Aim
To determine the acceptability and feasibility of an evidence-based prostate cancer survivorship virtual care intervention, tailored to post-surgical care, and delivered through a novel nurse-led approach.
Methods
This multi-methods pilot comprised a quasi-experimental pre/post-test design and an exploratory qualitative study using the Theoretical Framework of Acceptability (TFA). Study participants comprised: men newly diagnosed with localised prostate cancer who had undergone radical or robotic prostatectomy within the previous three months; and clinicians/stakeholders involved in the development and/or delivery of the program.
The intervention was tailored to the post-operative recovery journey targeting symptom management, psychoeducation, problem solving and goal setting, delivered over 12-weeks via videoconference. The primary outcome measure for this study was program acceptability. Secondary outcome measures included: quality of life; prostate cancer related distress; insomnia severity; fatigue severity; and program costs.
Results
Both men (n=17) and service stakeholders (n=6) reported very high levels of program acceptability across all constructs of the TFA. For men negligible burden and opportunity costs related to program participation, coupled with a strong sense of program ethicality, were key drivers of adherence and perceived program effectiveness. Clinically, the program improved care co-ordination, expediated identification of survivorship care needs, and met service priorities of providing quality care close to home
At baseline, almost half (47%) of men reported clinically significant psychological distress which had significantly decreased at 24-weeks (P=0.020). There was significant improvement in urinary irritative/ obstructive symptoms (P=0.030) and a corresponding decrease in urinary function burden (P=0.005) from baseline to 24-weeks. Current fatigue (P=0.024) and the degree to which fatigue interfered with life in the past 24-hours (P=0.041) significantly increased from baseline to 24-weeks, reflecting persistent fatigue associated with major surgery.
Conclusions
Findings from this study suggest virtual post-surgical care delivered via videoconferencing is highly acceptable to prostate cancer survivors in a regional setting.