Couple‐focused interventions for men with localized prostate cancer and their spouses: A randomized clinical trial

• Published in: British journal of health psychology 2019-05, Vol.24 (2), p.396-418
• Main Authors: Manne, Sharon L., Kashy, Deborah A., Zaider, Talia, Kissane, David, Lee, David, Kim, Isaac Y., Heckman, Carolyn J., Penedo, Frank J., Murphy, Evangelynn, Virtue, Shannon Myers
• Format: Article
• Language: English
• Subjects: Adaptation; Adaptation, Psychological; Adjustment; Cancer therapies; Clinical assessment; Clinical outcomes; Clinical research; Clinical trials; Communication; Couples therapy; Couples Therapy - methods; general health and wellness intervention; Humans; Intervention; Intimacy; intimacy‐enhancing therapy; Male; Masculinity; Men; Middle Aged; Moderators; Patient satisfaction; Personal Satisfaction; Prostate; Prostate cancer; Prostatic Neoplasms - psychology; Psychological distress; Psychological functioning; psychological intervention; Quality of life; Quality of Life - psychology; Spouses; Spouses - psychology; Spouses - statistics & numerical data
• ISSN: 1359-107X; 2044-8287
• DOI: 10.1111/bjhp.12359

Objectives Few couple‐focused interventions have improved psychological and relationship functioning among men diagnosed with localized prostate cancer and their spouses. This study compared the impact of intimacy‐enhancing therapy (IET), a general health and wellness intervention (GHW), and usual care (UC) on the psychological and relationship functioning of localized prostate cancer patients and their partners. Relationship length, relationship satisfaction, and patient masculinity were evaluated as moderators. Design This study was a randomized clinical trial with three study arms and four assessment time points. Methods A total of 237 patients and partners were randomly assigned to receive IET, GHW, or UC. Participants completed measures of psychological functioning and relationship satisfaction at baseline, 5 weeks, 3 months, and 6 months post‐baseline. Primary outcomes were psychological adjustment, depression, cancer‐specific distress, cancer concerns, and relationship satisfaction. Results Spouses in IET showed greater increases in relationship satisfaction than spouses in GHW and UC between the baseline and 5‐week follow‐up. Among patients in longer relationships, significant increases in psychological adjustment were found in both treatments compared to UC. Among spouses in longer relationships, psychological adjustment increased in both IET and UC but declined in GHW. Conclusions Intimacy‐enhancing therapy did not show an impact on general or cancer‐specific distress, but did show an early impact on relationship satisfaction among spouses. IET was superior to UC for patients in longer relationships. It will be important for researchers to understand which couple‐focused interventions benefits both patients and spouses and to identify characteristics of patients, partners, and couples who may not benefit from psychological treatments. Statement of contribution What is already known on this subject? Men diagnosed with localized prostate cancer report lower health‐related quality of life and both patients and spouses report elevated distress. Relationship communication plays a role in couples’ psychological adaptation to prostate cancer. Couple‐focused interventions have illustrated an impact on relationship communication. There are no studies comparing different couple‐focused interventions. What does this study add? Intimacy‐enhancing therapy was not superior to no treatment or a comparison treatment for the broad range of psychological and relat