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301706
Intervention targets for newly diagnosed prostate cancer patients experiencing significant emotional distress
Tuesday, November 18, 2014
Heather Orom, PhD
,
Community Health and Health Behavior, University at Buffalo, Buffalo, NY
D. Lynn Homish, B.S.
,
University at Buffalo, Buffalo, NY
Gregory G. Homish, PhD
,
Department of Community Health and Health Behavior, School of Public Health and Health Professions, University at Buffalo, State University of New York, Buffalo, NY
Willie Underwood, MD, MS, MPH
,
Urologic Oncology, Roswell Park Cancer Institute, Buffalo, NY
Christian Nelson, PhD
,
Memorial Sloan-Kettering Cancer Center, New York, NY
By most estimates, about a third of men diagnosed with prostate cancer develop clinically significant emotional distress. Early identification and intervention has been recommended for these men, given evidence that many will continue to experience elevated distress even several years post-treatment. To effectively screen and support survivors, we need to understand which factors are associated with distress in newly diagnosed patients, a topic that has received little attention. We investigated the extent to which beliefs, social resources, personality, and clinical and demographic characteristics were associated with distress assessed with the emotional distress thermometer in 1254 men newly diagnosed with localized prostate cancer (pre-treatment). Factors amenable to psycho-education intervention (lower confidence in cancer control, decision-making self-efficacy, and lower masculine self-esteem; ps<.01) were associated with higher distress, as were personality factors (lower optimism, and lower resilience; ps<.05). Clinical and demographic factors also predicted higher distress (higher Gleason score, younger age, black vs. white race, and higher perceived social status; ps<.05). The same predictors, with the exception of optimism and decision-making self-efficacy, were risk factors for clinically significant distress (≥5 on distress thermometer). Potential intervention targets include improving provider communication about prostate cancer prognosis, providing decision-making support to increase decision-making self-efficacy, and referral to brief cognitive behavioral interventions to help patients reframe and adjust to the health threat. Furthermore, as strategies are developed to reduce emotional distress in prostate cancer patients, early screening may become a useful tool for identifying and allocating resources to those at risk for poor adjustment in survivorship.
Learning Areas:
Provision of health care to the public
Social and behavioral sciences
Learning Objectives:
Describe social-cognitive, personality, clinical, and demographic factors associated with higher emotional distress in men with newly diagnose prostate cancer.
Discuss possible intervention targets for reducing emotional distress in men with newly diagnosed prostate cancer.
Explain potential benefits of screening for, and intervening in emotional distress in men with newly diagnosed prostate cancer.
Keyword(s): Mental Health, Cancer and Men’s Health
Presenting author's disclosure statement:Qualified on the content I am responsible for because: I am a principle investigator of a federally funded grant in which we are studying prostate cancer treatment decision-making and survivorship.
Any relevant financial relationships? No
I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines,
and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed
in my presentation.