Gerontological Nursing Interventions Research Center (GNIRC)

Title: Psychological Health Trajectories in Watchful Waiting
Principal Investigator: Donald Bailey, PhD, RN
Study Site: Duke University

Abstract
Significance: Watchful waiting has been proposed as a reasonable alternative for older men with localized prostate caner. However, this option is controversial, and men electing watchful waiting live with continual uncertainty. Unfortunately previous studies have overlooked the psychological ramifications of living with untreated prostate cancer and have not considered that asymptomatic men experience psychological distress often triggered by the knowledge that their cancer may be growing without specific disease symptoms.

Purpose: The specific aims for Phase I are to 1)describe the psychological health trajectories of men with prostate cancer who elect watchful waiting and in Phase II, 2) refine and enhance the Watchful Waiting Intervention (WWI) based on descriptive data and the theory and; 3) pilot test the refined WWI with a sample of older men electing watchful waiting as treatment for prostate cancer.

Conceptual Framework: Mishel's Reconceptualized Uncertainty in Illness Theory (1990) was chosen as the conceptual foundation for the study.

Methods: The proposed two-year study incorporates both quantitative and qualitative methodologies.

Data Analysis: Data collection and analyses will occur simultaneously beginning with the first subject. Item scores for each instrument will be entered into an analysis file to calculate summary scores for each instrument. Individual subject's mean scores will be plotted by graphs using a health pattern approach described by Clipp, et al (1998).

The expected outcome of this study will be the identificationn of psychological health trajectories of men with prostate cancer who elect watchful waiting. These finding will be used to refine, enhance and pilot the WWI.