Asian Oncol Nurs AON Asian Oncology Nursing 2287-2434 2287-447X Korean Oncology Nursing Society 10.5388/aon.2015.15.3.163 Original Article Educational Needs for Sexual Health and Its Effect on Depression and the Quality of Life in Patients with Prostate Cancer Oh Soonyoung 1 Ryu Eunjung 2 Graduate School, Chung-Ang University, Seoul, Korea. Department of Nursing, Chung-Ang University, Seoul, Korea. Address reprint requests to: Ryu, Eunjung. Department of Nursing, Chung-Ang University, 84 Heuksuk-ro, Dongjak-gu, Seoul 06974, Korea. Tel: +82-2-820-5681, Fax: +82-2-824-7961, go2ryu@cau.ac.kr 09 2015 30 09 2015 15 3 163 170 02 05 2014 25 08 2015 22 09 2015 © 2015 Korean Oncology Nursing Society 2015 This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. Purpose

The purpose of this study was to explore educational needs for sexual health, to identify relations among educational needs for sexual health, depression and quality of life, and to identify the factors affecting quality of life in patients with prostate cancer aged > 40 years.

 Methods

A sample of 78 patients was recruited from a university hospital in Seoul. A cross-sectional design was used in which participants completed the questionnaires to assess educational needs for sexual health, depression and quality of life. The data were analyzed using the t-test, ANOVA, correlation analysis and stepwise regression analysis.

 Results

The quality of life of participants differed significantly by occupation status before and after diagnosis, stage at diagnosis, underlying disease, performance status, and in the Gleason sum score. Stepwise regression analysis of the data showed that depression, sexual interaction, Gleason sum score, and occupation since diagnosis were the statistically significant factors associated with quality of life of patients with prostate cancer. This regression model explained 55.1% of the quality of life.

 Conclusion

These results indicate that depression and sexual interaction had the greatest impact on quality of life in prostate cancer patients. In clinical practice, we recommend that healthcare professionals take the initiative to provide adequate and accurate information about sexual health to prostate cancer survivors.

 Prostatic Neoplasms Educational Needs Assessment Depression Quality of Life

This article is based on a part of the first author's master's thesis from Chung-Ang University.

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Characteristics Categories n (%) M±SD
Age (year) 50~59 8 (10.0) 68.2±7.11
60~69 36 (46.0)
≥70 34 (44.0)
Marital status Married 76 (97.4)
Single (divorced or widowed) 2 (2.6)
Religion Christianity 18 (23.1)
Buddhist 5 (6.4)
Catholics 6 (7.7)
None 49 (62.8)
Educational level ≤Elementary school 8 (10.2)
Middle school 19 (24.4)
High school 32 (41.0)
≥College 19 (24.4)
Monthly income (10,000 won) ≤100 34 (43.6)
101~200 22 (28.2)
201~300 13 (16.7)
≥301 9 (11.5)
Occupation (before diagnosis) Yes 39 (50.0)
No 39 (50.0)
Occupation (after diagnosis) Yes 24 (30.8)
No 54 (69.2)
Diagnostic period (month) <12 27 (34.7) 24.78±24.15
12~23 16 (20.5)
24~35 14 (17.9)
36~47 7 (9.0)
≥48 14 (17.9)
Stage at diagnosis Stage 1 50 (64.2)
Stage 2 16 (20.5)
Stage 3 9 (11.5)
Stage 4 3 (3.8)
Type of cancer therapy Chemotherapy 6 (7.7)
Radiation therapy 4 (5.1)
Surgical therapy 64 (82.1)
Others 4 (5.1)
Comorbidity* Not applicable 29 (37.2)
hypertension 33 (42.3)
Diabetes mellitus 13 (16.7)
Heart disease 7 (9.0)
Others 7 (9.0)
ECOG PS Restricted but ambulatory 34 (43.6)
Ambulatory, capable of self-care 39 (50.0)
Capable of only limited self-care 5 (6.4)
Gleason sum score 5 2 (2.6) 7.17±1.00
6 14 (17.9)
7 42 (53.8)
8 11 (14.1)
9 7 (9.0)
10 2 (2.6)

*Multiple responses; ECOG PS=Eastern cooperative oncology group performance status.

 Educational Needs for Sexual Health, Depression and Quality of Life (<italic>N</italic>=78)
Variables Categories n (%) or M±SD Min-Max Possible range
Depression Total 7.00±8.42 0~38 0~60
<21 64 (88.9)
≥21 8 (11.1)
Educational needs of sexual health Sexual physiology 40.41±15.0
Sexual psychology 23.00±9.75
Sexual interaction 21.28±11.21
Total 84.69±29.90
Quality of life Physical well-being 23.45±5.02 7~28 0~28
Social/family well-being 17.81±5.56 4~28 0~28
Emotional well-being 19.46±3.47 8~24 0~24
Functional well-being 18.85±5.96 6~28 0~28
FACT-general 79.57±14.13 25~108 0~108
Prostate cancer symptoms 34.24±6.65 20~48 0~48
FACIT* 113.81±19.48 64~148 0~156

*The total score for the specific FACIT scales is the sum of the FACT-G plus the prostate cancer symptoms subscale.

 The Differences in Quality of Life according to Characteristics of Sample (<italic>N</italic>=78)
Variables Categories M ± SD t or F p Duncan test
Age (year) 50~59 119.00 ± 21.61 0.36 .697
60~69 113.94 ± 21.32
≥ 70 112.44 ± 17.20
Religion Yes 115.31 ± 21.80 0.52 .603
No 112.92 ± 18.15
Educational level ≤ Elementary school 115.25 ± 26.64 0.24 .867
Middle school 111.32 ± 17.59
High school 113.31 ± 19.89
≥ College 116.53 ± 18.46
Monthly income (10,000 won) ≤ 100 111.32 ± 18.82 1.31 .278
101~200 112.05 ± 18.90
201~300 123.38 ± 15.20
≥ 301 113.67 ± 26.89
Occupation (before diagnosis) Yes 119.49 ± 18.12 2.67 .009
No 108.13 ± 19.42
Occupation (after diagnosis) Yes 121.75 ± 19.65 2.48 .015
No 110.28 ± 18.51
Diagnostic period (month) < 12 112.04 ± 21.19 0.31 .736
12~35 115.97 ± 16.74
≥ 36 113.00 ± 21.41
Staging at diagnosis Stage 1a 117.56 ± 17.54 3.32 .042 c < a
Stage 2b 110.44 ± 19.92
Stage 3c 102.67 ± 22.98
Type of cancer therapy Surgical therapy 114.70 ± 19.22 0.86 .389
Non surgical therapy 109.71 ± 20.88
Underlying disease Yes 109.45 ± 19.00 - 2.67 .009
No 121.17 ± 18.31
ECOG PS* Restricted but ambulatory 120.32 ± 20.39 3.60 .032
Ambulatory, capable of self-care 108.79 ± 17.54
Capable of only limited self-care 108.60 ± 17.73
Gleason sum score ≤ 6a 128.25 ± 11.18 4.41 .007 b < a
7b 111.33 ± 20.66 c < a
8c 106.36 ± 17.38 d < a
≥9d 108.78±17.27

*ECOG PS=Eastern cooperative oncology group performance status.

 Correlations among Education Needs for Sexual Health, Depression and Quality of Life (<italic>N</italic>=78)
Variables Sexual physiology Sexual psychology Sexual interaction Depression
r (p) r (p) r (p) r (p)
Quality of life .03 (.736) .20 (.079) .39 (<.001) - .60 (<.001)
The Factors affecting on Quality of Life (<italic>N</italic>=78)
Variables B β t p R2 Adjusted R2 Durbin-Watson
(Constant) 142.03 11.43 <.001 1.51
Depression - 1.31 - .54 - 6.81 <.001 .36 .36
Sexual interaction 0.52 .29 3.55 .001 .49 .48
Gleason sum score - 4.59 - .22 - 2.78 .007 .54 .52
Occupation after diagnosis (yes=1 vs. no=0) 7.34 .17 2.06 .043 .57 .55