Presentation Authors: Daniela Wittmann*, Ann Arbor, MI, Akanksha Mehta, Atlanta, GA, Sharon Bober, Boston, MA, Rodney Dunn, Ziwei Zhu, Thomas Braun, Caroline Carter, Ashley Duby, Ann Arbor, MI, Kellie Paich, Culver City, CA, Ted Skolarus, Ann Arbor , MI, Larry An, Ann Arbor, MI, Christian Nelson, New York, NY, Christopher Saigal, Los Angeles, CA, Ronald Chen, Chapel Hill, NC, Craig Pollack, Baltimore, MD
Introduction: Despite high levels of sexual dysfunction and distress following the treatment of localized prostate cancer, usual care offers only physiologic management focused on erectile function. We performed a randomized controlled trial to test the effectiveness of an online intervention to address the psychosexual needs of men and their partners.
Methods: An online intervention for couplesâ€™ sexual recovery was developed using mixed methods research with prostate cancer patients and their partners, tailored to treatment type and sexual orientation. The intervention consisted of modules addressing expectations for sexual and emotional sequelae of treatment, rehabilitation and guidance towards recovery of sexual intimacy and included videos, psychoeducation, couple-oriented activities, and coping strategies. Control subjects accessed the American Cancer Societyâ€™s website. Couples recruited from 6 sites nationally completed validated measures at baseline and 3 and 6 months post-treatment. Group differences were assessed with t-tests for individual outcomes and the Actor-Partner Interaction Model for dyadic outcomes.
Results: 142 patients treated with surgery or radiation and their partners were randomized. All couples showed an expected post-treatment decline in PROMIS Satisfaction with Sex Life, with similar declines for the intervention and control groups. Both patients and partners in the intervention arm showed increased knowledge about sexual issues at 3-months post-treatment vs baseline. Patients more engaged in the intervention evidenced improved ability to communicate about sex with their partners than those less engaged. Dyadic analysis showed that higher complicated grief scores and negative coping by partner were associated with both patientsâ€™ and partnersâ€™ lower satisfaction with sex life. Subjects generally had high satisfaction levels with the module content (65-85%). Qualitative analysis found five satisfaction themes: managing expectations, couple communication, fostering couple coping and intimacy, increasing knowledge about rehabilitation, and not being alone.
Conclusions: Online psychosexual support for couples can succeed in impacting knowledge, sexual communication, loss and grief, and negative coping; more engaged couples experience the greatest benefits. Further refinements to the content and format may lead to larger impacts as the intervention is made available to a national audience giving patients and providers an important resource.
Source of Funding: Movember Foundation