PD03-10 PATIENT AND CAREGIVER COPING SKILLS, QUALITY OF LIFE, AND DECISION REGRET FOLLOWING RADICAL CYSTECTOMY

Abstract

You have accessJournal of UrologyHealth Services Research: Practice Patterns, Quality of Life and Shared Decision Making I (PD03)1 Sep 2021PD03-10 PATIENT AND CAREGIVER COPING SKILLS, QUALITY OF LIFE, AND DECISION REGRET FOLLOWING RADICAL CYSTECTOMY Elizabeth Green, Richard Reich, Wenyi Fan, Paul Crispen, Michael Poch, Wade Sexton, Philippe E. Spiess, Paul Jacobsen, and Scott Gilbert Elizabeth GreenElizabeth Green More articles by this author , Richard ReichRichard Reich More articles by this author , Wenyi FanWenyi Fan More articles by this author , Paul CrispenPaul Crispen More articles by this author , Michael PochMichael Poch More articles by this author , Wade SextonWade Sexton More articles by this author , Philippe E. SpiessPhilippe E. Spiess More articles by this author , Paul JacobsenPaul Jacobsen More articles by this author , and Scott GilbertScott Gilbert More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000001967.10AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Though a complex and complication-prone operation, cystectomy (Cx) remains the standard of care for muscle invasive bladder cancer. However, the impact of Cx and urinary diversion on patient-centered outcomes (PCOs) such as quality of life (QOL) and decision regret (DR) has not been well characterized. METHODS: 132 Cx patients were accrued in a prospective PCO study between 2014 to 2016 and followed for 1 year after surgery. Study patients and their caregivers completed the Patient Health Questionnaire-8 (PHQ-8), Medical Outcomes Study Sleep Scale (MOS-Sleep) and Short Form (SF-36) before and after surgery. Patients also completed the Bladder Cancer Index (BCI) and Body Image Scale (BIS). Coping strategy (CS) was assessed before Cx and DR was evaluated with the Decision Regret Scale after Cx. Mediation analysis was used to compare PCOs between patients receiving different urinary diversions and dyad analysis was used to examine the effect of patient-caregiver dyad CS on patient outcomes. RESULTS: Patients receiving a catheterizable pouch had the most DR (p=0.048, Table 1). Lower post-Cx PCOs were also associated with greater DR (SF-36, urinary BCI, bowel BCI, BIS and PHQ-8 p<0.05). Body image was a significant predictor of DR in adjusted models. In mediation analysis, DR was mediated by urinary BCI. Avoidant CS in patient-caregiver dyads was linked to lower baseline SF-36 health rating (p=0.004), SF-36 mental health score (p=0.003), and PHQ-8 (p=0.003) with mean PHQ-8 scores at or near the threshold for depression. At 12 months, these deficits were replaced by low SF-36 physical health scores (p=0.010). CONCLUSIONS: Decision regret after Cx is driven by several PCOs. Patients with pouches appear to be a unique group in terms of depression symptoms and DR, and urinary function appears to mediate DR. Avoidant coping skills are associated with low mental health scores before surgery, but these abate after Cx. Source of Funding: Florida Biomedical Research Program, Bankhead-Coley Research Grant © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e47-e47 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Elizabeth Green More articles by this author Richard Reich More articles by this author Wenyi Fan More articles by this author Paul Crispen More articles by this author Michael Poch More articles by this author Wade Sexton More articles by this author Philippe E. Spiess More articles by this author Paul Jacobsen More articles by this author Scott Gilbert More articles by this author Expand All Advertisement Loading ...