Skip to main content

Advertisement

SpringerLink
Log in

Enhancing survivorship care planning for patients with localized prostate cancer using a couple-focused web-based, mHealth program: the results of a pilot feasibility study

  • Published:
Journal of Cancer Survivorship Aims and scope Submit manuscript

Abstract

Purpose

To examine the feasibility of an enhanced survivorship care plan (ESCP) that integrated the web-based program Patient Education Resources for Couples (PERC) into a standardized survivorship care plan (SCP) and estimated the outcomes of ESCPs versus SCPs.

Methods

In this randomized pilot trial, localized prostate cancer (PC) patients and partners (i.e., couple) were randomly assigned to ESCP that contained a link to PERC or to SCP that contained a link to general PC information on the National Cancer Institute website. Couples completed assessments measuring quality of life (QOL), appraisal of symptoms, and coping resources at baseline (T1) and 4–6 months later (T2). We examined feasibility (e.g., recruitment and retention) using descriptive statistics. Linear mixed models examined changes in couples’ outcomes over time and Poisson regression examined differences in patient healthcare utilization.

Results

Sixty-two couples completed T1 surveys (recruitment rate 41.6%) and were randomly assigned to receive ESCP (n = 31) or SCP (n = 31). Twenty-eight (ESCP) and 25 (SCP) couples completed T2 surveys (retention rates = 90.3% vs. 80.7%). ESCP participants (70%) reviewed webpages consistent with patients’ symptoms. ESCP patients reported greater program satisfaction (p = 0.02) and better urinary symptom scores (p < 0.01) than SCP patients.

Conclusions

Delivering ESCPs that embed a web-link to a couple-focused, tailored program is feasible and can potentially improve patient outcomes. The promising results need to be validated in a larger definitive trial using a diverse sample.

Implications for Cancer Survivors

SCPs, enhanced using a web-based intervention (e.g., PERC), may help PC cancer survivors better manage their urinary symptoms.

Trial registration

ClinicalTrials.gov identifier: NCT04350788

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. American Cancer Society. Cancer facts & figures 2020. Atlanta: American Cancer Society; 2020.

    Google Scholar 

  2. Chen RC, Zhang Y, Chen MH, McMahon E, Loffredo M, McPherson CP, et al. Patient-reported quality of life during radiation treatment for localized prostate cancer: results from a prospective phase II trial. BJU Int. 2012;110(11):1690–5.

    Article  Google Scholar 

  3. Matthew AG, Alibhai SMH, Davidson T, Currie KL, Jiang H, Krahn M, et al. Health-related quality of life following radical prostatectomy: long-term outcomes. Qual Life Res. 2014;23(8):2309–17.

    Article  Google Scholar 

  4. Prabhu V, et al. Short-, intermediate-, and long-term quality of life outcomes following radical prostatectomy for clinically localized prostate cancer. Rev Urol. 2013;15(4):161–77.

    PubMed  PubMed Central  Google Scholar 

  5. Crook JM, Gomez-Iturriaga A, Wallace K, Ma C, Fung S, Alibhai S, et al. Comparison of health-related quality of life 5 years after SPIRIT: Surgical Prostatectomy Versus Interstitial Radiation Intervention Trial. J Clin Oncol. 2011;29(4):362–8.

    Article  Google Scholar 

  6. Bernat J, et al. Domain-specific symptom burden and information needs in prostate cancer survivors: a case for tailored long-term survivorship care. J Urol. 2015;193:e309.

    Google Scholar 

  7. Northouse LL, Mood DW, Montie JE, Sandler HM, Forman JD, Hussain M, et al. Living with prostate cancer: patients’ and spouses’ psychosocial status and quality of life. J Clin Oncol. 2007;25:4171–7.

    Article  Google Scholar 

  8. Harden J, Sanda MG, Wei JT, Yarandi HN, Hembroff L, Hardy J, et al. Survivorship after prostate cancer treatment: spouses’ quality of life at 36 months. Oncol Nurs Forum. 2013;40(6):567–73.

    Article  Google Scholar 

  9. Galbraith ME, Fink R, Wilkins GG. Couples surviving prostate cancer: challenges in their lives and relationships. Semin Oncol Nurs. 2011;27(4):300–8.

    Article  Google Scholar 

  10. Ervik B, Nordoy T, Asplund K. In the middle and on the sideline: the experience of spouses of men with prostate cancer. Cancer Nurs. 2013;36(3):E7–E14.

    Article  Google Scholar 

  11. Hoekstra RA, Heins MJ, Korevaar JC. Health care needs of cancer survivors in general practice: a systematic review. BMC Fam Pract. 2014;15:94.

    Article  Google Scholar 

  12. Bazzell, J.L., A. Spurlock, and M. McBride, Matching the Unmet Needs of Cancer Survivors to Resources Using a Shared Care Model. J Cancer Educ, 2015;30(2):312–8.

  13. Viswanathan, M., et al., Models of cancer survivorship care. 2014.

    Google Scholar 

  14. Skolarus TA, Wolf AM, Erb NL, Brooks DD, Rivers BM, Underwood W 3rd, et al. American Cancer Society prostate cancer survivorship care guidelines. CA Cancer J Clin. 2014;64(4):225–49.

    Article  Google Scholar 

  15. Mayer DK, Nekhlyudov L, Snyder CF, Merrill JK, Wollins DS, Shulman LN. American Society of Clinical Oncology clinical expert statement on cancer survivorship care planning. J Oncol Pract. 2014;10(6):345–51.

    Article  Google Scholar 

  16. Alfano CM, Smith T, de Moor JS, Glasgow RE, Khoury MJ, Hawkins NA, et al. An action plan for translating cancer survivorship research into care. J Natl Cancer Inst. 2014;106(11):dju287.

    Article  Google Scholar 

  17. American Society of Clinical Oncology. ASCO answers: cancer survivorship trusted information about life after treatment from the American Society of Clinical Oncology. Alexandria: American Society of Clinical Oncology; 2014.

    Google Scholar 

  18. Boekhout AH, et al. A survivorship care plan for breast cancer survivors: extended results of a randomized clinical trial. J Cancer Surviv. 2015;9(4):683–91.

    Article  Google Scholar 

  19. Grunfeld E, Julian JA, Pond G, Maunsell E, Coyle D, Folkes A, et al. Evaluating survivorship care plans: results of a randomized, clinical trial of patients with breast cancer. J Clin Oncol. 2011;29(36):4755–62.

    Article  Google Scholar 

  20. Nicolaije KA, Ezendam NP, Vos MC, Pijnenborg JM, Boll D, Boss EA, et al. Impact of an automatically generated cancer survivorship care plan on patient-reported outcomes in routine clinical practice: longitudinal outcomes of a pragmatic, cluster randomized trial. J Clin Oncol. 2015;33(31):3550–9.

    Article  Google Scholar 

  21. Ezendam NP, et al. Survivorship care plans to inform the primary care physician: results from the ROGY care pragmatic cluster randomized controlled trial. J Cancer Surviv. 2014;8(4):595–602.

    Article  Google Scholar 

  22. Mayer DK, Birken SA, Check DK, Chen RC. Summing it up: an integrative review of studies of cancer survivorship care plans (2006-2013). Cancer. 2014;121(7):978–96.

    Article  Google Scholar 

  23. Lazarus RS, Folkman S. Stress, appraisal, and coping. New York: Springer Publishing Company; 1984.

    Google Scholar 

  24. Lazarus RS. Stress and emotion: a new syntheis. Springer Publishing Company, Inc; 1999.

  25. Song L, Dunlap KL, Tan X, Chen RC, Nielsen ME, Rabenberg RL, et al. Enhancing survivorship care planning for patients with localized prostate cancer using a couple-focused mHealth symptom self-management program: protocol for a feasibility study. JMIR Res Protoc. 2018;7(2):e51.

    Article  Google Scholar 

  26. National comprehensive Cancer Network, NCCN clinical practice guidelines in oncology (NCCN Guideline): prostate cancer. 2014. National Comprehensive Cancer Network: http://www.nccn.org/professionals/physician_gls/pdf/prostate.pdf. Accessed 10 June 2016.

  27. Song L, Rini C, Deal AM, Nielsen ME, Chang H, Kinneer P, et al. Improving couples’ quality of life through a web-based, couple-oriented prostate cancer education intervention. Oncol Nurs Forum. 2015;42:183–92.

    Article  Google Scholar 

  28. Bastien JM. Usability testing: a review of some methodological and technical aspects of the method. Int J Med Inform. 2010;79(4):e18–23.

    Article  Google Scholar 

  29. Brooke J. SUS: a “quick and dirty” usability scale. In: Jordan PW, et al., editors. Usability evaluation in industry. London: Taylor and Francis; 1996.

    Google Scholar 

  30. Cella DF, Tulsky DS, Gray G, Sarafian B, Linn E, Bonomi A, et al. The Functional Assessment of Cancer Therapy scale: development and validation of the general measure. J Clin Oncol. 1993;11:570–9.

    Article  CAS  Google Scholar 

  31. Northouse LL, Mood D, Kershaw T, Schafenacker A, Mellon S, Walker J, et al. Quality of life of women with recurrent breast cancer and their family members. J Clin Oncol. 2002;20:4050–64.

    Article  Google Scholar 

  32. Wei JT, Dunn RL, Litwin MS, Sandler HM, Sanda MG. Development and validation of the expanded prostate cancer index composite (EPIC) for comprehensive assessment of health-related quality of life in men with prostate cancer. Urology. 2000;56(6):899–905.

    Article  CAS  Google Scholar 

  33. Mood D, et al. Assessing risk for distress in cancer patients and family caregivers. Oncol Nurs Forum. 2007;34(1):233.

    Google Scholar 

  34. Lewis FM. Family home visitation study final report. National Cancer Institute, National Institutes of Health, Bethesda; 1996.

  35. Patient-reported outcomes measurement information system. PROMISE Informational Support Instruments. 2015.

  36. Sheridan SL, Draeger LB, Pignone MP, Sloane PD, Samuel-Hodge C, Finkelstein EA, et al. Designing and implementing a comparative effectiveness study of two strategies for delivering high quality CHD prevention: methods and participant characteristics for the Heart to Health study. Contemp Clin Trials. 2013;36(2):394–405.

    Article  Google Scholar 

  37. Kraschnewski JL, Gold AD, Gizlice Z, Johnston LF, Garcia BA, Samuel-Hodge CD, et al. Development and evaluation of a brief questionnaire to assess dietary fat quality in low-income overweight women in the southern United States. J Nutr Educ Behav. 2013;45(4):355–61.

    Article  Google Scholar 

  38. Giles-Corti B, Timperio A, Cutt H, Pikora TJ, Bull FCL, Knuiman M, et al. Development of a reliable measure of walking within and outside the local neighborhood: RESIDE’s Neighborhood Physical Activity Questionnaire. Prev Med. 2006;42(6):455–9.

    Article  Google Scholar 

  39. Jones SA, Evenson KR, Johnston LF, Trost SG, Samuel-Hodge C, Jewell DA, et al. Psychometric properties of the modified RESIDE physical activity questionnaire among low-income overweight women. J Sci Med Sport. 2015;18(1):37–42.

    Article  Google Scholar 

  40. Charlson ME, Pompei P, Ales KL, MacKenzie CR. A new method of classifying prognostic comorbidity in longitudinal studies: development and validation. J Chronic Dis. 1987;40(5):373–83.

    Article  CAS  Google Scholar 

  41. Quan H, Li B, Couris CM, Fushimi K, Graham P, Hider P, et al. Updating and validating the Charlson Comorbidity Index and score for risk adjustment in hospital discharge abstracts using data from 6 countries. Am J Epidemiol. 2011;173(6):676–82.

    Article  Google Scholar 

  42. Hill RE, Wakefield CE, Cohn RJ, Fardell JE, Brierley ME, Kothe E, et al. Survivorship care plans in cancer: a meta-analysis and systematic review of care plan outcomes. Oncologist. 2020;25(2):e351–72.

    Article  Google Scholar 

  43. Stanford JL, Feng Z, Hamilton AS, Gilliland FD, Stephenson RA, Eley JW, et al. Urinary and sexual function after radical prostatectomy for clinically localized prostate cancer: the Prostate Cancer Outcomes Study. JAMA. 2000;283:354–60.

    Article  CAS  Google Scholar 

Download references

Acknowledgments

The authors thank the research participants, research staff, and advisory committee for their important contributions that have made the study possible. The authors also gratefully acknowledge the technical support of the UNC Connected Health for Applications and Interventions (CHAI) core for developing and maintaining the intervention website.

Funding

This study was funded by the National Cancer Institute (R21CA212516, PI: Song). CHAI core is supported through a grant from the National Institutes of Health (DK056350) to the University of North Carolina Nutrition Obesity Research Center and from NCI (P30CA16086, PI: Earp) to the Lineberger Comprehensive Cancer Center. Dr. Song’s work was also partially supported by R01NR016990 National Institute of Nursing Research (NIHR) (PI: Song) and University Cancer Research Fund, UNC Lineberger Comprehensive Cancer Center. Dr. Tan’s work was partially supported by R01NR016990 (PI: Song) and P30CA016086 (PI: Earp). Dr. Birken’s effort was supported by the National Center for Advancing Translational Sciences, National Institutes of Health, through Grant KL2TR002490.

Author information

Authors and Affiliations

  1. School of Nursing, University of North Carolina (UNC), Carrington Hall, Chapel Hill, NC, 27599-7460, USA

    Lixin Song, Peiran Guo & Deborah K. Mayer

  2. Lineberger Comprehensive Cancer Center, UNC, Chapel Hill, NC, USA

    Lixin Song, Xianming Tan, Matthew E. Nielsen & Deborah K. Mayer

  3. University of Kansas Medical Center, Kansas City, USA

    Ronald C. Chen

  4. School of Medicine, UNC, Chapel Hill, NC, USA

    Matthew E. Nielsen

  5. Gillings School of Global Public Health, UNC, Chapel Hill, NC, USA

    Sarah A. Birken

  6. School of Medicine, Duke University, Durham, NC, USA

    Bridget F. Koontz

  7. School of Nursing, University of Michigan, Ann Arbor, MI, USA

    Laurel L. Northouse

Authors
  1. Lixin Song
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Peiran Guo
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Xianming Tan
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Ronald C. Chen
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Matthew E. Nielsen
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Sarah A. Birken
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Bridget F. Koontz
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Laurel L. Northouse
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Deborah K. Mayer
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Lixin Song.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in this study were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. IRB #: 16-1913 (University of North Carolina-Chapel Hill).

Informed consent

Informed consent was obtained from all individual participants included in the study.

Disclaimer

The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH.

Additional information

Publisher’s note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Electronic supplementary material

ESM 1

(DOCX 24 kb)

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Song, L., Guo, P., Tan, X. et al. Enhancing survivorship care planning for patients with localized prostate cancer using a couple-focused web-based, mHealth program: the results of a pilot feasibility study. J Cancer Surviv 15, 99–108 (2021). https://doi.org/10.1007/s11764-020-00914-7

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11764-020-00914-7

Keywords

Search

Navigation