Originally published as JCO Early Release 10.1200/JCO.2006.09.6503 on July 16 2007

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Living With Prostate Cancer: Patients' and Spouses' Psychosocial Status and Quality of Life

Laurel L. Northouse, Darlene W. Mood, James E. Montie, Howard M. Sandler, Jeffrey D. Forman, Maha Hussain, Kenneth J. Pienta, David C. Smith, Martin G. Sanda, Trace Kershaw

From the School of Nursing and the Division of Hematology/Oncology, Departments of Urology and Radiation Oncology, University of Michigan, Ann Arbor; Wayne State University College of Nursing and School of Medicine; Department of Radiation Oncology, Karmanos Cancer Center, Detroit, MI; Division of Urology, Beth Israel Deaconess Medical Center; Department of Surgery, Harvard Medical School, Boston, MA; and the Yale University School of Public Health, New Haven, CT

Address reprint requests to Laurel L. Northouse, PhD, University of Michigan, 400 North Ingalls, Ann Arbor, MI, 48109-0482; e-mail: lnortho{at}umich.edu

Purpose Despite the high prevalence of prostate cancer, little information is available on the quality of life of men and their spouses during the phases of illness. This study assessed patients' and spouses' quality of life, appraisal of illness, resources, symptoms, and risk for distress across three phases of prostate cancer: newly diagnosed, biochemical recurrence, and advanced.

Patients and Methods The sample consisted of 263 patient/spouse dyads. A stress-appraisal conceptual model guided the selection of variables which were then assessed with established instruments. Study variables were examined for phase effects (differences in dyads across three phases), role effects (patients v spouses), and phase-by-role interactions (differences within dyads across phases) using analysis of variance (ANOVA).

Results More phase effects than role effects were found, indicating that the psychosocial experiences of patients and their spouses were similar, but differed from dyads in other phases. Dyads in the advanced phase were at highest risk for distress. These patients had the lowest physical quality of life, and their spouses had the lowest emotional quality of life of all participants. Dyads in the biochemical recurrence and advanced phases had more negative appraisals of illness and caregiving, greater uncertainty, and more hopelessness compared with dyads in the newly diagnosed phase. Spouses, in contrast to patients, had less confidence in their ability to manage the illness and perceived less support across all phases of illness.

Conclusion Phase-specific programs of care are needed to assist both men with prostate cancer and their spouses to manage the effects of illness.

published online ahead of print at www.jco.org on July 16, 2007.

Supported by Grant No. R01CA90739 from the National Cancer Institute (L.N.).

Authors' disclosures of potential conflicts of interest and author contributions are found at the end of this article.

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