ABSTRACT Lower urinary tract symptoms related to benign prostatic hyperplasia may negatively affect psychological well‐being, yet psychological symptoms are rarely assessed in routine urological care. This study examines the prevalence of self‐reported depression, anxiety, and stress symptoms and their association with urinary symptom severity among men with benign prostatic hyperplasia in Vietnam. A multicentre cross‐sectional study was conducted among 317 outpatients receiving medical treatment for benign prostatic hyperplasia at six healthcare facilities in Da Nang, Vietnam. Data were collected using the International Prostate Symptom Score and the Depression, Anxiety, and Stress Scale‐21 items, a self‐report measure of symptom severity. Multiple linear regression analyses were performed to identify factors associated with depression, anxiety, and stress scores. Depression, anxiety, and stress symptom scores above the normal range were observed in 16.7%, 31.5%, and 18.0% of participants, respectively. Urinary symptom severity was significantly associated with all three outcomes (all p < 0.001) and remained independently associated with depression ( β = 0.275), anxiety ( β = 0.198), and stress ( β = 0.270). Elevated anxiety symptoms were common among men with benign prostatic hyperplasia, and all three symptom scores were associated with urinary symptom severity. Urological nurses should be aware that greater urinary symptom burden may coexist with higher levels of self‐reported psychological symptoms. Further research is needed to determine whether nurse‐led psychological assessment and referral improve patient outcomes.
ABSTRACT Prostate cancer is the most common cancer in men in the UK, with rising incidence placing increasing demand on hormone therapy delivery. Traditional Clinical Nurse Specialist‐led injection clinics have become increasingly unsustainable due to growing referral numbers. This article describes the development and implementation of a dedicated injection hub (i‐hub) for prostate cancer hormone therapy within an NHS Trust in the North of England, delivered in partnership with a pharmaceutical company and a healthcare service company (HSC). Service redesign was guided by Lewin's three‐stage change management framework (Unfreeze, Change, Refreeze). The i‐hub model introduced HSC nurses to deliver hormone injections and manage simple toxicities, freeing the CNS team to focus on complex assessment and counselling. Implementation involved governance review, staff training, joint stakeholder meetings and patient communication, with progress and patient satisfaction data monitored throughout. In the first 6 months, 178 new patients were seen, with a patient satisfaction rate exceeding 99%. The new model increased clinic capacity by 77%, from 704 to 1248 appointment slots annually, while remaining cost‐neutral to the Trust. The prostate cancer i‐hub demonstrates that nurse‐led, partnership‐based service redesign can increase capacity and improve patient experience while maintaining safety and cost neutrality. Success depended on strong governance, clear role definition and sustained communication across multiple stakeholders. Further research is needed to evaluate replicability across other NHS Trusts and to assess the operational, economic and workforce implications of wider adoption.
