Predictors of well-being and quality of life in men who underwent radical prostatectomy: longitudinal study1.
Adilson Edson Romanzini, Maria da Graça Pereira, Caroline Guilherme and 2 others
PMID 30183870WHAT IT FOUND
Men's quality of life fell after prostatectomy and stayed below baseline at one year.
Pain, anxiety and depression were linked to lower quality of life, while coping focused on solving problems and marital dissatisfaction were linked to higher well-being.
Key findings
01Quality of life was lower at all postoperative periods compared with baseline, with expected relative reductions of 12.6% in T1, 15.9% in T2, 16.03% in T3 and 7.5% in T4.
02Time of surgery, problem-focused coping, anxiety and marital satisfaction predicted subjective well-being; each one-point increase in problem-focused coping was expected to raise mean well-being by 5.9%, anxiety by 0.6%, and higher marital satisfaction score (worse satisfaction) by 3.8%.
03Pain, emotion-focused coping, anxiety, depression and marital satisfaction predicted quality of life; each one-point increase in pain score was expected to reduce quality of life by 1.4%, and each one-point increase in depression score by 0.6%.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The number of men assessed dropped from 120 at baseline to 36 at the 360-day period, so later results rest on a much smaller group. Data collection windows varied from the labelled postoperative days, with T1 mean 15.9 days, T2 mean 91.4 days, T3 mean 203 days and T4 mean 322.7 days after surgery. The researcher read instructions and items to participants, which may have influenced responses. It was a single-centre observational study, so it cannot show that changing pain, anxiety, depression, coping or marital dissatisfaction would change well-being or quality of life. The paper reports loss to follow-up of 6.5% to 12.2% in different periods, but the table shows much lower numbers at later visits, so the attrition pattern needs checking.
Declared interests
Supported by Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq), process #142167/2014-2, Brazil. The paper is from a doctoral dissertation. No other conflict-of-interest declaration is given in the supplied text.
The easy way to misread this
Do not conclude that treating pain, anxiety or depression will improve quality of life, or that building problem-focused coping will improve well-being. This study only found associations over time in men after prostatectomy, and it did not test any intervention.