15250-m-cuypers

48 Chapter 3 ABSTRACT Objective – To test if patients’ health-related quality of life (HRQoL) declines after prostate biopsy to detect Pca, and treatment decision-making in case Pca is confirmed, and whether personality state and traits are associated with these potential changes in HRQoL. Methods – Patients who were scheduled for prostate biopsy to detect Pca (N=377) filled out a baseline questionnaire about HRQoL (EORTC QLQ-C30 and PR25), ‘big five’ personality traits (BFI-10), optimism (LOT-r), and self-efficacy (Decision Self-efficacy Scale) (t0). Patients with confirmed Pca (N=126), filled out a follow-up questionnaire on HRQoL within two weeks after treatment was chosen but had not yet started (t1). Results – HRQoL declined between t0 and t1, reflected in impaired role and cognitive functioning, and elevated fatigue, constipation, and prostate specific symptoms. Sexual activity and functioning improved. Baseline HRQoL scores were unrelated to the selection of a particular treatment, but for patients who chose a curative treatment, post-decision HRQoL showed a greater decline compared to patients who chose active surveillance. Optimismwas associated to HRQoL at baseline, decisional self-efficacy was positively associated to HRQoL at follow-up. No associations between HRQoL and the ‘big five’ personality traits were found. Conclusion – Patients who have undergone prostate biopsy and treatment decision- making for Pca, experience a decline in HRQoL. Choosing treatment with a curative intent was associated with greater decline in HRQoL. Interventions aimed at optimism and decision self-efficacy could be helpful to reduce HRQoL impairment around the time of prostate biopsy and treatment decision-making.