Research Article| Volume 31, ISSUE 4, P407-413, August 2017

Depression and Health-Related Quality of Life and Their Association With Resourcefulness in Survivors of Prostate Cancer

Published:April 25, 2017DOI:


      • Effects of resourcefulness on health-related mental and physical quality of life are identified among PC survivors.
      • Resourcefulness plays beneficial roles as mediators from pain to depressive symptoms, PQOL and MQOL, respectively, in PC survivors.
      • Resourcefulness has an impact to reduce depressive symptoms in PC survivors.



      This study aimed to identify the determinants of depressive symptoms (DSs) and health-related quality of life (HRQOL) in survivors of prostate cancer (PC).


      This study used a descriptive, correlational design to assess a sample of 133 individuals with PC. The participants were face-to-face interviewed to collect demographic data and disease characteristics, assess self-control schedule, and survey health status. Correlation analysis, Student's t-test, ANOVA, and regression analysis were applied.


      Over half the patients had depressive symptoms, and 96.1% had erectile dysfunction. Lack of resourcefulness was found to decrease PC-specific quality of life (PCQOL) and physical quality of life (PQOL). The participants who were more resourceful showed a better mental quality of life (MQOL) and PQOL (r = 0.53**; r = 0.41**) and fewer DSs (r = −0.52**). Most participants were stage II and IV, and there were significantly different effects on PQOL and MQOL related to cancer stage. Regarding the different outcomes of various therapies, the findings suggested that survivors of PC who underwent radical prostatectomy were more likely to have a better MQOL than those who underwent other treatments. In addition, resourcefulness had mediating effects on pain, PQOL/MQOL, and DSs in the patients with PC.


      Good mental health and resourcefulness can help patients with PC reduce pain and enhance positive thinking and may augment PQOL and MQOL.


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        • American Cancer Society
        Cancer facts & figures.
        (Retrieved from)
        • Australian Institute of Health and Welfare
        Cancer in Australia: an overview 2014.
        (Retrieved from)
        • Baron R.M.
        • Kenny D.A.
        The moderator-mediator variable distinction in social psychological research: Conceptual, strategic, and statistical considerations.
        Journal of Personality and Social Psychology. 1986; 51: 1173-1182
        • Bennett G.
        • Badger T.A.
        Depression in men with prostate cancer.
        Oncology Nursing Forum. 2005; 32: 545-556
        • Borghede G.
        • Sullivan M.
        Measurement of quality of life in localized prostatic cancer patients treated with radiotherapy. Development of a prostate cancer-specific module supplementing the EORTC QLQ-C30.
        Quality of Life Research. 1996; 5: 212-222
        • Chambers S.K.
        • Foley E.
        • Clutton S.
        • McDowall R.
        • Occhipinti S.
        • Berry M.
        • Davis I.D.
        The role of mindfulness in distress and quality of life for men with advanced prostate cancer.
        Quality of Life Research. 2016; 25: 3027-3035
        • Chen M.L.
        • Chang H.K.
        • Yeh C.H.
        Anxiety and depression in Taiwanese cancer patients with and without pain.
        Journal of Advanced Nursing. 2000; 32: 944-951
        • Clark J.A.
        • Rieker P.
        • Propert K.J.
        • Talcott J.A.
        Changes in quality of life following treatment for early prostate cancer.
        Urology. 1999; 53: 161-168
        • Cliff A.M.
        • MacDonagh R.P.
        Psychosocial morbidity in prostate cancer: II. A comparison of patients and partners.
        BJU International. 2000; 86: 834-839
        • Cohen J.
        Statistical power analysis for the behavioral sciences.
        Lawrence Erlbaum Association, Hillsdale, NJ1988
        • European Association of Urology
        Guidelines on prostate cancer.
        (Retrieved from)
        • Gerbershagen H.J.
        • Ozgur E.
        • Straub K.
        • Dagtekin O.
        • Gerbershagen K.
        • Petzke F.
        • Sabatowski R.
        Prevalence, severity, and chronicity of pain and general health-related quality of life in patients with localized prostate cancer.
        European Journal of Pain. 2008; 12: 339-350
        • Gogineni A.
        • Alsup R.
        • Gillespie D.F.
        Mediation and moderation in social work research.
        Social Work Research. 1995; 19: 57-63
        • Heim H.M.
        • Oei T.P.
        Comparison of prostate cancer patients with and without pain.
        Pain. 1993; 53: 159-162
        • Higano C.S.
        Side effects of androgen deprivation therapy: Monitoring and minimizing toxicity.
        Urology. 2003; 61: 32-38
        • Hsiao C.P.
        • Loescher L.J.
        • Moore I.M.
        Symptoms and symptom distress in localized prostate cancer.
        Cancer Nursing. 2007; 30: E19-E32
        • Huang C.Y.
        • Guo S.E.
        • Hung C.M.
        • Shih S.L.
        • Lee L.C.
        • Hung G.C.
        • Huang S.M.
        Learned resourcefulness, quality of life, and depressive symptoms for patients with breast cancer.
        Oncology Nursing Forum. 2010; 37: E280-E287
        • Huang C.Y.
        • Perng S.J.
        • Chen H.F.
        • Lai C.Y.
        The impact of learned resourcefulness on quality of life in type II diabetic patients: A cross-sectional correlational study.
        Journal of Nursing Research. 2008; 16: 264-274
        • Huang C.Y.
        • Sousa V.D.
        • Chen H.F.
        • Tu S.Y.
        • Chang C.J.
        • Pan I.J.
        Stressors, depressive symptoms, and learned resourcefulness among Taiwanese adults with diabetes mellitus.
        Research and Theory for Nursing Practice. 2007; 21: 83-97
        • Jayadevappa R.
        • Malkowicz S.B.
        • Chhatre S.
        • Johnson J.C.
        • Gallo J.J.
        The burden of depression in prostate cancer.
        Psycho-Oncology. 2012; 21: 1338-1345
        • Litwin M.S.
        • McGuigan K.A.
        • Shpall A.I.
        • Dhanani N.
        Recovery of health related quality of life in the year after radical prostatectomy: Early experience.
        Journal of Urology. 1999; 161: 515-519
        • McHorney C.A.
        • Ware Jr., J.E.
        • Raczek A.E.
        The MOS 36-item short-form health survey (SF-36): II. Psychometric and clinical tests of validity in measuring physical and mental health constructs.
        Medical Care. 1993; 31: 247-263
        • Ministry of Health and Welfare
        The ten major causes of death of Taiwanese [Press release].
        (Retrieved from)
        • Nam R.K.
        • Cheung P.
        • Herschorn S.
        • Saskin R.
        • Su J.
        • Klotz L.H.
        • Narod S.A.
        Incidence of complications other than urinary incontinence or erectile dysfunction after radical prostatectomy or radiotherapy for prostate cancer: A population-based cohort study.
        Lancet Oncology. 2014; 15: 223-231
        • Namiki S.
        • Ishidoya S.
        • Kawamura S.
        • Tochigi T.
        • Arai Y.
        Quality of life among elderly men treated for prostate cancer with either radical prostatectomy or external beam radiation therapy.
        Journal of Cancer Research and Clinical Oncology. 2010; 136: 379-386
        • Namiki S.
        • Ishidoya S.
        • Tochigi T.
        • Ito A.
        • Arai Y.
        Quality of life after radical prostatectomy in elderly men.
        International Journal of Urology. 2009; 16: 813-819
        • Nelson
        • Balk
        • Roth
        Distress, anxzxiety, depression, and emotional well-being on African-American men with prostate cacner.
        Psycho-Oncology. 2010; 19: 1052-1060
        • Radloff L.S.
        The CES-D scale: A self-report depression scale for research in the general population.
        Applied Psychological Measurement. 1977; 1: 385-401
        • Reeve B.B.
        • Potosky A.L.
        • Smith A.W.
        • Han P.K.
        • Hays R.D.
        • Davis W.W.
        • Clauser S.B.
        Impact of cancer on health-related quality of life of older Americans.
        Journal of the National Cancer Institute. 2009; 101: 860-868
        • Rosen R.C.
        • Riley A.
        • Wagner G.
        • Osterloh I.H.
        • Kirkpatrick J.
        • Mishra A.
        The international index of erectile function (IIEF): A multidimensional scale for assessment of erectile dysfunction.
        Urology. 1997; 49: 822-830
        • Rosenbaum M.
        Learned resourcefulness: On coping skills, self-control, and adaptive behavior.
        Springer Pub. Co., New York1990
        • Roth A.J.
        • Kornblith A.B.
        • Batel-Copel L.
        • Peabody E.
        • Scher H.I.
        • Holland J.C.
        Rapid screening for psychologic distress in men with prostate carcinoma: A pilot study.
        Cancer. 1998; 82: 1904-1908
        • Schroder F.H.
        Prostate cancer around the world. An overview.
        Urologic Oncology. 2010; 28: 663-667
        • Sharifi N.
        • Gulley J.L.
        • Dahut W.L.
        Androgen deprivation therapy for prostate cancer.
        JAMA. 2005; 294: 238-244
        • Sim H.G.
        • Cheng C.W.
        Changing demography of prostate cancer in Asia.
        European Journal of Cancer. 2005; 41: 834-845
        • Stanford J.L.
        • Feng Z.
        • Hamilton A.S.
        • Gilliland F.D.
        • Stephenson R.A.
        • Eley J.W.
        • Potosky A.L.
        Urinary and sexual function after radical prostatectomy for clinically localized prostate cancer: The prostate cancer outcomes study.
        JAMA. 2000; 283: 354-360
        • Steginga S.K.
        • Turner E.
        • Donovan J.
        The decision-related psychosocial concerns of men with localised prostate cancer: Targets for intervention and research.
        World Journal of Urology. 2008; 26: 469-474
        • Wang S.M.
        • Lai C.Y.
        • Chang Y.Y.
        • Huang C.Y.
        • Zauszniewski J.A.
        • Yu C.Y.
        The relationships among work stress, resourcefulness, and depression level in psychiatric nurses.
        Archives of Psychiatry Nursing. 2015; 29: 64-70
        • Weber B.A.
        • Roberts B.L.
        • Mills T.L.
        • Chumbler N.R.
        • Algood C.B.
        Physical and emotional predictors of depression after radical prostatectomy.
        American Journal of Men's Health. 2008; 2: 165-171
        • Wittmann D.
        • Northouse L.
        • Foley S.
        • Gilbert S.
        • Wood Jr., D.P.
        • Balon R.
        • Montie J.E.
        The psychosocial aspects of sexual recovery after prostate cancer treatment.
        International Journal of Impotence Research. 2009; 21: 99-106
        • Zauszniewski J.A.
        • Chung C.
        Resourcefulness and health practices of diabetic women.
        Research in Nursing and Health. 2001; 24: 113-121
        • Zauszniewski J.A.
        • Eggenschwiler K.
        • Preechawong S.
        • Roberts B.L.
        • Morris D.L.
        Effects of teaching resourcefulness skills to elders.
        Aging & Mental Health. 2006; 10: 404-412