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Salifu Y, Almack K, Caswell G. 'Out of the frying pan into the fire': a qualitative study of the impact on masculinity for men living with advanced prostate cancer. Palliat Care Soc Pract 2023; 17:26323524231176829. [PMID: 37266393 PMCID: PMC10230602 DOI: 10.1177/26323524231176829] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Accepted: 05/03/2023] [Indexed: 06/03/2023] Open
Abstract
Background Studies have highlighted how advanced prostate cancer causes biographical disruption and presents challenges to masculine identities for men. This article draws on a wider study that focused on the experiences of men living with advanced prostate cancer and their caregivers. Although men's experience of advanced illness is not overlooked in the literature, only a small body of work has taken an in-depth look at men's experiences with advanced prostate cancer and their caregivers in a non-Westernised cultural and social context. Objective To explore how advanced prostate cancer impacts on men's masculine identity from the perspective of patients and their caregivers. Methods A qualitative study of men living with advanced prostate cancer (n = 23) and family caregivers (n = 23) in Ghana. We used the Consolidated Criteria for Reporting Qualitative Studies (COREQ) as the reporting guideline. Results The findings from this study highlight profound challenges for most men to their masculine identities, from both the treatment and the symptoms of advanced prostate cancer within a non-Westernised, patriarchal society. Four main themes were developed. These were the impact on masculinity in terms of: (1) physical changes, (2) sexual ability, (3) socio-economic roles and (4) expressing emotions. Changes in physical appearance, feeling belittled, having no active sexual life and the inability to continue acting as provider and protector of the family made some men describe their situation as one of moving out of the 'frying pan into the fire'. Conclusion This study revealed the impact of advanced prostate cancer on masculine identity. These narratives add a new dimension to what is already known about the impacts on men's masculine identities when dealing with advanced prostate cancer. This knowledge can help improve the care provided to men with advanced prostate cancer with emphasis on the cultures, beliefs and aspirations of these men and their caregivers.
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Affiliation(s)
| | - Kathryn Almack
- Professor of Family Lives and Care, Centre for
Future Societies Research Communities, Young People and Family Lives Centre
for Research in Public Health and Community Care, School of Health and
Social Work, University of Hertfordshire, Hatfield, UK
| | - Glenys Caswell
- Independent Social Researcher and Death Studies
Scholar, Nottigham, UK
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Bowie J, Brunckhorst O, Stewart R, Dasgupta P, Ahmed K. Body image, self-esteem, and sense of masculinity in patients with prostate cancer: a qualitative meta-synthesis. J Cancer Surviv 2022; 16:95-110. [PMID: 33963973 PMCID: PMC8881246 DOI: 10.1007/s11764-021-01007-9] [Citation(s) in RCA: 26] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2020] [Accepted: 02/17/2021] [Indexed: 11/30/2022]
Abstract
PURPOSE Body image, self-esteem, and masculinity are three interconnected constructs in men with prostate cancer, with profound effects on quality of life. This meta-synthesis aimed to evaluate all known qualitative studies published studying the effect of prostate cancer on these constructs. METHODS A systematic review utilising PubMed, Embase, MEDLINE, and PsycINFO databases up to May 2020 was conducted in line with PRISMA and ENTREQ guidelines. All qualitative studies of men's experiences with body image, self-esteem, and masculinity whilst living with prostate cancer were included. A thematic meta-synthesis was conducted to identify emergent descriptive and analytical themes under the main study constructs. RESULTS Of 2188 articles identified, 68 were included. Eight descriptive themes were identified under two analytical themes: 'Becoming a Prostate Cancer Patient' and 'Becoming a Prostate Cancer Survivor'. These described the distress caused by changes to body image, sexual functioning, sense of masculinity, and self-esteem, and the subsequent discourses men engaged with to cope with and manage their disease. A key element was increased flexibility in masculinity definitions, and finding other ways to re-affirm masculinity. CONCLUSIONS Prostate cancer has an important effect on men's health post-diagnosis, and we identified strong relationships between each construct evaluated. The role of hegemonic masculinity is important when considering men's coping mechanisms and is also a key factor when addressing these constructs in counselling post-treatment. IMPLICATIONS FOR CANCER SURVIVORS This meta-synthesis provides key topics that uniquely affect prostate cancer survivors, enabling these patients to be effectively counselled, and have their concerns recognised by clinicians.
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Affiliation(s)
- Jessica Bowie
- MRC Centre for Transplantation, Guy's Hospital Campus, King's College London, King's Health Partners, London, UK
| | - Oliver Brunckhorst
- MRC Centre for Transplantation, Guy's Hospital Campus, King's College London, King's Health Partners, London, UK
| | - Robert Stewart
- King's College London Institute of Psychiatry, Psychology and Neuroscience, London, UK
- South London and Maudsley NHS Foundation Trust, London, UK
| | - Prokar Dasgupta
- MRC Centre for Transplantation, Guy's Hospital Campus, King's College London, King's Health Partners, London, UK
| | - Kamran Ahmed
- MRC Centre for Transplantation, Guy's Hospital Campus, King's College London, King's Health Partners, London, UK.
- Department of Urology, King's College Hospital, London, UK.
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3
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Hartonen VR, Väisänen P, Karlsson L, Pöllänen S. A stage of limbo: A meta‐synthesis of refugees' liminality. APPLIED PSYCHOLOGY-AN INTERNATIONAL REVIEW-PSYCHOLOGIE APPLIQUEE-REVUE INTERNATIONALE 2021. [DOI: 10.1111/apps.12349] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Affiliation(s)
- Ville R. Hartonen
- School of Applied Educational Science and Teacher Education University of Eastern Finland Joensuu Finland
| | - Pertti Väisänen
- School of Applied Educational Science and Teacher Education University of Eastern Finland Joensuu Finland
| | - Liisa Karlsson
- Faculty of Educational Sciences, Department of Education University of Helsinki Helsinki Finland
| | - Sinikka Pöllänen
- School of Applied Educational Science and Teacher Education University of Eastern Finland Joensuu Finland
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4
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McMahon K, Stoddart K, Harris F. Rescripting-A grounded theory study of the contribution that fathers make to Family-Based Treatment when a young person has anorexia nervosa. J Clin Nurs 2021; 31:1598-1611. [PMID: 34448286 DOI: 10.1111/jocn.16013] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Revised: 08/02/2021] [Accepted: 08/04/2021] [Indexed: 11/28/2022]
Abstract
AIM To present a grounded theory of the contribution that fathers make to family-based treatment when a young person has anorexia nervosa. BACKGROUND Research indicates a potential to improve outcomes by involving both parents in the treatment of anorexia nervosa. However, fathers are underrepresented both within treatment and research. Family-based treatment requiring the involvement of both parents presents an opportunity to better understand the role of the father in treatment. DESIGN Classic grounded theory. METHODS Individual interviews conducted with fifteen fathers involved in family-based treatment. The COREQ checklist was followed. RESULTS Fathers valued being involved in family-based treatment and felt they had an important contribution to make. The analysis captures the overall contribution that fathers make and the impact of their involvement. Four categories; Being on the Outside, Finding a Way In, Finding a Way to Be and Finding a Way to Let Go and one core category Repositioning were generated from the data. A substantive theory of Rescripting, generated from categories and the core category, describes the way that participating in family-based treatment changes fathers and their role. CONCLUSIONS Fathers make an important and significant contribution to family-based treatment when a young person has anorexia nervosa. The findings inform clinicians about the importance of including fathers in the treatment of young people with anorexia nervosa. They highlight the importance of incorporating support mechanisms into family-based treatment to harness and maximise the paternal contribution. RELEVANCE TO CLINICAL PRACTICE Paternal contribution to family-based treatment can be maximised to improve outcomes for young people with anorexia nervosa.
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5
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Yu Ko WF, Oliffe JL, Johnson JL, Bottorff JL. Reformulating the Worker Identity: Men's Experiences After Radical Prostatectomy. QUALITATIVE HEALTH RESEARCH 2020; 30:1225-1236. [PMID: 30674232 DOI: 10.1177/1049732318825150] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
The number of men in the Canadian workforce who have prostate cancer is increasing. The purpose of the study was to explore the processes involved in men's return to work post radical prostatectomy and understand how these events are connected to masculinities. Drawing on data collected through individual interviews with 24 participants, constructivist grounded theory method was used to develop the substantive theory of Reformulating the Worker Identity which comprises two processes, recovering after radical prostatectomy and renegotiating work expectations. Recovering after radical prostatectomy revealed how men overcame side effects at home and evaluated their potential for returning to work. Renegotiating work expectations included participant's strategies for securing graduated return to work accommodations. Study findings revealed that the challenges for fully returning to work post prostatectomy are often underestimated by clinicians and patients. In this context, preempting return to work challenges preoperatively might allay significant anxieties for many men.
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Affiliation(s)
- Wellam F Yu Ko
- The University of British Columbia, Vancouver, British Columbia, Canada
| | - John L Oliffe
- The University of British Columbia, Vancouver, British Columbia, Canada
| | - Joy L Johnson
- Simon Fraser University, Burnaby, British Columbia, Canada
| | - Joan L Bottorff
- The University of British Columbia, Okanagan Campus, Kelowna, British Columbia, Canada
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6
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Schultze M, Müller-Nordhorn J, Holmberg C. Discussing the effects of prostate cancer beyond biographical disruption and new normalcy: the experiences of men with prostate cancer in Germany. SOCIOLOGY OF HEALTH & ILLNESS 2020; 42:1359-1378. [PMID: 32614484 DOI: 10.1111/1467-9566.13113] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
The concept of biographical disruption has been used to explain the experience of a cancer diagnosis. Studies on cancer experience increasingly suggest that people diagnosed in older age may not have such disruptive experiences. Prostate cancer is diagnosed more often in older men and is often considered a disease of old age; furthermore, the signs of illness in prostate cancer and the signs of ageing might become convoluted. With this in mind, this paper aims to explore how 42 men with prostate cancer who participated in an interview study respond to and make sense of bodily changes. The sample was selected using a maximum variation strategy in order to describe a range of possible experiences with prostate cancer. Analysis was conducted thematically. The men's narratives tell of the constant process of dealing with ageing-related and/or cancer-related changes to both their bodies and their social interactions, and their struggle to disentangle the related effects of ageing and/or cancer on their bodies. We describe how men "muddle through" problems of urinary leakage, potency and loss of libido. We then identify how men attributed changes as part of ageing and/or cancer to (better) manage the experiences of loss.
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Affiliation(s)
- Martin Schultze
- Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Institute of Public Health, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Jacqueline Müller-Nordhorn
- Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Institute of Public Health, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Christine Holmberg
- Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Institute of Public Health, Charité - Universitätsmedizin Berlin, Berlin, Germany
- Institute of Social Medicine and Epidemiology, Brandenburg Medical School Theodor Fontane, Brandenburg an der Havel, Germany
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7
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Dawson C, Adams J, Fenlon D. Liminality and head and neck cancer: core concepts and applications for clinical practice. Ecancermedicalscience 2020; 13:986. [PMID: 32010210 PMCID: PMC6974377 DOI: 10.3332/ecancer.2019.986] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2019] [Indexed: 12/14/2022] Open
Abstract
This article explores the concept of liminality and its potential application to understand the experience of being diagnosed and receiving treatment for head and neck cancer.The article describes how we identified liminality in people who had received surgical treatment of head and neck cancer and why it is important that the clinical team understand and consider liminality in their interventions, to improve outcomes.
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Affiliation(s)
- Camilla Dawson
- Queen Elizabeth Hospital Birmingham, Birmingham B15 2TH, UK
| | - Jo Adams
- University of Southampton, Southampton B15 2TH, UK
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8
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Whitehead L, Tierney S, Biggerstaff D, Perkins GD, Haywood KL. Trapped in a disrupted normality: Survivors' and partners' experiences of life after a sudden cardiac arrest. Resuscitation 2019; 147:81-87. [PMID: 31887365 DOI: 10.1016/j.resuscitation.2019.12.017] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2019] [Revised: 11/27/2019] [Accepted: 12/19/2019] [Indexed: 12/13/2022]
Abstract
AIM OF THE STUDY Advances in resuscitation science have resulted in a growing number of out-of-hospital cardiac arrest (OHCA) survivors. However, we know very little about the natural history of recovery and the unmet needs of survivors and their partners. This qualitative study sought to address this knowledge gap to improve understanding of the consequences of surviving cardiac arrest. METHODS In-depth qualitative interviews were undertaken separately with survivors and their partners between 3 and 12-months following the cardiac arrest. An interpretative phenomenological approach (IPA) to data analysis was adopted. Developing themes were discussed between members of the research team. RESULTS 8 survivors (41-79 years; 5 male; mean time 6.3 months post-hospital discharge) and 3 partners (1 male) were interviewed. The key (super-ordinate) theme of being 'trapped in a disrupted normality' was identified within the data. Five related subordinate themes included: existential impact, physical ramifications, emotional consequences, limiting participation in social activities and altered family roles. CONCLUSION Recovery for survivors is hindered by a wide range of physical, emotional, cognitive, social and spiritual challenges that disrupt perceptions of 'normality'. Survivors and their carers may benefit from focussing on establishing a 'new normal' rather than striving to achieve a pre-cardiac social and physical position. Survivor-centred assessment should support rather than undermine this goal.
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Affiliation(s)
- Laura Whitehead
- Warwick Clinical Trials Unit, Warwick Medical School, The University of Warwick, Gibbet Hill, Coventry, CV4 7AL, United Kingdom
| | - Stephanie Tierney
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Radcliffe Observatory Quarter, Woodstock Road, Oxford OX2 6GG, United Kingdom
| | - Deborah Biggerstaff
- Warwick Mental Health and Wellbeing, Division of Health Sciences, Warwick Medical School, The University of Warwick, Gibbet Hill, Coventry. CV4 7AL, United Kingdom
| | - Gavin D Perkins
- Warwick Clinical Trials Unit, Warwick Medical School, The University of Warwick, Gibbet Hill, Coventry, CV4 7AL, United Kingdom
| | - Kirstie L Haywood
- Warwick Research in Nursing, Division of Health Sciences, Warwick Medical School, The University of Warwick, Gibbet Hill, Coventry. CV4 7AL, United Kingdom.
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9
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Green R. Maintaining masculinity: Moral positioning when accounting for prostate cancer illness. Health (London) 2019; 25:399-416. [PMID: 31144532 DOI: 10.1177/1363459319851555] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
This article explores men's experiences following treatment for prostate cancer through the lens of chronic illness. Recent empirical work suggests prostate cancer may be better understood as a chronic illness. Prostate cancer offers a case study to examine how older men's masculinities are disrupted by chronic illness experience. Qualitative interviews with 29 men, recruited from two prostate cancer support groups, explored prostate cancer and post-treatment experiences. Men's experiences are examined by drawing on the works of Steve Robertson and Kathy Charmaz for understanding masculinities in relation to health and illness. Aspects of chronic illness experience are identified in men's accounts, particularly concerns with loss of moral status resulting from ongoing and potentially stigmatising treatment side effects. Four forms of moral positioning are identified that align with Steve Robertson's empirically derived model theorising the relationship between health and hegemonic masculinity. These findings facilitate discussion of the interaction between chronic illness experience, morality and masculinities, providing insight into how older men maintain their masculinity in the wake of illness.
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10
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Le Boutillier C, Archer S, Barry C, King A, Mansfield L, Urch C. Conceptual framework for living with and beyond cancer: A systematic review and narrative synthesis. Psychooncology 2019; 28:948-959. [PMID: 30812066 PMCID: PMC6594071 DOI: 10.1002/pon.5046] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2018] [Revised: 02/22/2019] [Accepted: 02/25/2019] [Indexed: 11/06/2022]
Abstract
OBJECTIVE The concept of living with and beyond cancer is now emerging in policy and literature. Rather than viewing this notion simply as a linear timeline, developing an agreed understanding of the lived experience of people affected by cancer will aid the development of person-centred models of care. METHODS A systematic review was conducted. The review question was "What does the term 'living with and beyond cancer' mean to people affected by cancer?" The protocol for the review was preregistered in the PROSPERO database (PROSPERO CRD42017059860). All included studies were qualitative, so narrative synthesis was used to integrate descriptions and definitions of living with and beyond cancer into an empirically based conceptual framework. RESULTS Out of 2345 papers that were identified and 180 that were reviewed, a total of 73 papers were included. The synthesis yielded three interlinked themes: Adversity (realising cancer), Restoration (readjusting life with cancer), and Compatibility (reconciling cancer), resulting in the ARC framework. CONCLUSIONS Three themes describe the experience of living with and beyond cancer: adversity, restoration, and compatibility. The ARC framework provides an empirically informed grounding for future research and practice in supportive cancer care for this population.
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Affiliation(s)
- Clair Le Boutillier
- Department of Surgery, Cardiovascular and CancerImperial College Healthcare NHS TrustLondonUK
| | - Stephanie Archer
- Department of Surgery & Cancer, Faculty of MedicineImperial College LondonLondonUK
- Public Health and Primary CareUniversity of Cambridge, Strangeways Research LaboratoryCambridgeUK
| | - Claire Barry
- Department of Surgery, Cardiovascular and CancerImperial College Healthcare NHS TrustLondonUK
| | - Alex King
- Department of Surgery, Cardiovascular and CancerImperial College Healthcare NHS TrustLondonUK
| | | | - Catherine Urch
- Department of Surgery, Cardiovascular and CancerImperial College Healthcare NHS TrustLondonUK
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11
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Marshall S, Grinyer A, Limmer M. Dual Liminality: A Framework for Conceptualizing the Experience of Adolescents and Young Adults with Cancer. J Adolesc Young Adult Oncol 2019; 8:26-31. [DOI: 10.1089/jayao.2018.0030] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Steve Marshall
- Department of Palliative Care, Policy and Rehabilitation, King's College Hospital NHS Foundation Trust, Cicely Saunders Institute, London, United Kingdom
| | - Anne Grinyer
- Department of Health Research, Faculty of Health and Medicine, Furness College, Lancaster University, Lancaster, United Kingdom
| | - Mark Limmer
- Department of Health Research, Faculty of Health and Medicine, Furness College, Lancaster University, Lancaster, United Kingdom
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12
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Dencker A, Murray SA, Mason B, Rix BA, Bøge P, Tjørnhøj-Thomsen T. Disrupted biographies and balancing identities: A qualitative study of cancer patients' communication with healthcare professionals about dependent children. Eur J Cancer Care (Engl) 2019; 28:e12991. [PMID: 30628750 DOI: 10.1111/ecc.12991] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2017] [Revised: 11/05/2018] [Accepted: 12/16/2018] [Indexed: 11/26/2022]
Abstract
OBJECTIVE About 14% of cancer patients live with dependent children. Healthcare professionals are well placed to help patients support their children as part of a patient-centred practice. Children tend to appreciate open communication during the course of illness, but patients often find this difficult. However, research is unclear about patients' preferences and their willingness to talk with healthcare professionals about their dependent children. METHODS We conducted 15 in-depth interviews with patients from haematological (N = 11) and gynaecological oncology (N = 4). The interviews and subsequent analysis focused on patients' communicative preferences, taking the theoretical framework of "biographical disruption" as a starting point and using Jenkins' concept of identity as a social, relational and dynamic process. RESULTS We identified two overall identities at stake for seriously ill patients with parental responsibility: "patient identity" and "parent identity." As "patients," patients were ambivalent about relating to their children, but as "parents" they wanted healthcare professionals to talk about their children. CONCLUSION In order to be patient-centred, clinicians should, we suggest, acknowledge that patients have these conflicting perspectives and identities, which surface at various times and situations throughout their illness trajectories. Research is needed to further explore these findings in different illness groups and cultures.
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Affiliation(s)
- Annemarie Dencker
- Patient Support, The Danish Cancer Society, Copenhagen, Denmark.,National Institute of Public Health, Research Programme on Health Promotion and Prevention, University of Southern Denmark, Copenhagen, Denmark
| | - Scott A Murray
- Primary Palliative Care Research Group, The Usher Institute of Population Health Sciences and Informatics, The University of Edinburgh Medical School, Edinburgh, UK
| | - Bruce Mason
- Primary Palliative Care Research Group, The Usher Institute of Population Health Sciences and Informatics, The University of Edinburgh Medical School, Edinburgh, UK
| | | | - Per Bøge
- Patient Support, The Danish Cancer Society, Copenhagen, Denmark
| | - Tine Tjørnhøj-Thomsen
- National Institute of Public Health, Research Programme on Health Promotion and Prevention, University of Southern Denmark, Copenhagen, Denmark
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13
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Certainty within uncertainty: a qualitative study of the experience of metastatic melanoma patients undergoing pembrolizumab immunotherapy. Support Care Cancer 2018; 27:1845-1852. [DOI: 10.1007/s00520-018-4443-3] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2018] [Accepted: 08/23/2018] [Indexed: 12/17/2022]
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14
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Meirelles CDS, Diez-Garcia RW. Taste changes as a metaphor for biographical disruption: A qualitative study in patients undergoing haematopoietic stem cell transplantation. Clin Nutr ESPEN 2018; 27:127-133. [PMID: 30144885 DOI: 10.1016/j.clnesp.2018.05.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2018] [Accepted: 05/09/2018] [Indexed: 11/30/2022]
Abstract
PURPOSE and objective: The treatment side effects of patients undergoing haematopoietic stem cell transplantation can cause various eating difficulties. The objective of this study was to explore the significance of eating experiences and taste changes from the perspective of patients undergoing haematopoietic stem cell transplantation. METHOD This was a qualitative, exploratory study based on semi-structured interviews applied during hospitalisation for haematopoietic stem cell transplantation. Thematic content analysis and the biographical disruption concept were used as theoretical references to explore the results. RESULTS Twenty patients were studied. The overarching theme identified from the results was deconstruction of the taste reference resulting from sensory taste change, loss of eating references and changes to the hedonic relationship with food caused by the treatment. In addition to this deconstruction, participants described the reformulation of eating habits as a way of coping with the disease, which affected the eating experience and motivated the dietary strategies adopted. CONCLUSIONS Taste changes during haematopoietic stem cell transplantation are related to both biological issues and metaphysical aspects. This study raises the meaning of loss of sensory references and their symbolic aspects. These results were important to expand our view to include other aspects that can contribute to improving the care given to these individuals.
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Affiliation(s)
- Camila de Souza Meirelles
- Laboratory of Food Practices and Behaviour, University of Sao Paulo, Brazil; Department of Internal Medicine, Nutrition and Metabolism Program, Ribeirão Preto Medical School, University of Sao Paulo (FMRP/USP), Brazil
| | - Rosa Wanda Diez-Garcia
- Laboratory of Food Practices and Behaviour, University of Sao Paulo, Brazil; Department of Internal Medicine, Nutrition and Metabolism Program, Ribeirão Preto Medical School, University of Sao Paulo (FMRP/USP), Brazil.
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15
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Ussher JM, Perz J. Threat of biographical disruption: the gendered construction and experience of infertility following cancer for women and men. BMC Cancer 2018; 18:250. [PMID: 29506492 PMCID: PMC5836444 DOI: 10.1186/s12885-018-4172-5] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2017] [Accepted: 02/26/2018] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Infertility is a major concern for people with cancer and their partners. There have been calls for further research on the gendered nature of psychosocial, emotional and identity concomitants of fertility post-cancer across women and men. METHOD The gendered construction and experience of infertility following cancer was examined through a survey of 693 women and 185 men, and in-depth one-to-one interviews with a subsample of survey respondents, 61 women and 17 men, purposively selected across cancer types and age groups. Thematic decomposition was used to examine the open ended survey responses and interviews. The chi square test for independence was used to test for group differences between women and men on closed survey items. RESULTS In the thematic decomposition, infertility was identified as providing a 'Threat of Biographical Disruption' which impacted on life course and identity, for both women and men. Subthemes identified were: 'Parenthood as central to adulthood'; 'Infertility as a threat to gender identity'; ' Unknown fertility status and delayed parenthood'; 'Feelings of loss and grief'; 'Absence of understanding and support'; 'Benefit finding and renegotiation of identity'. In the closed survey items, the majority of women and men agreed that they had always 'wanted to be a parent' and that 'parenthood was a more important life goal than a satisfying career'. 'It is hard to feel like a true adult until you have a child' and impact upon 'my feelings about myself as a man or a woman' was reported by both women and men, with significantly more women reporting 'I feel empty because of fertility issues'. Many participants agreed they 'could visualise a happy life without a child' and there is 'freedom without children'. Significantly more men than women reported that they had not discussed fertility with a health care professional. CONCLUSION The fear of infertility following cancer, or knowledge of compromised fertility, can have negative effects on identity and psychological wellbeing for both women and men, serving to create biographical disruption. Support from family, partners and health care professionals can facilitate renegotiation of identity and coping.
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Affiliation(s)
- Jane M. Ussher
- Translational Health Research Institute, School of Medicine, Western Sydney University, Locked Bag 1797, Penrith South, 2751 Australia
| | - Janette Perz
- Translational Health Research Institute, School of Medicine, Western Sydney University, Locked Bag 1797, Penrith South, 2751 Australia
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16
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Thomas C, Wootten AC, Robinson P, Law PCF, McKenzie DP. The impact of sexual orientation on body image, self-esteem, urinary and sexual functions in the experience of prostate cancer. Eur J Cancer Care (Engl) 2018; 27:e12827. [PMID: 29461652 DOI: 10.1111/ecc.12827] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/19/2017] [Indexed: 11/27/2022]
Abstract
Prostate cancer (PCa) poses a large health burden globally. Research indicates that men experience a range of psychological challenges associated with PCa including changes to identity, self-esteem and body image. The ways in which sexual orientation plays a role in the experience of PCa, and the subsequent impact on quality of life (QoL), body image and self-esteem have only recently been addressed. By addressing treatment modality, where participant numbers were sufficient, we also sought to explore whether gay (homosexual) men diagnosed with PCa (PCaDx) and with a primary treatment modality of surgery would report differences in body image and self-esteem compared with straight (heterosexual) men with PCaDx with a primary treatment modality of surgery, compared with gay and straight men without PCaDx. The results of our study identified overall differences with respect to PCaDx (related to urinary function, sexual function and health evaluation), and sexual orientation (related to self-esteem), rather than interactions between sexual orientation and PCaDx. Gay men with PCaDx exhibited higher levels of urinary functioning than straight men with PCaDx, the difference being reversed for gay and straight men without PCaDx; but this result narrowly failed to achieve statistical significance, suggesting a need for further research, with larger samples.
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Affiliation(s)
- C Thomas
- Epworth Prostate Centre, Epworth HealthCare, Richmond, Victoria, Australia
| | - A C Wootten
- Smiling Mind, Melbourne, Victoria, Australia
| | - P Robinson
- School of Psychology and Public Health, College of Science, Health and Engineering, La Trobe University, Bundoora, Victoria, Australia
| | - P C F Law
- Monash Alfred Psychiatry Research Centre, Monash University Central Clinical School, The Alfred Hospital, Melbourne, Victoria, Australia
| | - D P McKenzie
- Epworth Research Institute, Epworth HealthCare, Richmond, Victoria, Australia.,Department of Epidemiology and Preventive Medicine, Monash University, Clayton, Victoria, Australia
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17
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Marshall S, Grinyer A, Limmer M. The Experience of Adolescents and Young Adults Treated for Cancer in an Adult Setting: A Review of the Literature. J Adolesc Young Adult Oncol 2018; 7:283-291. [PMID: 29437492 DOI: 10.1089/jayao.2017.0123] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
The purpose of this review is to explore the literature on the experience of adolescents and young adults (AYAs) having cancer treatment in an adult setting, rather than on a specialist adolescent cancer unit. The integrative review method was used to explore the current literature. Primary research on the topic was located systematically and then synthesized into a thematic narrative. The experience of AYAs undergoing treatment in an adult setting was generally negative. This can be attributed to three themes: feeling isolated in the adult setting; the lack of empathy from staff working in the adult setting; and the inappropriateness of the adult environment for this age group. As many AYAs with cancer will continue to have treatment in adult settings, staff working in this environment should be aware of the negative experience of this cohort and the impact this can have on a vulnerable group of patients. Staff could consider simple ways of improving the AYA experience, such as connecting AYA patients with their peers to reduce isolation; adapting their approach to take account of the unique emotional needs of this age group; and considering ways of making the environment more welcoming and age-appropriate.
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Affiliation(s)
- Steve Marshall
- 1 Palliative Care Team, King's College Hospital NHS Foundation Trust, Cicely Saunders Institute , London, United Kingdom
| | - Anne Grinyer
- 2 Faculty of Health and Medicine, Furness College, Lancaster University , Lancaster, United Kingdom
| | - Mark Limmer
- 2 Faculty of Health and Medicine, Furness College, Lancaster University , Lancaster, United Kingdom
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18
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Parton C, Katz T, Ussher JM. ‘Normal’ and ‘failing’ mothers: Women’s constructions of maternal subjectivity while living with multiple sclerosis. Health (London) 2017; 23:516-532. [DOI: 10.1177/1363459317739442] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Multiple sclerosis causes physical and cognitive impairment that can impact women’s experiences of motherhood. This study examined how women construct their maternal subjectivities, or sense of self as a mother, drawing on a framework of biographical disruption. A total of 20 mothers with a multiple sclerosis diagnosis took part in semi-structured interviews. Transcripts were analysed using thematic decomposition to identify subject positions that women adopted in relation to cultural discourses of gender, motherhood and illness. Three main subject positions were identified: ‘The Failing Mother’, ‘Fear of Judgement and Burdening Others’ and ‘The Normal Mother’. Women’s sense of self as the ‘Failing Mother’ was attributed to the impact of multiple sclerosis, contributing to biographical disruption and reinforced through ‘Fear of Judgement and Burdening Others’ within social interactions. In accounts of the ‘Normal Mother’, maternal subjectivity was renegotiated by adopting strategies to manage the limitations of multiple sclerosis on mothering practice. This allowed women to self-position as ‘good’ mothers. Health professionals can assist women by acknowledging the embodied impact of multiple sclerosis on maternal subjectivities, coping strategies that women employ to address potential biographical disruption, and the cultural context of mothering, which contributes to women’s experience of subjectivity and well-being when living with multiple sclerosis.
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19
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Matheson L, Watson EK, Nayoan J, Wagland R, Glaser A, Gavin A, Wright P, Rivas C. A qualitative metasynthesis exploring the impact of prostate cancer and its management on younger, unpartnered and gay men. Eur J Cancer Care (Engl) 2017; 26. [PMID: 28382745 DOI: 10.1111/ecc.12676] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/10/2017] [Indexed: 11/29/2022]
Abstract
Prostate cancer (PCa) can negatively impact on men's sexual, urinary and emotional functioning, affecting quality of life. Most men with PCa are older (≥65 years), married and heterosexual and little is known about the impact on men who are younger, unpartnered or gay. We aimed to synthesise existing qualitative research on these three groups of men. A systematic metasynthesis was undertaken that included data on the unique impacts of PCa on younger (<65 years) (n = 7 papers), unpartnered (n = 17 papers) or gay or bisexual men (n = 11 papers) using a modified meta-ethnographic approach. The three overarching constructs illustrated the magnified disruption to men's biographies, that included: marginalisation, isolation and stigma-relating to men's sense of being "out of sync"; the burden of emotional and embodied vulnerabilities and the assault on identity-illustrating the multiple threats to men's work, sexual and social identities; shifting into different communities of practice-such as the shift from being part of a sexually active community to celibacy. These findings suggest that PCa can have a particular impact on the quality of life of younger, unpartnered and gay men. This has implications for the provision of tailored support and information to these potentially marginalised groups.
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Affiliation(s)
- L Matheson
- Department of Applied Health and Professional Development, Oxford Brookes University, Oxford, UK
| | - E K Watson
- Department of Applied Health and Professional Development, Oxford Brookes University, Oxford, UK
| | - J Nayoan
- Faculty of Health Sciences, University of Southampton, Southampton, UK
| | - R Wagland
- Faculty of Health Sciences, University of Southampton, Southampton, UK
| | - A Glaser
- Leeds Institute of Cancer and Pathology, Faculty of Medicine and Health, University of Leeds, Leeds, UK
| | - A Gavin
- School of Medicine, Dentistry and Biomedical Sciences, Centre for Public Health, Queen's University Belfast, Belfast, UK
| | - P Wright
- Leeds Institute of Cancer and Pathology, Faculty of Medicine and Health, University of Leeds, Leeds, UK
| | - C Rivas
- Faculty of Health Sciences, University of Southampton, Southampton, UK
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20
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Rees S. 'Am I really gonna go sixty years without getting cancer again?' Uncertainty and liminality in young women's accounts of living with a history of breast cancer. Health (London) 2016; 21:241-258. [PMID: 28521649 DOI: 10.1177/1363459316677628] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Although much research has examined the experience of breast cancer, the distinctive perspectives and lives of young women have been relatively neglected. Women diagnosed with breast cancer under the age of 45, and who had completed their initial treatment, were interviewed, and social constructionist grounded theory methods were used to analyse the data. The end of initial treatment was accompanied by a sense of unease and uncertainty in relation to recurrence and survival, and also fertility and menopausal status. The young women's perceptions about the future were altered, and their fears about recurrence were magnified by the possibility of many decades ahead during which breast cancer could recur. The implications for the young women's life course, in terms of whether they would be able to have children, would not become clear for several years after initial treatment. This resulted in a liminal state, in which young women found themselves neither cancer-free nor cancer patients, neither pre- nor post-menopausal, neither definitively fertile nor infertile. This liminal state had a profound impact on young women's identities and sense of agency. This extends previous understanding of life after cancer, exploring the age-related dimensions of liminality.
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21
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Bell SL, Tyrrell J, Phoenix C. Ménière's disease and biographical disruption: Where family transitions collide. Soc Sci Med 2016; 166:177-185. [PMID: 27566047 DOI: 10.1016/j.socscimed.2016.08.025] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2016] [Revised: 08/10/2016] [Accepted: 08/16/2016] [Indexed: 10/21/2022]
Abstract
People's lived experiences of chronic illness have garnered increasing research interest over the last 30-40 years, with studies recognising the disruptive influence of illness onset and progression, both to people's everyday lives and to their biographical selves. We extend this body of work, drawing on the experiences of people living with Ménière's disease; a long-term progressive vestibular disorder characterised by unpredictable episodes of debilitating vertigo, tinnitus and permanent sensorineural hearing loss. In response to calls for more critical examination of the wider biographical contexts in which chronic illnesses are encountered, we draw on 28 in-depth narrative interviews with Ménière's patients and their family members to discuss how personal chronic illness experiences may be closely entwined with, and deeply shaped by, the life transitions (illness-related and otherwise) of 'linked others'. Interviews were conducted in south west England from January to June 2015. Focusing on intersecting transitions of parenthood, caregiving and retirement, we explore how and why familial relationships can both facilitate and hinder adaptation to a lifetime of chronically disrupted normalities, contributing to fluctuating experiences of 'cherished time', 'anomalous time' and 'turbulent time'. In so doing, we suggest that the onset and progression of chronic illness could usefully be re-conceptualised as one of many 'biographical oscillations' encountered during the life course that serve to re-route us between continually shifting life trajectories. In recognising life's dynamism and challenging the identity-limiting and self-damaging nature of entrenched cultural life course constructions, we suggest value in recognising alternative ways of 'living well' when negotiating the wide-ranging biographical maps that life can follow.
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Affiliation(s)
- Sarah L Bell
- European Centre for Environment and Human Health, University of Exeter Medical School, Knowledge Spa, Truro, Treliske, TR1 3HD, United Kingdom.
| | - Jessica Tyrrell
- European Centre for Environment and Human Health, University of Exeter Medical School, Knowledge Spa, Truro, Treliske, TR1 3HD, United Kingdom.
| | - Cassandra Phoenix
- Department for Health, University of Bath, Bath, BA2 7AY, United Kingdom.
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22
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Salamonsen A, Kiil MA, Kristoffersen AE, Stub T, Berntsen GR. "My cancer is not my deepest concern": life course disruption influencing patient pathways and health care needs among persons living with colorectal cancer. Patient Prefer Adherence 2016; 10:1591-600. [PMID: 27574408 PMCID: PMC4994880 DOI: 10.2147/ppa.s108422] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND The concept of "patient pathways" in cancer care is most commonly understood as clinical pathways, operationalized as standardized packages of health care based on guidelines for the condition in question. In this understanding, patient pathways do not address multimorbidity or patient experiences and preferences. This study explored patient pathways understood as the individual and cultural life course, which includes both life and health events. The overall aim was to contribute to supportive and targeted cancer care. MATERIALS AND METHODS Nine Norwegian patients recently diagnosed with rectal cancer Tumor-Node-Metastasis stage I-III participated in qualitative interviews, five times over 1 year. Five patients later participated in a workshop where they made illustrations of and discussed patient pathways. RESULTS Patient pathways including both health and life events were illustrated and described as complex and circular. Stress, anxiety, and depression caused by life events had significant disruptive effects and influenced patient-defined health care needs. The participants experienced the Norwegian public health service as focused on hospital-based standardized cancer care. They expressed unmet health care needs in terms of emotional and practical support in their everyday life with cancer, and some turned to complementary and alternative medicine. CONCLUSION This study suggests that acknowledging life course disruption before cancer diagnosis may have significant relevance for understanding complex patient pathways and individual health care needs. Approaching patient pathways as individual and socially constructed may contribute important knowledge to support targeted cancer care.
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Affiliation(s)
- Anita Salamonsen
- National Research Center in Complementary and Alternative Medicine, Department of Community Medicine, UiT the Arctic University of Norway, Tromsø, Norway
| | - Mona A Kiil
- Department of Clinical Medicine, UiT the Arctic University of Norway, Tromsø, Norway
| | - Agnete Egilsdatter Kristoffersen
- National Research Center in Complementary and Alternative Medicine, Department of Community Medicine, UiT the Arctic University of Norway, Tromsø, Norway
| | - Trine Stub
- National Research Center in Complementary and Alternative Medicine, Department of Community Medicine, UiT the Arctic University of Norway, Tromsø, Norway
| | - Gro R Berntsen
- National Research Center in Complementary and Alternative Medicine, Department of Community Medicine, UiT the Arctic University of Norway, Tromsø, Norway
- Norwegian Center for eHealth Research, University Hospital of Northern Norway, Tromsø, Norway
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Abstract
BACKGROUND The initial impact of treatments for men with prostate cancer is well reported in the literature. Less is known about the psychosocial needs of these men as their journey after diagnosis and treatment continues into the months and years. OBJECTIVE The objective of this study was to examine and understand the supportive care needs of men diagnosed and treated for prostate cancer at key identifiable periods of their cancer journey. METHODS An international Web-based survey was conducted in 2012, investigating men's prostate cancer pathways. The survey was based on substantial qualitative research and assessed for validity and reliability before piloting. To provide a unique insight into men living with prostate cancer, the views of partners were also elicited. RESULTS Completed questionnaires were obtained from 193 men and 40 partners from 6 nations. The physical and psychosocial impact of treatment and need for support varied along the cancer journey. Fear, distress, loss, regret, anxiety, low self-esteem, depression, changes in sexuality, masculinity, and relationships were also described by both men and partners as adverse effects of the diagnosis and treatment for prostate cancer. CONCLUSIONS Wives and partners are a key psychosocial support to men with prostate cancer. They may also provide valuable insight into men's supportive care needs that men are often unable to recognize themselves. IMPLICATIONS FOR PRACTICE Findings suggest that wives and partners of men with prostate cancer can provide nurses and healthcare authorities with a powerful and unique resource in providing supportive care for men who are challenged by prostate cancer.
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Dunn E, Arber A, Gallagher A. The Immediacy of Illness and Existential Crisis: Patients' lived experience of under-going allogeneic stem cell transplantation for haematological malignancy. A phenomenological study. Eur J Oncol Nurs 2016; 21:90-6. [PMID: 26952683 DOI: 10.1016/j.ejon.2016.01.001] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2015] [Revised: 12/18/2015] [Accepted: 01/05/2016] [Indexed: 10/22/2022]
Abstract
PURPOSE This paper reports a study exploring the lived experience of fifteen men and women treated with allogeneic stem cell transplant (SCT) for haematological malignancy. METHOD The study followed an interpretive phenomenological methodology using semi-structured interviews. Participants aged between 22 and 68 years were purposively recruited from two specialist treatment centres and were interviewed within three months to one year post SCT between April and September 2013. Data were then analysed using interpretive phenomenological analysis. RESULTS An overarching theme that emerged from the data was: The Immediacy of Illness and Existential Crisis. The Immediacy of Illness and Existential Crisis developed from participants' experiences of critical events accompanied by enduring uncertainty continuing into the recovery period. Participants suffer major disruption to their lives physically, psychosocially and emotionally, including facing their own mortality, without a sense of when they may resume the normality of their former lives. CONCLUSIONS Ambiguity and uncertainty characterise the experiences of those with haematological malignancy. Whilst participants have access to specialist teams, there are opportunities for health and social care professionals to provide more support for individuals to come to terms with the critical events they have faced and to prepare them for their return home and to continue former lives and aspirations following prolonged hospitalisation.
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Affiliation(s)
- Elizabeth Dunn
- Guy's and St Thomas' Foundation Trust, Westminster Bridge Road, London SE1 7EH, UK.
| | - Anne Arber
- Faculty of Health and Medical Sciences, University of Surrey, Guildford GU2 7TE, UK
| | - Ann Gallagher
- Faculty of Health and Medical Sciences, University of Surrey, Guildford GU2 7TE, UK
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25
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Moffatt S, Noble E. Work or welfare after cancer? Explorations of identity and stigma. SOCIOLOGY OF HEALTH & ILLNESS 2015; 37:1191-1205. [PMID: 26139163 DOI: 10.1111/1467-9566.12303] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
With increasing numbers of people living with cancer, a greater focus is required on the social consequences of the disease. This article explores the connections between cancer and employment and the constraints imposed by ill health and wider structural conditions. Narrative data from 23 people of working age with cancer in north-east England collected longitudinally over 16 months highlight the impact of financial strain caused by temporary or permanent interruption to employment, and the positive benefits of an upstream welfare rights intervention in enabling participants to claim benefit entitlements and boost incomes. Returning to work, for those who were able, helped repair the disruption caused by the illness. For those unable to work, reliance on welfare benefits, while necessary, conferred a stigmatised identity that compounded the disruption wrought by cancer. While stigma occurs at the individual level, the structural dimensions of stigma need to be acknowledged in order to analyse the forces that cause, maintain and perpetuate the stigma associated with claiming welfare while ill. We conclude that current UK policies and welfare reforms to reduce sickness-related welfare claims will lead to greater hardship during periods of ill health and increase inequalities.
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Affiliation(s)
| | - Emma Noble
- Institute of Health and Society, Newcastle University, UK
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26
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Baker P, Beesley H, Fletcher I, Ablett J, Holcombe C, Salmon P. ‘Getting back to normal’ or ‘a new type of normal’? A qualitative study of patients' responses to the existential threat of cancer. Eur J Cancer Care (Engl) 2014; 25:180-9. [DOI: 10.1111/ecc.12274] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/04/2014] [Indexed: 11/30/2022]
Affiliation(s)
- P. Baker
- Clinical and Health Psychology Section; School of Psychological Sciences; University of Manchester; Manchester UK
| | - H. Beesley
- Royal Liverpool and Broadgreen University Hospital NHS Trust; Liverpool UK
| | - I. Fletcher
- Division of Health Research; University of Lancaster; Lancaster UK
| | - J. Ablett
- Royal Liverpool and Broadgreen University Hospital NHS Trust; Liverpool UK
| | - C. Holcombe
- Royal Liverpool and Broadgreen University Hospital NHS Trust; Liverpool UK
| | - P. Salmon
- Division of Clinical Psychology; University of Liverpool; Liverpool UK
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López YAA, Trad LAB. ["Before and after CML": illness experiences and dimensions of chronic myeloid leukemia as a biographical disruption]. CAD SAUDE PUBLICA 2014; 30:2199-208. [PMID: 25388322 DOI: 10.1590/0102-311x00171613] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2013] [Accepted: 03/18/2014] [Indexed: 11/22/2022] Open
Abstract
This article examines the illness experiences of patients with chronic myeloid leukemia (CML), focusing on dimensions that link the onset of the disease as a biographical disruption. This qualitative study was based on analysis of narratives by six patients 23 to 62 years of age who were users of the Brazilian Unified National Health System (SUS) and patients at a referral hospital for hematological care in Salvador, Bahia State, Brazil. The results reveal the experience of disruption in three categories: (1) the meanings of illness and CML as life-threatening, (2) physical and social disruption and stigmatizing experiences, and (3) the "before-and-after" perception of CML, focusing on changes in self, social relations, and daily life. The article concludes that the biographical, social, and health-system impacts (considering the cost of medication) update and extend issues such as access to treatment and confronting certainty and uncertainty, where patients struggle to draw on their everyday knowledge to deal with what is "known" about CML.
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Stapleton S, Pattison N. The lived experience of men with advanced cancer in relation to their perceptions of masculinity: a qualitative phenomenological study. J Clin Nurs 2014; 24:1069-78. [PMID: 25319948 DOI: 10.1111/jocn.12713] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/08/2014] [Indexed: 11/27/2022]
Abstract
AIMS AND OBJECTIVES The aim of this exploratory research was to understand how men experience their advanced cancer in relation to their perceptions of masculinity. BACKGROUND There are differences in the way men and women experience illness and health care. There are inequalities in incidence and morbidities of many diseases as well as differences in rates of help-seeking behaviours. Theories on masculinity offer some explanation towards this. Men's experiences of advanced cancer in relation to masculinity are under reported, published literature suggests that there are certain issues or men dealing with advanced disease that justify investigation. DESIGN A Qualitative approach using a Husserlian Phenomenological design was conducted. SAMPLE Eight men (aged 26-68) all with advanced cancer, defined as advanced or metastatic disease for which the patient had exhausted all standard therapeutic options. METHODS In-depth interviews were conducted to capture narratives of the experiences of men. Data were analysed using Colaizzi's seven stage framework. RESULTS Themes included thwarted ambition, changing expectations, protection and provision, stoicism and coping, images of illness versus images of masculinity, importance of being a fighter and loss. CONCLUSION Findings showed that the experiences of these men were complex and should be handled sensitively. Ideas for gender-specific interventions and further research were developed from the findings in relation to current literature. RELEVANCE TO CLINICAL PRACTICE A better understanding and awareness of this in this context will help nurses to consider more subtle challenges that these patients may be dealing with that in turn could affect how they cope with the burden of cancer.
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Love B, Thompson CM, Knapp J. The need to be Superman: the psychosocial support challenges of young men affected by cancer. Oncol Nurs Forum 2014; 41:E21-7. [PMID: 24368249 DOI: 10.1188/14.onf.e21-e27] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE/OBJECTIVES To investigate how gender-specific issues shape the experiences of young adult men with cancer and what they report to be problematic. RESEARCH APPROACH A qualitative, descriptive approach. SETTING Website, focus group in the southwestern United States, and phone interviews throughout the United States. PARTICIPANTS Text from an online forum (N=3,000 posts), focus group of six men, and separate interviews with four men. METHODOLOGIC APPROACH Data analysis took place over two months through constant comparison of online text as well as a focus group and interview transcripts. FINDINGS Men face challenges being both a receiver and provider of support in relationships with their peers, romantic partners, and children. Cultural expectations to "be strong" drive their support-seeking beliefs and behaviors. CONCLUSIONS Men report conflict between desires to show strength and to be honest that present a barrier to support, as well as contribute to inadequate relationships with male peers and greater difficulty in exchanging support with romantic partners. INTERPRETATION The authors identified attitudes about and barriers to men's experiences with social support, which healthcare providers, such as nurses, should be sensitive to when developing and providing support.
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Affiliation(s)
- Brad Love
- Department of Advertising and Public Relations, University of Texas in Austin
| | | | - Jessica Knapp
- Department of Communication Studies, University of Texas
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30
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Cunningham N, Cunningham T. Women's experiences of infertility - towards a relational model of care. J Clin Nurs 2013; 22:3428-37. [DOI: 10.1111/jocn.12338] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/27/2013] [Indexed: 11/30/2022]
Affiliation(s)
- Nicola Cunningham
- School of Nursing, Midwifery and Health; University of Stirling; Stirling UK
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Klimmek R, Wenzel J. Adaptation of the illness trajectory framework to describe the work of transitional cancer survivorship. Oncol Nurs Forum 2013; 39:E499-510. [PMID: 23107863 DOI: 10.1188/12.onf.e499-e510] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
PURPOSE/OBJECTIVES To examine and refine the Illness Trajectory Framework, and to address transitional cancer survivorship. DATA SOURCES CINAHL®, PubMed, and relevant Institute of Medicine reports were searched for survivors' experiences during the year following treatment. DATA SYNTHESIS Using an abstraction tool, 68 articles were selected from the initial search (N > 700). Abstracted data were placed into a priori categories refined according to recommended procedures for theory derivation, followed by expert review. CONCLUSIONS Derivation resulted in a framework describing the work of transitional cancer survivorship, defined as survivor tasks, performed alone or with others, to carry out a plan of action for managing one or more aspects of life following primary cancer treatment. Theoretically, survivors engage in three reciprocally interactive lines of work: (a) illness-related, (b) biographical, and (c) everyday life work. Adaptation resulted in refinement of these domains and the addition of survivorship care planning under "illness-related work." IMPLICATIONS FOR NURSING Understanding this process of work may allow survivors and those who support them to better prepare for the post-treatment period. This adaptation provides a framework for future testing and development. Validity and utility of this framework within specific survivor populations also should be explored.
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Affiliation(s)
- Rachel Klimmek
- School of Nursing, Johns Hopkins University, Baltimore, MD, USA.
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Wenger LM. 'Living under assault': men making sense of cancer. Eur J Cancer Care (Engl) 2013; 22:389-99. [PMID: 23350656 DOI: 10.1111/ecc.12042] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/18/2012] [Indexed: 11/27/2022]
Abstract
In accepting illness as a subjective experience, there is value in examining how individuals perceive, interpret and understand its challenges, knowledge critical to understanding patterns of response. Although researchers have considered how prostate cancer can challenge 'embodied masculinities' few studies have considered gendered dynamics in men's cancer experiences more broadly. This article helps attends to this gap by examining how men with a variety of cancers made sense of the challenges of their illness. The results, part of a grounded theory study including 30 Canadian adult men, highlight how the men perceived a troubled future and a discordant present, a profound sense of uncertainty, and feelings of isolation. These patterns, infused with societal expectations for male bodies and lives, move beyond the particular needs varying by medical, demographic and situational diversities. More specifically, they are recognised as consistent with a 'biographical disruption' or an ongoing problematic situation destabilising how the men made sense of their individual selves and the world around them. Focused on commonalities and considerate of diversities, findings are reviewed in relation to existing work on illness and gender identity and work specific to men with cancer. Implications are discussed.
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Affiliation(s)
- L M Wenger
- School of Nursing, University of British Columbia, Vancouver, British Columbia, Canada.
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33
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Brunton L, Booker J, Molassiotis A. Making sense of symptoms in men with prostate cancer: a longitudinal qualitative exploration. INTERNATIONAL JOURNAL OF UROLOGICAL NURSING 2012. [DOI: 10.1111/j.1749-771x.2012.01150.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Blows E, Bird L, Seymour J, Cox K. Liminality as a framework for understanding the experience of cancer survivorship: a literature review. J Adv Nurs 2012; 68:2155-64. [DOI: 10.1111/j.1365-2648.2012.05995.x] [Citation(s) in RCA: 65] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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35
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Hubbard G, Forbat L. Cancer as biographical disruption: constructions of living with cancer. Support Care Cancer 2011; 20:2033-40. [DOI: 10.1007/s00520-011-1311-9] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2011] [Accepted: 11/01/2011] [Indexed: 11/25/2022]
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36
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Carlander I, Ternestedt BM, Sahlberg-Blom E, Hellström I, Sandberg J. Four aspects of self-image close to death at home. Int J Qual Stud Health Well-being 2011; 6:10.3402/qhw.v6i2.5931. [PMID: 21526139 PMCID: PMC3082294 DOI: 10.3402/qhw.v6i2.5931] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/28/2011] [Indexed: 11/23/2022] Open
Abstract
Living close to death means an inevitable confrontation with one's own existential limitation. In this article, we argue that everyday life close to death embodies an identity work in progress. We used a narrative approach and a holistic-content reading to analyze 12 interviews conducted with three persons close to death. By illuminating the unique stories and identifying patterns among the participants' narratives, we found four themes exemplifying important aspects of the identity work related to everyday life close to death. Two of the themes, named "Inside and outside of me" and "Searching for togetherness," represented the core of the self-image and were framed by the other themes, "My place in space" and "My death and my time." Our findings elucidate the way the individual stories moved between the past, the present, and the future. This study challenges the idea that everyday life close to impending death primarily means limitations. The findings show that the search for meaning, new knowledge, and community can form a part of a conscious and ongoing identity work close to death.
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Affiliation(s)
- Ida Carlander
- Division of Nursing, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
- Department of Palliative Care Research, Ersta Sköndal University College, Stockholm, Sweden
| | - Britt-Marie Ternestedt
- Division of Nursing, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
- Department of Palliative Care Research, Ersta Sköndal University College, Stockholm, Sweden
- Research and Development Unit, Stockholm Sjukhem Foundation, Stockholm, Sweden
| | - Eva Sahlberg-Blom
- School of Health and Medical Sciences Örebro University, Örebro, Sweden
| | - Ingrid Hellström
- Department of Social and Welfare Studies, Linköping University, Norrköping, Sweden
| | - Jonas Sandberg
- Department of Palliative Care Research, Ersta Sköndal University College, Stockholm, Sweden
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Anderson M, Elam G, Gerver S, Solarin I, Fenton K, Easterbrook P. “It took a piece of me”: initial responses to a positive HIV diagnosis by Caribbean people in the UK. AIDS Care 2010; 22:1493-8. [DOI: 10.1080/09540121.2010.482125] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Moji Anderson
- a Department of Sociology, Psychology and Social Work , University of the West Indies , Mona , Kingston , Jamaica
| | - Gillian Elam
- b Centre for Sexual Health and HIV Research , University College London , London , UK
| | - Sarah Gerver
- c Department of Infectious Disease Epidemiology , Imperial College London , London , UK
| | - Ijeoma Solarin
- d Reproductive Health Research Unit , University of Witswatersrand , Johannesburg , South Africa
| | - Kevin Fenton
- e National Center for HIV/AIDS, Viral Hepatitis, STD and TB Prevention , Centers for Disease Control and Prevention , Atlanta , GA , USA
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