Early decision and psychosocial support intervention for men with localised prostate cancer: an integrated approach

Abstract

Goal: Men diagnosed with prostate cancer experience high decision-related distress concurrent with cancer-related distress. Psycho-education, problem solving and decision support were integrated in a novel telephone-delivered supportive care intervention targeting men at diagnosis and assessed for feasibility.

Materials and methods: An exploratory single-group pre-post-test design tracked session frequency, duration and content. Standardised measures assessed decisional conflict, cancer-related distress and decision involvement. Brief screening measures for psychological and decision-related distress were incorporated into the intervention protocol. Twenty men (77% response) newly diagnosed with localised prostate cancer received the intervention.

Results: Men who were undecided about treatment at study entry required more pre-treatment intervention calls (p < 0.013). Pre-treatment support calls were longer (M = 40.2 min) and more complex by comparison to post-treatment calls (M = 30.9 min; p < 0.002). Brief screening for decision-related distress correlated with concurrent (p < 0.008) and prospective (p < 0.046) decisional conflict. Decisional conflict and intrusion decreased at post-test (p < 0.001; p < 0.005). Men reported a high level of satisfaction with the support received with benefits identified including anonymity and accessibility.

Conclusions: In this setting, a tele-based supportive care and decision support intervention for men newly diagnosed with prostate cancer was feasible. The use of brief screening measures as within-intervention clinical tools appears promising.