Educational Needs for Sexual Health and Its Effect on Depression and the Quality of Life in Patients with Prostate Cancer

Soonyoung Oh; Eunjung Ryu

doi:10.5388/aon.2015.15.3.163

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Oh and Ryu: Educational Needs for Sexual Health and Its Effect on Depression and the Quality of Life in Patients with Prostate Cancer

Original Article

Asian Oncology Nursing 2015; 15(3): 163-170.

Published online: 30 September 2015

DOI: https://doi.org/10.5388/aon.2015.15.3.163

Educational Needs for Sexual Health and Its Effect on Depression and the Quality of Life in Patients with Prostate Cancer

Soonyoung Oh¹, Eunjung Ryu²

¹Graduate School, Chung-Ang University, Seoul, Korea.

²Department 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

Received 2 May 2014 Revised 25 August 2015 Accepted 22 September 2015

(open-access):

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.

Abstract

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.

Keywords: Prostatic Neoplasms, Educational Needs Assessment, Depression, Quality of Life

Figures and Tables

Table 1

General and Clinical Characteristics of Sample (N=78)

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)
Marital status	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)
Occupation (before diagnosis)	No	39 (50.0)
Occupation (after diagnosis)	Yes	24 (30.8)
Occupation (after diagnosis)	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.

Table 2

Educational Needs for Sexual Health, Depression and Quality of Life (N=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.

Table 3

The Differences in Quality of Life according to Characteristics of Sample (N=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
Religion	No	112.92 ± 18.15	0.52	.603
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
Occupation (before diagnosis)	No	108.13 ± 19.42	2.67	.009
Occupation (after diagnosis)	Yes	121.75 ± 19.65	2.48	.015
Occupation (after diagnosis)	No	110.28 ± 18.51	2.48	.015
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
Type of cancer therapy	Non surgical therapy	109.71 ± 20.88	0.86	.389
Underlying disease	Yes	109.45 ± 19.00	- 2.67	.009
Underlying disease	No	121.17 ± 18.31	- 2.67	.009
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	≤ 6^a	128.25 ± 11.18	4.41	.007	b < a
	7^b	111.33 ± 20.66			c < a
	8^c	106.36 ± 17.38			d < a
	≥9^d	108.78±17.27			d < a

^*ECOG PS=Eastern cooperative oncology group performance status.

Table 4

Correlations among Education Needs for Sexual Health, Depression and Quality of Life (N=78)

Variables	Sexual physiology	Sexual psychology	Sexual interaction	Depression
Variables	r (p)	r (p)	r (p)	r (p)
Quality of life	.03 (.736)	.20 (.079)	.39 (<.001)	- .60 (<.001)

Table 5

The Factors affecting on Quality of Life (N=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

Notes

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

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