, IN USA
[4] Regenstrief Inst Hlth Care, Indianapolis, IN 46202 USA
[5] Boston Univ, Sch Med, Boston, MA 02118 USA
[6] Massachusetts Gen Hosp, Ctr Canc, Ctr Outcomes Res, Boston, MA USA
[7] Harvard Univ, Sch Med, Boston, MA 02115 USA
关键词
prostate cancer; quality of life; treatment outcomes;
D O I
10.1097/00005650-200308000-00006
中图分类号
R19 [保健组织与事业(卫生事业管理)];
学科分类号
摘要
BACKGROUND. Compared with careful attention to the physical (eg, urinary, bowel, sexual) dysfunction that may follow treatment, little attention has been given to the behavioral, emotional, and interpersonal changes that the diagnosis of early prostate cancer and subsequent physical dysfunction may bring. OBJECTIVE. To construct patient-centered measures of the outcomes of treatment for early prostate cancer. RESEARCH DESIGN. Qualitative study followed by survey of early prostate cancer patients and group of comparable patients with no history of prostate cancer. Analysis of focus groups identified relevant domains of quality of life, which were represented by Likert scale items included in survey questionnaires. Psychometric analyses of survey data defined scales evaluated with respect to internal consistency and validity. RESULTS. Qualitative analysis identified three domains: urinary control, sexuality, and uncertainty about the cancer and its treatment. Psychometric analysis defined 11 scales. Seven were generically relevant to most older men: urinary control (eg, embarrassment with leakage), sexual intimacy (eg, anxiety about completing intercourse), sexual confidence (eg, comfort with sexuality), marital affection (eg, emotional distance from spouse/partner), masculine self esteem (eg, feeling oneself a whole man), health worry (eg, apprehensiveness about health changes), and PSA concern (eg, closely attending to one's PSA). Four scales were specific to the treatment experience: perceived cancer control, quality of treatment decision making, regret of treatment choice, and cancer-related outlook. CONCLUSION. The scales provide definition and metrics for patient-centered research in this area. They complement measures of physical dysfunction and bring into resolution outcomes of treatment that have gone unnoticed in previous studies.
引用
收藏
页码:923 / 936
页数:14
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