NorthPoint Domain

Higher Self-Efficacy Leads to Better Quality of Life after Prostate Cancer Treatment

Interventions to improve patient-physician communication may improve outcomes

Among disadvantaged men with localized prostate cancer, those with higher self-efficacy while interacting with their physicians report better quality of life, according to the results of a study published recently in the Journal of Urology.

Radical prostatectomy, external beam radiation therapy, and brachytherapy achieve similar oncological outcomes for clinically localized prostate cancer for most men, so health-related quality of life (HRQOL) measures are important factors when considering treatments. Effective patient-physician communication can improve health outcomes, but effective communication depends on a patient's confidence in his ability to communicate with his physician. Among vulnerable populations, such as disadvantaged men with prostate cancer, however, evidence of lower self-esteem can contribute to suboptimal outcomes. The authors undertook the current study after finding little research regarding the role of self-efficacy in HRQOL among disadvantaged men with clinically localized prostate cancer.

The researchers prospectively analyzed data collected from 99 men enrolled in IMPACT, a state-funded program in California that provided free prostate cancer treatment to indigent men. The authors measured patient self-efficacy and the general and prostate-specific HRQOL outcomes of urinary, sexual and bowel bother, symptom distress, psychological well being, and vitality. Self-efficacy had a measurable effect on subjective measurements of general and disease-specific HRQOL scores across all outcomes. Low self-efficacy was significantly associated with worse bowel bother and general symptom distress during the two-year study period. Similar HRQOL outcome trajectories were observed across self-efficacy categories.

The authors write that the current study "provides new insight into self-efficacy in patient-physician interactions among impoverished men with prostate cancer. Our findings suggest the importance of self-efficacy among these patients and present a novel focus for strategies and interventions to improve health outcomes."

Source: Heckman JE, Chamie K, Maliski SL, et al. 2011. The role of self-efficacy in quality of life for disadvantaged men with prostate cancer. Journal of Urology 186:1855-1861.