Current Research



PROSTMATE: Examining the feasibility of clinical integration 

Project lead/s: Dr Addie Wootten and Prof Meinir Krishnasamy

Collaborators: A/Prof Declan Murphy4, Ms Emma Birch4, Ms Robyn Cockerall4

  1. Department of Urology, Royal Melbourne Hospital, Parkville, VIC; Australia
  2. Australian Prostate Cancer Research Centre Epworth, Richmond, VIC; Australia
  3. Australian Prostate Cancer Research, East Melbourne, VIC; Australia
  4. Peter MacCallum Cancer Centre, East Melbourne; VIC, Australia.

This project aimed to develop and pilot test the integration of real-time nursing and allied health clinical consultations for men with prostate cancer over the internet. The PROSTMATE system delivers information, clinical assessment, education and support via a tele-health model that can be integrated into the public or private healthcare setting and lead into a sustainable model of care.

This pilot study evaluated the clinical integration of the PROSTMATE system into clinical practice at Peter MacCallum Cancer Centre. Men undergoing treatment for localised prostate cancer, or those who had recently completed treatment, were invited to participate. Of the 42 men who were eligible to participate, 21 men consented to participate. Fourteen men and one partner actively engaged in the PROSTMATE system.

Participant feedback about the PROSTMATE system was excellent. The majority of participants felt that it was a valuable resource and that the tools to track their progress were particularly beneficial. The use of the telehealth component was very low, however this appeared to be related to systemic challenges of competing services within the pilot hospital site and the short duration of the pilot did not allow for integration of these two systems. Further refinement and engagement is required.

This pilot project demonstrates feasibility and accessibility of the service, however further improvements are indicated and ongoing integration work with the clinical team is required.

To access the PROSTMATE system please visit: www.prostmate.org.au

 

Partner Support Program

Project lead: Dr Addie Wootten

Collaborators: Abbott, J. M., Austin, D. W., Klein, B., Costello, A. J., Murphy, D. M.

Funding agency: beyondblue, with funding support from the Movember Foundation

  1. Department of Urology, Royal Melbourne Hospital, Parkville, VIC; Australia
  2. Australian Prostate Cancer Research Centre Epworth, Richmond, VIC; Australia
  3. Australian Prostate Cancer Research, East Melbourne, VIC; Australia
  4. National eTherapy Centre, Swinburne University of Technology, Hawthorn, Victoria, Australia.
  5. Centre for Mental Health and Wellbeing Research, School of Psychology, Deakin University, Burwood, VIC; Australia
  6. DVC-R Portfolio & School of Health Sciences, Federation University Australia, Ballarat, VIC; Australia
  7. Centre for Mental Health Research, The Australian National University, Canberra, Australia
  8. Peter MacCallum Cancer Centre, East Melbourne; VIC, Australia.

Research, development and evaluation of an online psychological support program for partners of men with prostate cancer.

The objective of this study is to firstly establish the psychosocial support needs of partners of men with prostate cancer and to use this information to develop an internet based support program for partners which aims to:

1) Improve the mental health status of partners of men with prostate cancer

2) Improve the relationship between the partner and the man with prostate cancer including their communication techniques, intimacy and sexual relationship

The study further aims to assess the useability and acceptability of the online psychological support program by way of pilot testing and user feedback.

The Partner Program offers information, education and support about managing the many challenges faced by the partner and the couple in relation to prostate cancer. The program offers strategies and exercises to manage issues such as stress management, communication, sexual intimacy and self-care.

Research Status:

Stage one of this study has been completed. A series of focus group meetings have been undertaken and this qualitative research data has been analysed and reported. See publication:

Wootten, A. C., Abbott, J. M., Osborne, D., Austin, D. W., Klein, B., Costello, A. J., & Murphy, D. G. (2014). The impact of prostate cancer on partners: a qualitative exploration. Psychooncology. doi: 10.1002/pon.3552

A systematic review of the literature examining the efficacy of psychological support interventions for partners of men with prostate cancer has also been published. See publication:

Wootten, A. C., Abbott, J. M., Farrell, A., Austin, D. W., & Klein, B. (2014). Psychosocial interventions to support partners of men with prostate cancer: a systematic and critical review of the literature. J Cancer Surviv. doi: 10.1007/s11764-014-0361-7

The feasibility and acceptability of the developed online intervention has also been completed. The program is currently undergoing further pilot testing. To learn more about this program or to participate please visit: www.partners.prostmate.org.au

 

My Road Ahead

Project lead: Dr Addie Wootten

Collaborators: Jo-Anne M Abbott, Denny Meyer, Katherine Chisholm, David W Austin, Britt Klein, Marita McCabe, Declan G Murphy, Anthony J Costello

Funding agency: The Prostate Cancer Foundation of Australia (PCFA), and beyondblue, with funding support from the Movember Foundation

  1. Department of Urology, Royal Melbourne Hospital, Parkville, VIC, Australia
  2. Epworth Prostate Centre, Epworth Healthcare; Richmond, VIC, Australia
  3. Australian Prostate Cancer Research, East Melbourne, VIC, Australia
  4. National eTherapy Centre, Swinburne University of Technology, Hawthorn, VIC, Australia
  5. Department of Psychology, Deakin University, Burwood, VIC, Australia
  6. DVC-Research & Innovation Portfolio; the School of Health Sciences; and the Collaborative Research Network, Federation University, Ballarat, Australia
  7. National Institute for Mental Health Research, The Australian National University, Canberra, Australia
  8. Faculty of Health, Arts and Design; Swinburne University of Technology, Hawthorn, VIC, Australia
  9. Peter MacCallum Cancer Centre, East Melbourne, VIC, Australia

Online psychological intervention to support men following treatment for localised prostate cancer.

In order to improve psychological outcomes following and during treatment for prostate cancer, and to reduce the risk of the development of mental health disorders such as anxiety disorders and major depression, easily accessible and timely support is required for prostate cancer patients. The overarching objective of this project was to develop and assess the efficacy of a unique online psychological

intervention that is accessible, user friendly and engaging to men with prostate cancer and that reduces the stigma of psychological distress in the context of prostate cancer.

My Road Ahead is a structured cognitive behavioural therapy based online intervention that delivers six sequential modules across a 10-week intervention period. This program offers participants access to other men’s stories about their experiences with prostate cancer, strategies to manage the emotional challenges faced with prostate cancer and information and support to manage other difficulties such as sexual intimacy and relationship challenges.

A randomised controlled trial has been conducted to examine the efficacy of this online psychological intervention in reducing patient distress, improving quality of life outcomes and relationship and intimacy outcomes. Participants were randomised to one of three intervention arms.

The study protocol has been published. See publication:

Wootten, A. C., Abbott, J. M, Chisholm, K. E., Austin, D. W., Klein, B., McCabe, M. P., . . . Murphy, D. G. (2014). My Road Ahead study protocol: a randomised controlled trial of an online psychological intervention for men following treatment for localised prostate cancer. BMC Cancer, 14(1), 83. doi: 10.1186/1471-2407-14-83

Detail about the development, feasibility and acceptability of the intervention has also been published. See publication:

Wootten, A.C., Abbott, J. M., Chisholm, K., Austin, D. W., Klein, B., McCabe, M., Murphy, D. G., Costello, A, J., (2014). Development, feasibility and usability of an online psychological intervention for men with prostate cancer: My Road Ahead. Internet Interventions, 1, 188–195. DOI: 10.1016/j.invent.2014.10.001

Preliminary results have been analysed and reported. See publication:

Wootten, A.C., Abbott, J. M., Meyer, D., Chisholm, K., Austin, D. W., Klein, B., McCabe, M., Murphy, D. G., Costello, A. J., (2014, accepted in press, early view available). Preliminary Results of a Randomised Controlled Trial of an Online Psychological Intervention to Reduce Distress in Men Treated for Localised Prostate Cancer. European Urology http://dx.doi.org/ 10.1016/j.eururo.2014.10.024

In summary the provision of the online psychological intervention in combination with access to a moderated peer forum resulted in significantly better reductions in psychological distress than the other two intervention conditions. Participants adhered to the online intervention and as such the online intervention was deemed acceptable. This intervention shows promise in providing much needed psychological support to men following treatment for localised prostate cancer. However, integration of this program into clinical practice is a much needed next step to ensure that those men who would benefit from the intervention have access to it.

Developing a new model of care for urological patients: An audit of current urology outpatient services, patient satisfaction and unmet needs

Ongoing evaluation of clinical practice and clinical service delivery is vital to ensure that the best possible care is provided. In collaboration with Royal Melbourne Hospital department of Urology we are interested in developing a new model of care for urological patients in the public hospital system.

This audit of urology out-patient experiences will enable us to understand patient flow through the clinics, the continuity of care, patient waiting times and patient reported supportive care needs. This audit will allow us to identify any challenges to the flow of patients through the urology clinics, areas in need of improvement and potentially any ways in which services can be enhanced. This audit will also allow us to identify any areas of unmet supportive care needs being experienced by our patients.

We hope to use this audit data to develop an improved model of care that enables access to appropriate medical, nursing and allied health care in a timely and efficient manner.