Objectives

The aim of this study was to evaluate the role of spouses and the relevance of quality of life (QoL) and life expectancy (LE) in the treatment decision-making process of patients with advanced prostate cancer (CaP). We also addressed the role of possible mental deterioration, partnership quality, QoL, distress, anxiety, and depression in patients and their spouses.

Methods and Material

This was a cross-sectional non-interventional explorative study. We administered questionnaires to 96 patients with advanced CaPand their spouses. Both patients and their spouses were asked about the influence of the spouses on treatment decision making, if they prefer quality of life or life expectancy as main goal of treatment and the perceived deterioration of the patients’ mental abilities. Additional questionnaires were used to assess medical history, partnership, global quality of life, distress, depression, and anxiety. We performed statistical tests to compare patients with spouses and correlations to detect associations between variables.

Results

The spouses (65 ± 9 years) were significantly younger than the patients (69 ± 9 years). Ninety-five percent of the patients and 91% of the spouses reported that the spouses were involved in making treatment decisions. There was a high similarity within couples with regard to their preference for QoL or LE during treatment. Between couples, this preference differed markedly. Emotional control and motivation were the areas most commonly reported to have deteriorated among patients’ mental abilities. The quality of the partnership was rated as being higher than average by both partners. Among the spouses, the quality of partnership correlated significantly with the preference for LE with regard to treatment decision making. Patients and spouses reported high psychological burdens in all areas, with higher levels of distress and anxiety in spouses (P< 0.01). Reduced quality of life and greater distress, depression, and anxiety were significantly correlated with the amount of deterioration of the patients’ mental abilities.

Conclusions

Spouses of patients with advanced CaP seem to respond to different aspects of the disease by adjusting both their involvement in treatment decision making and their preferred goal of treatment. Due to mental deterioration in the patients and pronounced anxiety in their spouses, we suggest that it is important for the attending physician to provide detailed information and support to both partners. Overall, the high-stress situation seems to affect both partners to similar degrees.

中文翻译：

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夫妇应对晚期前列腺癌：关于治疗决策、精神恶化、伙伴关系和心理负担的探索性研究

目标

本研究的目的是评估配偶在晚期前列腺癌 (CaP) 患者治疗决策过程中的作用以及生活质量 (QoL) 和预期寿命 (LE) 的相关性。我们还讨论了患者及其配偶可能的精神恶化、伙伴关系质量、生活质量、痛苦、焦虑和抑郁的作用。

方法和材料

这是一项横断面非干预性探索性研究。我们对 96 名晚期 CaP 患者及其配偶进行了问卷调查。患者及其配偶都被问及配偶对治疗决策的影响，他们是否更喜欢生活质量或预期寿命作为治疗的主要目标，以及患者心智能力的感知恶化。额外的问卷用于评估病史、伙伴关系、全球生活质量、痛苦、抑郁和焦虑。我们进行了统计检验来比较患者与配偶和相关性以检测变量之间的关联。

结果

配偶（65 ± 9 岁）明显小于患者（69 ± 9 岁）。95% 的患者和 91% 的配偶报告说配偶参与了治疗决策。夫妻之间在治疗期间对 QoL 或 LE 的偏好具有高度相似性。在夫妻之间，这种偏好明显不同。情绪控制和动机是最常报告的患者心智能力恶化的领域。合作伙伴的质量被双方评为高于平均水平。在配偶中，伙伴关系的质量与在治疗决策方面对 LE 的偏好显着相关。患者和配偶在所有方面都报告了较高的心理负担，配偶的痛苦和焦虑程度更高（P < 0.01)。生活质量下降和更大的痛苦、抑郁和焦虑与患者心智能力的恶化程度显着相关。

结论

晚期 CaP 患者的配偶似乎通过调整他们对治疗决策的参与和他们首选的治疗目标来应对疾病的不同方面。由于患者的精神恶化和配偶的明显焦虑，我们建议主治医生向双方提供详细的信息和支持是很重要的。总体而言，高压力情况似乎对双方的影响程度相似。