Objective: To determine the effects of an innovative health promotion strategy (dyadic intervention, i.e., one-to-one support) aimed at reducing depression in men after radical prostatectomy for prostate cancer.
Design: Experimental
Sample and Setting: Thirteen White and two Black men (M age=59.7) who underwent radical prostatectomy within three months of diagnosis were randomly assigned to control group (usual care) and 13 White and two Black men (M age=57.5) to the dyadic intervention.
Intervention and Outcome Variable(s): Based underpinnings of Bandura’s theory of self-efficacy (vicarious experience, verbal persuasion, and arousal state) experimental subjects who were recently diagnosed with prostate cancer and treated by radical prostatectomy were paired (dyads) with support partners whom themselves had had a radical prostatectomy over 3 years prior. Variables of interest included social support (Modified Inventory of Socially Supportive Behaviors), self-efficacy (Stanford Inventory of Cancer Patient Adjustment), depression (Geriatric Depression Scale), physical function (UCLA Prostate Cancer Index), quality of the intervention (weekly dyadic logs).
Methods: Dyads met weekly (M time=60 minutes; range 5 to 360 minutes) for 8 weeks to discuss the lived experience associated with the aftermath of prostate cancer, radical prostatectomy, and urinary and sexual dysfunction. Findings: No significant differences were detected on social support, but after 4 and 8 weeks, significant differences were present between controls (Ms=1.7 and 2.1, respectively; p<.05) and experimentals (Ms=0.3 and 0.4, respectively; P<.05) on depression. After 8 weeks, there were also significant within group differences on self-efficacy for experimentals (Ms=309 and 314, respectively; p<.05). Although there were no significant differences between experimentals and controls on urinary (Ms=74 and 57, respectively) or sexual function (Ms=13 and 21, respectively), experimentals improved more quickly than controls in urinary (61% and 28%, respectively) and sexual function (81% and 53%, respectively) from baseline to 8 weeks.
Conclusions: Despite the small sample, dyadic intervention was a low cost health promoting strategy that was effective at reducing depression, increasing self-efficacy, and promoting quicker return of urinary and sexual function in men treated by radical prostatectomy.
Implications: Strategies related to health promotion such as improving emotional well-being and the quality of life for cancer patients after diagnosis and treatment are paramount to comprehensive nursing care. Results from this study will add to the scientific knowledge base of the known effect of such a strategy that is dyadic intervention for men surviving prostate cancer. It is expected that dyadic intervention will enhance survival and/or reduce depression among this group and results may be extended to others with cancer.
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