Barriers and facilitators for healthy lifestyle and recommendations for counseling in endometrial cancer follow-up care: a qualitative study.

OBJECTIVES: Lifestyle promotion during follow-up consultations may improve long-term health and quality of life in endometrial cancer patients. This study aimed to identify barriers and facilitators to improve and sustain a healthy lifestyle that can be translated to behavioral methods and strategies for lifestyle counseling. METHODS: Endometrial cancer patients from three hospitals were recruited to participate in a semi-structured interview. The data were transcribed and coded. Thematic analysis was applied to identify themes and the behavior change wheel was used as a theoretical framework. Data saturation was confirmed after 18 interviews. RESULTS: Barriers included knowledge gaps as well as lack of motivation and environmental opportunities to engage in health-promoting behavior. Facilitators included applying incremental lifestyle changes, social support, positive reinforcements, and the ability to overcome setbacks. CONCLUSIONS: We propose the following intervention functions: education, persuasion, training, environmental restructuring, and enablement. Suitable behavior change techniques to deliver the intervention functions include information about the consequences of certain behavior, feedback on behavior, credible source, graded tasks, habit formation, restructuring of the environment, prompts/cues, goal setting, action planning, and social support. Including these recommendations in lifestyle counseling could aid lasting lifestyle change since it suits the needs and preferences of patients.

Prevalence and correlates of mental health problems in prostate cancer survivors: A case-control study comparing survivors with general population peers.

OBJECTIVE: The purpose of this study was to identify factors associated with mental health (MH) problems in prostate cancer (PC) survivors. Toward this end, we evaluated (1) differences in the prevalence of MH problems between PC survivors and age-matched men from the general population (GenPop) and (2) correlates of MH in PC survivors and the GenPop. METHODS AND MATERIALS: In this observational case-control study, we age-matched PC survivors (n = 644, alive≥5y after diagnosis of a stage I-IV carcinoma) recruited from Dutch community hospitals (Patient Reported Outcomes Following Initial treatment and Long-term Evaluation of Survivorship registry) with GenPop peers (n = 644) selected from a population-based sample recruited in general practices (NIVEL). MH was operationalized using the 5-item Mental Health Inventory of the Short Form Health Survey (SF-36). Potential correlates of MH included sociodemographic characteristics, health-related quality of life scores, and clinical characteristics (PC survivors only). We used analysis of (co)variance and chi-square tests to address the 2 research questions. RESULTS: We observed clinically relevant MH symptoms in 14% of the PC survivors and 6% of the GenPop controls (P<0.01, odds ratio = 2.45 [1.66-3.62]). The most important correlates of lower MH scores in the PC survivors were being widowed, a lower educational level, lower general health perceptions, more bodily pain and urinary bother, and less sexual satisfaction. The most important correlates of lower MH scores in the GenPop were as follows: lower general health perceptions, more role limitations because of physical problems, and more bodily pain. CONCLUSIONS: Our results indicate that long-term PC survivors have poorer MH, as assessed by the 5-item Mental Health Inventory questionnaire, than men of a comparable age from the GenPop without a history of PC. Attention to potentially modifiable factors associated with MH problems in PC survivors, such as urinary function and its related bother, bodily pain, and sexual satisfaction, may help to prevent or limit MH problems in this survivor population.