Paper
Friday, July 13, 2007
Monitoring of men with hot flashes following androgen ablation: A Transdisciplinary Approach
Christine A. Engstrom, MS, Nursing, Veterans Administration, Baltimore, MD, USA and Christine E. Kasper, RN, PhD, FAAN, FACSM, Nursing, Veterans Administration, Uniformed Services University of the Health Sciences, Bethesda, MD, USA.
| Learning Objective #1: The learner will be able to describe the hot flash frequency, bother and intensity in prostate cancer patients treated with androgen ablation. |
| Learning Objective #2: The learner will be able to describe the feasibilty of an objective measures of hot flashes in men as an outcome measure of treatment. |
Hot flashes/flushes affect up to 80 percent of prostate cancer patients treated with androgen ablation. A number of studies have reported the efficacy and toxicities of pharmacologic interventions for hot flashes/flushes in this population relying on subjective self-report outcome measures; to date there have been no published studies of any objective measures of hot flashes/flushes in men. Such research is important for improving quality of life of men who experience unrelieved hot flashes/flushes. The Theory of Unpleasant Symptoms was used as a conceptual framework to guide this study; the purpose of this pilot study was to assess the feasibility of an objective measure of hot flashes/flushes in a sample of prostate cancer patients treated with androgen ablation. The Biolog® sternal skin conductance monitor was worn by each patient for 24 hours. The concordance between subjective measures and objective hot flash frequencies over a 24 hour period with the monitor was done in a group of 20 men aged 54 to 80. A secondary objective was to assess whether frequency and severity of hot flashes/flushes have an impact on patients’ health related quality of life (HRQOL) and sleep disturbances. Correlation between the frequency of hot flashes recorded by a sternal skin conductance monitor and the number of self identified hot flashes in study participants was used to assess the accuracy of the hot flash/flush monitor. The monitor will provide an objective measurement of this phenomenon in men for future interventional studies. Multivariate repeated measures approach was used to estimate the relationship between patients’ HRQOL sleep and hot flashes/flushes. The implications of the findings of this study will be addressed.