Psychosocial moderators of presurgical stress management for men undergoing radical prostatectomy.

Abstract

It is important to identify factors that predict who will benefit the most from psychosocial interventions in cancer populations. This study examines the moderating effect of baseline social support (social support, SS; dyadic adjustment DA), distress (Brief Symptom Inventory, BSI; Impact of Event Scale, IES), and coping style (Brief COPE) on quality of life outcomes (SF-36 Physical Component Summary scores, PCS) 1 year postsurgery derived from a presurgical cognitive-behavioral stress management (SM; n = 23) program, supportive attention (SA; n = 37), or standard care (SC; n = 29). Moderation analyses indicated that men who reported low SS and were in the SM group had increased PCS 1 year after surgery as compared with men with low SS in the SC group (β = -0.39, p < .01), with SA having a nonsignificant intermediate effect. Men who reported high distress (BSI) at baseline and were in the SA group had increased PCS 1 year after surgery, as compared with those in the SC group (β = 24.80, p = .01), with SM having a nonsignificant intermediate effect. Mediation analyses suggested that neither SM nor SA improved quality of life simply by increasing social support or decreasing general distress. Distressed individuals may benefit more from unstructured discussion of distress, whereas those low in social support may benefit more from a structured approach to learning coping skills.