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Siddons H.M.,Royal Melbourne Hospital | Wootten A.C.,Royal Melbourne Hospital | Wootten A.C.,Australian Prostate Cancer Research Center Epworth | Costello A.J.,Royal Melbourne Hospital
Psycho-Oncology | Year: 2013

Objective To examine the effectiveness of a cognitive-behavioural therapy (CBT) group intervention to facilitate improved psycho-sexual adjustment to treatment side effects in prostate cancer survivors post-radical prostatectomy. Methods A randomised, wait-list controlled trial was conducted with a total of 60 men who participated in a manualised 8-week cognitive-behavioural group intervention 6 months to 5 years post-radical prostatectomy for localised prostate cancer. Participants completed standardised questionnaires pre-intervention and post-intervention, which assessed mood state, stress, general and prostate cancer anxiety, quality of life and areas of sexual functioning. Results Paired samples t-tests identified a significant improvement in sexual confidence, masculine self-esteem, sexual drive/relationship and a significant decline in sexual behaviour from pre-intervention to post-intervention. Hierarchical regression analyses revealed that after controlling for covariates, participation in the group intervention significantly improved sexual confidence, sexual intimacy, masculine self-esteem and satisfaction with orgasm. Conclusions This group-based CBT intervention for men post-radical prostatectomy for localised prostate cancer shows promising results in terms of improving quality of life. Copyright © 2013 John Wiley & Sons, Ltd.

Chisholm K.E.,Deakin University | McCabe M.P.,Deakin University | Wootten A.C.,Australian Prostate Cancer Research Center Epworth | Abbott J.-A.M.,Swinburne University of Technology
Journal of Sexual Medicine | Year: 2012

Introduction. Although previous research has evaluated the effectiveness of psychosocial interventions for men with prostate cancer, no previous review has investigated the effects of psychosocial interventions on both sexual and relationship functioning. Aim. To review the effectiveness of psychosocial interventions that focus on sexual and/or relationship functioning for men with prostate cancer and their partners. Method. A systematic literature review of research reported in the Medline, PsychINFO, PsychArticles databases from January 1990 to September 10, 2011. Main Outcome Measure. The review focused on the evaluation of interventions that aimed to improve the sexual and/or relationship functioning of men and their partners. Results. There was evidence that psychosocial interventions can improve men's sexual functioning, particularly when delivered face-to-face and when using more complex strategies to target sexuality in men and in relationships. There was inconclusive evidence for the effectiveness of psychosocial interventions in improving men's relationship functioning or the sexual or relationship functioning of their partners. Conclusions. There is a need for further research to target improving and measuring men and their partner's sexual and relationship functioning in the context of prostate cancer. The effectiveness of tailoring interventions to the specific needs of men and to their stage of cancer also needs to be further examined. © 2012 International Society for Sexual Medicine.

Sharpley C.F.,University of New England of Australia | Wootten A.C.,University of New England of Australia | Wootten A.C.,Australian Prostate Cancer Research Center Epworth | Bitsika V.,Bond University | Christie D.R.H.,University of New England of Australia
American Journal of Men's Health | Year: 2013

Although there is some evidence that psychological resilience may "buffer" against depression following major stressors, no data have been reported on the nature and variability of this buffering effect among prostate cancer patients during the 5 years following their initial diagnosis. Patients from two sites in Australia and who had received their initial diagnosis within 5 years (n = 255) were surveyed, and the results indicated that there was a significant inverse relationship between resilience and depression in the overall data, but that was mostly accounted for by a single factor of the resilience scale ("Confidence to cope with change"). Variability in that buffering effect was noted over time since diagnosis, with peaks during the first 6 months, at 24 and 60 months. These findings support the argument to develop focused psychiatric interventions at various periods following a diagnosis of prostate cancer. © The Author(s) 2013.

Thomas C.,La Trobe University | Thomas C.,Australian Prostate Cancer Research Center Epworth | Wootten A.,Australian Prostate Cancer Research Center Epworth | Robinson P.,La Trobe University
European Journal of Cancer Care | Year: 2013

Research concerning gay and bisexual men diagnosed with prostate cancer is sparse. An online focus group was conducted over a 4-week period with participants responding to a range of discussion questions concerning their experiences following a prostate cancer diagnosis. Emerging themes were identified and consensus reached. A summary of each of the themes was produced which the coders agreed conveyed the essence of the online discussion. All men who took part in the online focus group reported that prostate cancer significantly impacted their lives. Unexpectedly, some participants actually gained a positive perspective and adopted a sense of empowerment. Participants spoke about emotional responses to a diagnosis of prostate cancer, accessing help and support, the impact of incontinence, the impact of sexual changes on identity, a re-evaluation of life, changed sexual relationships, the need to find the most suitable healthcare professionals and identification of current needs to improve quality of care. These areas of disquiet suggest that the psychological impact of this disease may be quite significant over an extended time-frame. Further research needs to be undertaken to assess the degree of distress accompanying the treatment of gay and bisexual men with prostate cancer. © 2013 John Wiley & Sons Ltd.

Dowrick A.S.,Norwegian University of Science and Technology | Dowrick A.S.,Royal Melbourne Hospital | Wootten A.C.,Royal Melbourne Hospital | Wootten A.C.,Australian Prostate Cancer Research Center Epworth | And 4 more authors.
BJU International | Year: 2016

Objective: To investigate in a prospective, observational study whether transperineal prostate biopsy (TPbx) results in patient-reported quality-of-life (QoL) changes from baseline in the first 3-months after TPbx. Patients and methods: Consenting patients completed the 26-item Expanded Prostate cancer Index Composite (EPIC-26), the Sexual Health Inventory for Men, the International Prostate Symptom Score, the Generalised Anxiety Disorder seven-item scale, the Patient Health Questionnaire nine-item scale, and a global question about willingness to have a repeat TPbx in a years' time. The instruments were scored using published scoring methods. Wilcoxon signed–rank tests and Mann–Whitney U-tests were used to investigate statistically significant differences. Clinically significant differences were also investigated defined by published minimal important differences for the EPIC-26 and changes in established categorical groups for the other instruments. Results: In all, 53 patients consented to participate and completed the baseline questionnaire, in addition to at least one of the 1- or 3-month follow-up questionnaires. We found that most patients having a TPbx had no clinically significant change in QoL in the first 3 months after TPbx. However, 24% had clinically worse urinary function and 18% had worse sexual function at 1 month. At 3 months, 3% of patients had clinically worse urinary function and 25% continued to have worse sexual function compared with baseline. Patients who were subsequently diagnosed with cancer based on the results of the TPbx, had statistically significantly reduced QoL for the EPIC-26 urinary scales and reduced improvements in scores on the psychological scales at the 1-month follow-up compared with those who were not diagnosed with cancer. Conclusions: Most patients having a TPbx had no clinically significant change in QoL in the first 3 months after TPbx. However, patients should be advised that a quarter may have clinically worse urinary function and nearly 20% have clinically worse sexual function in the first month, and that sexual function deficits may continue up to 3 months. The results of this study provide a resource that the clinician can use when discussing TPbx with patients. © 2016 The Authors BJU International © 2016 BJU International Published by John Wiley & Sons Ltd

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