Health-related Quality of Life and Depression after Radical Prostatectomy or Hormonal Therapy

Geum Ja Yang; Jeong Hee Kang; In Sun Suh; Hye Young Kim

doi:10.5388/aon.2013.13.4.248

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Yang, Kang, Suh, and Kim: Health-related Quality of Life and Depression after Radical Prostatectomy or Hormonal Therapy

Original Article

Asian Oncol Nurs 2013;13(4):248-255.

Published online: 5 December 2013

DOI: https://doi.org/10.5388/aon.2013.13.4.248

Health-related Quality of Life and Depression after Radical Prostatectomy or Hormonal Therapy

Geum Ja Yang¹, Jeong Hee Kang², In Sun Suh², Hye Young Kim²

¹Department of Nursing, Chonbuk National University Hospital, Jeonju, Korea

²College of Nursing, Chonbuk National University, Jeonju, Korea

Address reprint requests to: Kang, Jeong Hee College of Nursing, Chonbuk National University, 567 Baekje-daero, Deokjin-gu, Jeonju 561-756, Korea Tel: +82-63-270-3125 Fax: +82-63-270-3127 E-mail: jeonghee@jbnu.ac.kr

^∗ This article is based on a part of the first author's master's thesis from Chonbuk National University.

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.

초록

Purpose

The aim of this study was to compare the health-related quality of life (HQOL) and depression in prostate cancer patients with radial prostatectomy or hormonal therapy more than 6 months ago.

Methods

A total of 116 patients participated in the study (83 radical prostatectomy patients and 33 hormonal therapy). Data were collected from 13th September to 13th November 2012, using two instruments-translated into Korean: Expanded Prostate Cancer Index Composite and Geriatric Depression Scale Short Form.

Results

Hormonal therapy participants reported significantly higher scores of HQOL than radical prostatectomy participants did (p⁼ .002). The HQOL subscales with significant differences were urinary function (p^< .001) and incontinence (p^< .001) under urinary domain and sexual bother (p< .001) under sexual domain. The level of depression was not significantly different between the two treatment groups. There were moderate negative correlations between HQOL and depression in both groups.

Conclusion

Many of prostate cancer patients reported treatment-related functional deteriorations in urinary and sexual domains and they were depressed even more than 6 months after the treatment completion. To manage prostate cancer patients’ HQOL and depression, clinicians including nurses should evaluate patients’ complaints according to their treatment modality and intervene accordingly.

Keywords: Prostatic Neoplasms, Quality of Life, Depression, Prostatectomy, Hormone Replacement Therapy

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Table 1.

Homogeneity Tests on Participants’ Characteristics (N=116)

Variables	Characteristics	Categories	RP (n=83)	HT (n=33)	x² or t	p
Variables	Characteristics	Categories	n (%) or M± SD	n (%) or M± SD	x² or t	p
General characteristics	Age (year)	60-69	26 (31.3)	5 (15.2)	20.28	<.001
		70-79	53 (63.9)	16 (48.5)
		≥80	4 (4.8)	12 (36.8)
			71.5±5.5	76.5±7.6	-3.47	.001
	Spouse	Yes	75 (90.4)	28 (84.8)		.514∗
	Spouse	Yes No	75 (90.4) 8 (9.6)	28 (84.8) 5 (15.2)		.514∗
	Religion	Yes	45 (54.2)	20 (60.6)	0.39	.532
		No	38 (45.8)	13 (39.4)
	Job	Yes	39 (47.0)	12 (36.4)	1.08	.298
		No	44 (53.0)	21 (63.6)
	Economic status	High	3 (3.6)	0 (0.0)		.232∗
		Middle	47 (56.6)	15 (45.5)
		Low	33 (39.8)	18 (54.5)
Disease-related	Hypertension	Yes	41 (49.4)	11 (33.3)	2.46	.117
	characteristics	No	42 (50.6)	22 (66.7)
	Diabetes	Yes	12 (14.5)	5 (15.2)		.566∗
		No	71 (85.5)	28 (84.8)
	Coronary heart disease	e Yes	12 (14.5)	3 (9.1)		.330∗
		No	71 (85.5)	30 (90.9)
	Cancer stage	T2	51 (61.4)	18 (54.5)	0.47	.534
		T3	32 (38.6)	15 (45.5)
	Gleason score	2-4	2 (2.4)	1 (3.0)		1.000∗
		5-67-10	20 (24.1)61 (73.5)	8 (24.2)24 (72.8)
		7-10	61 (73.5)	24 (72.8)
	Months post treatmen	t <12	15 (18.1)	20 (60.6)	20.28	<.001
		≥12	68 (81.9)	13 (39.4)

RP= Radical prostatectomy; Ht= Hormonal therapy

^∗ Fisher's exact test.

Table 2.

Comparisons of Health-related Quality of Life and Depression (N=116)

Variables	RP (n=83)		HT (n=33)		F or χ²	p
Variables	M± SD or n (%)	AM	M± SD or n (%)	AM	F or χ²	p
Health-related quality of life
Total	69.46±8.32	69.09	74.04±6.66	74.96	9.64	.002
Urinary domain
Function	77.14±16.20	76.13	90.91±13.14	93.45	22.94	<.001
Bother	70.05±21.19	69.3358.65	75.65±20.81	77.47	2.54	.114
Icontinence	60.41±27.09	58.65	84.85±20.90	89.27	25.06	<.001
Bowel domain
Function	97.93±4.73	97.81	91.19±4.62	97.49	0.80	.776
Bother	97.20±7.44	96.89	99.13±2.00	99.91	3.85	.052
Sexual domain
Function	10.32±12.43	9.42	10.82±10.74	13.09	1.69	.196
Bother	37.12±34.14	37.92	71.21±29.35	69.22	17.44	<.001
Hormonal domain
Function	88.73±11.94	88.46	84.24±17.51	84.94	1.11	.295
Bother	90.96±11.87	88.4691.17	90.03±11.41	89.51	0.33	.565
Depression	4.73±3.88	4.90	6.36±4.69	5.91	0.91	.341
Normal	54 (65.0)		16 (48.5)		4.87	.088
Moderately depressed	18 (21.7)		7 (21.2)
Depressed	11 (13.3)		(30.3)

RP= Radical prostatectomy; HT= Hormonal therapy; AM= Adjusted mean.

Table 3.

Correlations of Health-related Quality of Life with Depression (N=116)

Variable	Depression
	RP (n=83)	HT (n=33)
	r (p)	r (p)
Health-related quality of life
Total	-.46 (<.001)	-.55 (.001)
Urinary domain
Function	-.28(.010)	-.28(.114)
Bother	-.32(.003)	-.36(.039)
Incontinence	-.31(.005)	-.28(.115)
Bowel domain Function
Function	-.13(.243)	.11(.540)
Bother	-.12(.263)	.08(.650)
Sexual domain
Function	-.34 (.002)	-.18 (.313)
Bother	-.17(.117)	-.27(.128)
Hormonal domain
Function	-.34 (.002)	-.40 (.020)
Bother	-.42(<.001)	-.48(.005)

RP= Radical prostatectomy; HT= Hormonal therapy.

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