Examining the Mediators of Mental Health Improvement in Men with Localized Prostate Cancer: Self-Efficacy, Illness Perception, and Heart Rhythm Coherence in PC-PEP vs. Standard Care

Abstract

Understanding how interventions reduce psychological distress in patients with prostate cancer (PC) is crucial for enhancing patient care. In a randomized controlled trial, 128 PC patients were assigned to either the 6-month Prostate Cancer Patient Empowerment Program (PC-PEP) or a standard care control group. The PC-PEP focused on relaxation and stress management, healthy nutrition, exercise, pelvic floor muscle training, social support, and improving intimacy and relationships. Participants in PC-PEP experienced significant enhancements in self-efficacy and specific illness perceptions (personal control and emotional representations) compared to the control group. These factors mediated the relationship between the PC-PEP intervention and a reduction in psychological distress post-intervention, with self-efficacy explaining 52% of the reduction in psychological distress. No significant differences in heart rhythm coherence were observed. This study validates the critical role of self-efficacy and certain illness perceptions in facilitating psychological improvements in PC patients participating in the PC-PEP.