Exploring prostate cancer survivors' self-management behaviours and examining the mechanism effect that links coping and social support to health-related quality of life, anxiety and depression: A prospective longitudinal study Catherine Paterson a, * , Allison Robertson b , Ghulam Nabi a a University of Dundee, UK b NHS Tayside, Dundee, UK Keywords: Prostate cancer Coping Social support Self-management Health-related quality of life Anxiety Depression Survivorship abstract Objective: Little is known about the influence of psycho-social factors on health-related quality of life (HRQoL), anxiety and depression in men affected by prostate cancer. Developing an understanding in this area can help to identify men who are at high risk of inadequate support and suggest directions for appropriately targeted interventions. Moreover, little is known about how men affected by prostate cancer mobilise social support in their self-management behaviours over time. This is the first study to test the effects of coping and social support on HRQoL and emotional outcome, and assessed the self- management behaviours of men affected by prostate cancer overtime. Methods: The study population was 74 prostate cancer patients with a mean age of 67.3 (SD 7.9) years and mixed treatment modalities. The EORTC QLQ-C30, PR25 and HADS were used to assess the dependant variables before treatment and at six months follow-up. Statistical analysis was performed in SPSS version 17.0 using parametric tests and non-parametric tests. Results: A significant decline in quality of life was observed at 6 months post diagnosis (p < 0.001). Perceived social support before radical treatment was the most important social support construct that predicted better global quality of life and less depression at six months, explaining approximately 30% of the variance. Despite men's self-management efforts and use of social support overtime, self- management self-efficacy significantly reduced at six months (p < 0.05). Conclusion: These findings provide support towards the development of a psycho-social intervention study to improve quality of life, self-management self-efficacy and improve patients' symptom management. © 2014 Elsevier Ltd. All rights reserved. Introduction Prostate cancer is the most prevalent type of cancer in men in developed countries (excluding non-melanoma skin cancer (Jemal et al., 2011)). Prostate cancer for the most part is a disease of older men, and a diagnosis is less common for men below the age of 50 years (Burford et al., 2009). Now, not only is quantity of life important, but patients' quality of life of survivors is crucial as men are living longer with the consequences of this disease and its treatment (Chen et al., 2008; Couper et al., 2009; Sanders et al., 2006). The delicate nature of treatments means that men with prostate cancer often face a host of after effects including urinary, bowel and sexual dysfunction which can negatively affect health- related quality of life (HRQoL) (Cockle-Hearne and Faithfull, 2010). Health-related quality of life is defined as a multi- dimensional concept that encompasses physical, emotional and social components associated with an illness or treatment (Bowling, 2001). The physical aftermath of this disease has been well documented; but the extent to which coping and social sup- port influence HRQoL and emotional outcome is still limited (Paterson et al., 2013). Men with prostate cancer have reported a number of difficulties and these include: psychological distress, sexuality-related issues, self-management of enduring lower urinary tract symptoms, informational support particularly regarding the on-going issues of * Corresponding author. E-mail addresses: c.i.e.paterson@dundee.ac.uk (C. Paterson), allisonrobertson@ nhs.net (A. Robertson), g.nabi@dundee.ac.uk (G. Nabi). Contents lists available at ScienceDirect European Journal of Oncology Nursing journal homepage: www.elsevier.com/locate/ejon http://dx.doi.org/10.1016/j.ejon.2014.10.008 1462-3889/© 2014 Elsevier Ltd. All rights reserved. European Journal of Oncology Nursing xxx (2014) 1e9 Please cite this article in press as: Paterson, C., et al., Exploring prostate cancer survivors' self-management behaviours and examining the mechanism effect that links coping and social support to health-related quality of life, anxiety and depression: A prospective longitudinal study, European Journal of Oncology Nursing (2014), http://dx.doi.org/10.1016/j.ejon.2014.10.008