The experiences and needs of couples affected by prostate cancer aged 65 and under: a qualitative study

The lived experience of prostate cancer: 10-year survivor perspectives following contemporary treatment of localized prostate cancer

PURPOSE

Studies relying on standardized instruments to measure patient-centered harms and benefits of cancer treatment may fail to capture important elements of the lived experience of cancer patients. Further, qualitative studies on the survivorship experience of men with localized prostate cancer (PCa) are limited. We sought to explore the early experience, long-term experience, and advice provided for others among long-term survivors of localized PCa.

METHODS

Semi-structured qualitative interviews with a subset (n = 66) of respondents to a survey of 10-year PCa survivors who underwent active surveillance, radical prostatectomy, or radiotherapy. Topics included early and long-term experiences and advice to other men and physicians.

RESULTS

Immediately after treatment, men were mostly satisfied with radiation and active surveillance due to remaining whole and avoiding surgical removal of the prostate. Meanwhile, men treated with surgery felt relieved by the removal of cancer. Some early negative perception was related to short-term anxiety, particularly among men who underwent active surveillance. Long-term experiences included accepting the trade-offs of urinary and sexual side effects with survival. Most men fared well financially, some had strengthened relationships, and many reported greater appreciation and compassion. Men provided essential advice to other men and physicians on the importance of gathering detailed information on treatments and establishing a strong relationship with physicians.

CONCLUSIONS

Long-term survivors of localized PCa generally do well by accepting the long-term effects of contemporary treatments, experiencing strengthened relationships, and developing a better overall life approach.

IMPLICATIONS FOR CANCER SURVIVORS

We provide useful perspectives and insights for men opting to use current-day treatments for localized PCa.

The Experiences and Perspectives of Persons with Prostate Cancer and Their Partners: A Qualitative Evidence Synthesis Using Meta-Ethnography

Prostate cancer affects one in nine men, so understanding patients' and their partners experiences is crucial for developing effective treatments. The purpose of this review was to synthesis and report the experiences and views of persons with prostate cancer and their partners.

METHODS

A qualitative evidence synthesis (QES) was conducted following the eMERGe reporting guideline. Six databases were searched for the relevant literature, and the Critical Appraisal Skills Program (CASP) tool was used for quality appraisal.

RESULTS

A total of 1372 papers were identified, and 36 met the inclusion criteria. Four themes emerged: quality of life, relationships and dynamics, treatment journey and survivorship and aftercare.

CONCLUSIONS

Prostate cancer's impact on patients and partners is significant, requiring comprehensive support, holistic care, tailored assistance, and research into therapies to minimize adverse effects and address emotional distress and relationship strain. Prostate cancer treatment causes physical changes, triggering feelings of loss and grief, and affects coping mechanisms. Drawing on emotional support and education is vital for boosting confidence and resilience, as many patients and partners face fears of recurrence and lifestyle changes, highlighting the need for tailored information and presurgery support.

Are couple-based psychological interventions beneficial for the mental health of prostate cancer patients and their spouses? A systematic review and meta-analysis

As the survival rates for prostate cancer (PCa) have improved, there has been an increasing focus on the mental health of couples affected by this condition. There have been several couple-based psychological interventions, and yet the impact of this treatment modality on the mental health of PCa patients and their spouses is unclear. Consequently, a systematic search was conducted in PubMed, Embase, Cochrane, LILACS, and Web of Science up to March 2023 for randomized controlled trials (RCTs) addressing the impacts of couple-based psychological interventions on both PCa patients and their spouses. Besides, the Cochrane Risk of Bias Assessment Tool was employed to evaluate the methodological quality and potential bias of the included studies. Moreover, statistical analysis and meta-analysis were performed utilizing Revman 5.4, and the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) was employed to assess the certainty of evidence. A total of nine RCTs were included, utilizing anxiety, depression, distress, communication, and self-efficacy as outcome indicators to assess mental health. Results demonstrated that couple-based psychological interventions increased spouses' self-efficacy (WMD, 0.21; 95% CI: -0.00 ~ 0.42; P = 0.05) and communication (SMD, 0.34; 95% CI: 0.09 ~ 0.59; P = 0.009), while reducing their distress (SMD, -0.21; 95% CI: -0.40 ~ -0.02; P = 0.03). Nonetheless, there is a need for additional research on the effect of couple-based psychological interventions on the mental health of PCa-affected couples given the limited evidence supporting this conclusion.

Care needs of Japanese men for sexual dysfunction associated with prostate cancer treatment

PURPOSE

Prostate cancer (PC) treatment causes sexual dysfunction (SD) and alters fertility, male identity, and intimate relationships with partners. In Japan, little attention has been paid to the importance of providing care for SD associated with PC treatment. This study is aimed at clarifying the care needs of Japanese men regarding SD associated with PC treatment.

METHODS

One-to-one semi-structured interviews were conducted with 44 PC patients to identify their care needs. Data were analyzed using thematic analysis.

RESULTS

Four core categories emerged from the analysis. (1) "Need for empathy from medical staff regarding fear of SD": patients had difficulty confiding in others about their sexual problems, and medical staff involvement in their SD issues was lacking. (2) "Need for information that provides an accurate understanding of SD and coping strategies before deciding on treatment": lack of information about SD in daily life and difficulty understanding information from medical institutions, caused men to regret their treatment. (3) "Need for professional care for individuals and couples affected by SD": men faced loss of intimacy because of their partners' unwillingness to understand their SD issues or tolerate non-sexual relationships. (4) "Need for an environment that facilitates interaction among men to resolve SD issues": men felt lonely and wanted to interact with other patients about their SD concerns.

CONCLUSION

These findings may help form care strategies tailored to these needs and applicable to other societies with strong traditional gender norms.

A qualitative study about colorectal cancer patients and spousal caregivers' experience and needs during COVID-19: implications for self-efficacy intervention

Objective

This study aims to understand the experiences of colorectal cancer (CRC) patients and their spousal caregivers during the COVID-19 pandemic and to refine a self-efficacy (SE) intervention for these couples.

Methods

A descriptive phenomenological approach was used in this study. Data were collected from 11 CRC couples. All interviews were recorded, transcribed, and analyzed using the Colaizzi strategy.

Results

Three themes and eight subthemes emerged: (1) Get and contribute support, (2) Life's challenges, and (3) Journey of reconstruction. The CRC couples encountered escalating challenges in coping with cancer during COVID-19. At the same time, they have received considerable support and developed confidence in rebuilding themselves in the process. Healthcare providers are advised to focus on giving appropriate support to CRC couples, so they can go further.

Conclusions

This study gave insights into healthcare providers on the experiences of CRC couples and the development of SE intervention program to support these couples: (1) initially providing caregiving training for spousal caregivers and psychological support for patients, (2) encouraging self-care for CRC couples in the middle stage, (3) guiding them to view life positively in the later stage, and (4) assessing their situation in time to identify their needs and to provide support. Healthcare providers are recommended to increase flexibility in the SE intervention program delivery format to reduce the impact of COVID-19 on CRC couples.

The impact of radical prostatectomy on the social well-being of prostate cancer survivors: A qualitative meta-synthesis

INTRODUCTION

The impact of radical prostatectomy on the social well-being of survivors remains poorly understood. This meta-synthesis therefore aimed to integrate the findings of qualitative research evaluating the impact of surgery on the patient relationships with partners, family and wider societal interactions.

METHODS

Medline, CINAHL, PsycINFO and Embase were searched for qualitative studies evaluating social well-being dimensions. A thematic meta-synthesis was conducted to inductively construct descriptive themes and overarching analytical themes.

RESULTS

Thirty-one articles were included, with seven descriptive themes under two analytical themes generated to describe the experiences of 469 participants. 'Pathway to Conversion' encompassed three themes on the evolving social behaviour of men with both partners and family to adapt to their new normality postoperatively. 'A Man on My Own' discussed four themes focussing on both intimate and wider social relations, describing the stigma, shame and embarrassment felt by patients due to changes in their perceived body image and physical function. This resulted in men feeling alone, unsupported and seeking isolation.

CONCLUSION

Radical prostatectomy's impact on survivors' social well-being extends beyond surgery and causes a shift in their relationship dynamics with partner and family, highlighting the importance of preoperative and postoperative clinician's counselling to both patient and partner.

Sexual dysfunction associated with prostate cancer treatment in Japanese men: a qualitative research

Purpose

We investigated the experiences of Japanese men with sexual dysfunction associated with various prostate cancer treatments.

Methods

We included 38 Japanese men who underwent the following initial treatments for prostate cancer: radical prostatectomy (n = 10), external beam radiotherapy (n = 12), brachytherapy (n = 5), and androgen deprivation therapy (n = 11). Semi-structured interviews were conducted regarding sexual dysfunction associated with prostate cancer treatment. Data were analyzed using a content analysis method. To obtain a unique experience for each treatment, we confirmed and organized the treatment method from which the code that constituted each category was derived. The category reliability was calculated based on Scott’s formula for the matching rate of the classification by three qualitative researchers. The criterion for good reliability was set at 70%.

Results

Japanese men with sexual dysfunction associated with prostate cancer treatments experienced the following: a desire to maintain sexual function and conflict in decision-making concerning the initial treatment for prostate cancer; a loss of values related to sexual dysfunction; an uncertainty regarding the consequences of sexual dysfunction; a sense of calm with fewer adverse effects of sexual dysfunction at the early treatment stage; an effort to accept sexual dysfunction; and management of their changed body at the later treatment stages. The concordance rates for the categories were 70% and 78%. Additionally, there were glimpses of experiences common to all treatments and trends in treatment-specific experiences.

Conclusion

It is necessary to provide care based on the experience of Japanese men with sexual dysfunction after prostate cancer treatment.

Men's experiences of sex and intimacy after prostate cancer treatment in China: a qualitative study

Purpose

While the existing knowledge base on the impact of prostate cancer (PC) and its treatment on sexuality and intimacy has been generated from Western populations, there is a lack of such evidence in the Asian context. This study aimed to explore men’s experiences of sex and intimacy after PC treatment in China.

Methods

This study adopted an interpretive descriptive design. Using purposive sampling, 13 PC patients were selected from a urology outpatient unit of a hospital in South China and proceeded with individual semi-structured telephone interviews. Each interview was transcribed verbatim and analyzed using constant comparison analysis.

Results

Four themes emerged from the interview data, including (a) encountering altered sexuality, (b) communication and sexual adjustments, (c) maintenance of quality intimate relationship, and (d) lack of sexual health support.

Conclusions

The findings revealed that PC treatment significantly impaired patients’ sexual functions, and their sexual health needs were mainly unmet by healthcare providers. There is a great need to design culturally relevant interventions to improve sexual health among this population.

Supplementary Information

The online version contains supplementary material available at 10.1007/s00520-021-06720-w.

Using the Framework Method for the Analysis of Qualitative Dyadic Data in Health Research

There are an increasing number of qualitative studies which focus on the dyad (couples, families, caregivers-patients, health care professionals-patients). However, there is limited literature regarding qualitative methodology for dyadic analysis when members of the couple have been interviewed separately. The aim of this article is to share the knowledge we gained from undertaking a novel approach to dyadic analysis. We used an adapted version of the Framework method on data gathered in a study exploring the impact of prostate cancer on younger men and their partners. In this article, we examine and reflect on the challenges of this type of analysis and describe how we analyzed the interview data from a dyadic point of view, to share what we learned in the process.