Men's experiences following laparoscopic radical prostatectomy: a qualitative descriptive study

Prostate Cancer Related Sexual Dysfunction and Barriers to Help Seeking: A Scoping Review

OBJECTIVE

Despite available support, sexuality needs are the most frequently reported unmet need among men with prostate cancer, which may be due to low help-seeking rates. Using the Ecological Systems Framework as a theoretical foundation, we conducted a scoping review of the available literature to understand what factors impact help-seeking behaviour for sexual issues after prostate cancer treatment among men who had received treatment.

METHODS

Following PRISMA guidelines, a systematic search on Medline, PsychInfo, Embase, Emcare, and Scopus was conducted to identify studies of adult prostate cancer patients post-treatment, which reported barriers and/or facilitators to help-seeking for sexual health issues. Quality appraisals were conducted using Joanna Briggs Institute appraisal tools, and results were qualitatively synthesised.

RESULTS

Of the 3870 unique results, only 30 studies met inclusion criteria. In general, studies were considered moderate to good quality, though only six used standardised measures to assess help-seeking behaviour. Barriers and facilitators for sexual help-seeking were identified across all five levels of the Ecological Systems Framework, including age, treatment type, and previous help seeking experience (individual level), healthcare professional communication and partner support (microsystem), financial cost and accessibility of support (meso/exosystem), and finally embarrassment, masculinity, cultural norms, and sexuality minority (macrosystem).

CONCLUSIONS

Addressing commonly reported barriers (and inversely, enhancing facilitators) to help-seeking for sexual issues is essential to ensure patients are appropriately supported. Based on our results, we recommend healthcare professionals include sexual wellbeing discussions as standard care for all prostate cancer patients, regardless of treatment received, age, sexual orientation, and partnership status/involvement.

Exploring the Hidden Struggles: A Qualitative Insight into Urinary Incontinence Among Prostate Cancer Survivors Post-Surgery

Objective

This study aimed to explore the experiences and challenges of prostate cancer patients suffering from urinary incontinence following radical prostatectomy.

Methods

A descriptive qualitative research design was employed. Purposeful sampling was used to select 22 prostate cancer patients who underwent radical prostatectomy and experienced urinary incontinence after surgery. These patients were interviewed between August to October 2023 at a tertiary B-grade hospital's pelvic floor center in Shanghai. The data were collected through semi-structured in-depth interviews and analyzed using content analysis to identify and refine themes.

Results

The experiences of urinary incontinence in patients can be categorized into four main themes: (1) Daily life disturbances (including 4 sub-themes: sleep disorders, fluid intake restriction, travel inconvenience, loss of sexual life); (2) Negative emotional experiences (including 4 sub-themes: perceived discrimination, concerns about recovery, loss of confidence in life, doubts about the surgical decision); (3) Social withdrawal (including 2 sub-themes: reduced desire for social interaction, decreased ability to socialize); (4) Limited support obtained (including 4 sub-themes: reliance on personal experience, seeking help from relatives and friends, difficulty discerning online information, lack of professional guidance).

Conclusion

Postoperative urinary incontinence in prostate cancer patients presents a multidimensional experience. Healthcare professionals need to pay attention to these patients' daily life, psychological state, and social interactions. Integrating various resources to provide professional support and rehabilitation guidance is crucial.

Treatment burden in individuals living with and beyond cancer: A systematic review of qualitative literature

BACKGROUND

Individuals with cancer are being given increasing responsibility for the self-management of their health and illness. In other chronic diseases, individuals who experience treatment burden are at risk of poorer health outcomes. Less is known about treatment burden and its impact on individuals with cancer. This systematic review investigated perceptions of treatment burden in individuals living with and beyond cancer.

METHODS AND FINDINGS

Medline, CINAHL and EMBASE databases were searched for qualitative studies that explored treatment burden in individuals with a diagnosis of breast, prostate, colorectal, or lung cancer at any stage of their diagnostic/treatment trajectory. Descriptive and thematic analyses were conducted. Study quality was assessed using a modified CASP checklist. The review protocol was registered on PROSPERO (CRD42021145601). Forty-eight studies were included. Health management after cancer involved cognitive, practical, and relational work for patients. Individuals were motivated to perform health management work to improve life-expectancy, manage symptoms, and regain a sense of normality. Performing health care work could be empowering and gave individuals a sense of control. Treatment burden occurred when there was a mismatch between the resources needed for health management and their availability. Individuals with chronic and severe symptoms, financial challenges, language barriers, and limited social support are particularly at risk of treatment burden. For those with advanced cancer, consumption of time and energy by health care work is a significant burden.

CONCLUSION

Treatment burden could be an important mediator of inequities in cancer outcomes. Many of the factors leading to treatment burden in individuals with cancer are potentially modifiable. Clinicians should consider carefully what they are asking or expecting patients to do, and the resources required, including how much patient time will be consumed.

Assessment of an evidence-based laryngeal cancer fact sheet: A mixed methods study

To evaluate perceptions of a laryngeal cancer fact sheet amongst people with direct experience of the disease and its treatment. A mixed methods study (questionnaire and interview) evaluating the information resource was conducted across two institutions. In total 20 participants responded to the questionnaire. Overall participants reported the information resource was detailed and understandable. Insufficient information was provided on: impact on family in eight participants (40%); impact on work in six (33%); and, second opinions and long-term side effects in five (25%). The majority (67%) wanted a large amount of information with the preferred source being one-on-one meetings with their doctor. The thematic analysis identified three main themes: preferences for information, self-management; and, information sources. People with direct experience of laryngeal cancer and its treatments reported the information resource was comprehensive and clear. There were some gaps in the information provided, particularly related to survivorship issues.

Reformulating the Worker Identity: Men's Experiences After Radical Prostatectomy

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.

Men's perceptions of the impact of the physical consequences of a radical prostatectomy on their quality of life: a qualitative systematic review

OBJECTIVE

To identify men's perceptions of the impact of the physical consequences of a radical prostatectomy on their quality of life.

INTRODUCTION

Prostate cancer is the most common male cancer and second most common cause of cancer death of men in the Western world. Compared to other prostate cancer treatments, trials report worse urinary incontinence and sexual function and similar bowel function among men with prostate-specific antigen detected prostate cancer who underwent radicalized prostatectomy.

INCLUSION CRITERIA

This review included men of all ages and nationalities who had undergone a radical prostatectomy as treatment for any stage of prostate cancer. It considered studies that investigated:Any setting where the topic was addressed with participants meeting the inclusion criteria was included. The review considered studies that focused on qualitative data including, but not limited to: phenomenology, grounded theory, ethnography and action research. Studies were included if they reported results relating to one or more of the phenomena of interest. Studies not written in English were excluded.

METHODS

The search strategy aimed to find published studies from six databases from database inception to November 2017. Methodological quality of studies was independently assessed by two reviewers using the standardized JBI Critical Appraisal Checklist for Qualitative Research. For data extraction, the standardized Joanna Briggs Institute System for the Unified Management, Assessment and Review of Information (JBI SUMARI) data extraction tool was used. A meta-aggregation was undertaken and the final synthesis of the findings was reached through discussion. Results are presented as five aggregated qualitative syntheses.

RESULTS

Nineteen qualitative studies were included in the review. The five synthesized findings were: CONCLUSIONS:: Urinary incontinence and erectile dysfunction are significant side-effects of radical prostatectomy which have a negative impact on men's quality of life for which they feel ill prepared, and physical and psychosocial support is essential.

Development of an ICF-based questionnaire for urinary and/or fecal incontinence (ICF-IAF): The male patients' perspective using focus groups

AIMS

This study seeks to explore barriers faced by and resources available to male patients with urinary (UI) and/or fecal incontinence (FI) based on the ICF framework. As a result, this study contributes to the development of the ICF-Incontinence Assessment Form (ICF-IAF), which is designed to be a standardized planning and evaluation tool for interventions in a multidisciplinary setting.

METHODS

A mixed-method sequential design that places emphasis on the quantitative approach was considered appropriate for this study. Focus group interviews (FG) were chosen to collect data. Data were analysed with deductive content analysis and themes identified during FG were linked to the most corresponding ICF categories by two raters. Cohen's κ was calculated to determine interrater reliability.

RESULTS

Four FG were conducted with a total of 13 male participants. The mean age of the participants was 74.7 years. A total of 73 barriers and resources on the second ICF level (body functions 26, body structures five, activities and participation 26 and environmental factors 16), whereby four categories were not sufficiently covered by the ICF, could be identified. The κ score for the two raters was 0.82.

CONCLUSIONS

While barriers are fundamental factors affecting patients, this study found that resources are as important and should not be overlooked in the conventional treatment in both UI and FI-specific assessments.

Men's experiences after prostatectomy: A meta-synthesis

OBJECTIVE

The purpose of this review was to critically analyze, interpret, and synthesize the literature on men's experiences after prostatectomy.

DESIGN

A meta-synthesis was conducted.

DATA SOURCES

Six databases (PubMed, EMBASE, CINAHL, PsycINFO, AgeLine, and Sociological Abstract) were searched from the earliest year to 2016. From initial searches with main keywords (prostatectomy and qualitative study), 642 abstracts were retrieved. Based on inclusion criteria (English-language published qualitative study focusing on the experience of men after prostatectomy), this meta-synthesis included 15 studies.

REVIEW METHODS

Components of meta-study (meta-data-analysis, meta-method, and meta-theory) were employed to analyze, interpret, and synthesize the results of included studies. Three authors independently appraised the methodological quality of the included studies using a combined appraisal tool (The Critical Appraisal Skills Programme Qualitative Research Checklist and Paterson et al.'s Primary Research Appraisal Tool). The Enhancing Transparency in Reporting the Synthesis of Qualitative Research Statement was used to strengthen the completeness of reporting.

RESULTS

Fifteen studies met inclusion criteria and quality appraisal guidelines, however, most did not identify or relate their findings to theory. Through meta-synthesis, five themes emerged: facing a life-changing situation, experiencing changes and their impact, striving to manage and adjust to changes, coping with masculinity, and anticipating the future.

CONCLUSIONS

After prostatectomy, men experienced physical, psychological, and social changes. Many men are physically and psychologically ill-prepared and suffer from lack of information and support. Health care providers need to be sensitive to men's needs including perceptions of masculinity, realize the importance of support as an essential component of men's adaptation post-prostatectomy, and provide comprehensive and individualized patient-centered interventions. Future studies need to use rigorous research methods, clearly identify methodological approaches, and consider employing or developing theory.

Developing and evaluating Robocare; an innovative, nurse-led robotic prostatectomy care pathway

PURPOSE

A Robotic Prostatectomy Care Pathway ("Robocare"), aiming to prepare men for robotic-assisted radical prostatectomy (RARP) and manage side-effects and long-term follow-up in a multidisciplinary fashion was established. The pathway enhances patient care by providing adequate information and support and optimizes efficiency by reducing length of stay and minimizing hospital visits. Our study assesses the pathway for patient satisfaction, co-ordination of care between disciplines, length of stay and readmission rates.

METHOD

We analysed our database of all patients undergoing RARP with Robocare between July 2012 and December 2013 at Peter MacCallum Cancer Centre, Australia (PMCC). Compliance, Length of Stay and Postoperative Course were analysed. Patient satisfaction was assessed.

RESULTS

Overall 124 patients underwent RARP with 105 (85%) being discharged day 1 post-op (mean 1.3 days). Post-operative support phone calls were received by >95% of patients. Thereafter, 74 patients (60%) were followed in the long-term follow-up phone clinic. Twenty-nine complications were identified of which 19 (66%) were resolved by the nurse specialist. Eighteen patients had psychologist, 44 sexual health and 44 physiotherapist referral. Patient satisfaction in 74 (60%) returned surveys revealed 71 (96%) being well/very well supported.

CONCLUSIONS

The Robocare pathway is safe with high patient satisfaction. It contributes to reducing post-operative length of stay and readmission rates as well as the outpatient follow-up. A true multidisciplinary approach that is nurse-led likely improves care and outcomes for RARP patients and may lower impact on hospital resources.

Canadian Men's Self-Management of Chronic Diseases: A Literature Analysis of Strategies for Dealing With Risks and Promoting Wellness

This article reviews the qualitative research on men's self-management of mental and physical chronic diseases, with emphasis on strategies for dealing with risks and promoting wellness. Using Bardin's method of document analysis, it was focused on the findings of Canadian qualitative studies published in French or English from 2005 to 2011. Boltanski's theory on social uses of the body inspired the analysis. Living with a chronic disease threatens men's sense of masculinity and self-image, as well as their perceived ability to fulfill expected social roles. Social images of men's bodies influence how men express their emotions, attributes, and attitudes, or acknowledge the need for and seek social affirmation. Self-management has been documented in Canadian qualitative literature as a complex phenomenon influenced by the social environment, personal capacities, feelings, perceptions, and potentials. The extent of how all these features interact within the scope of men's mental and physical health and illness experiences was partially revealed in this study. The findings underscore the social invisibility of men's bodies, especially those of men facing social inequities. Attending to principles of social justice can ensure that future research on men's health will amplify the range of men's voices and allow them to be heard. Recommendations address also the international scientific community interested in advancing men's health research, especially in those countries that lack a national men's health policy.

Men's experience with penile rehabilitation following radical prostatectomy: a qualitative study with the goal of informing a therapeutic intervention

BACKGROUND

Erectile rehabilitation (ER) following radical prostatectomy (RP) is considered an essential component to help men regain erectile functioning; however, many men have difficulty adhering to this type of program. This qualitative study explored men's experience with ER, erectile dysfunction (ED), and ED treatments to inform a psychological intervention designed to help men adhere to ER post-RP.

METHODS

Thirty men, 1-to-3-years post-RP, who took part in an ER program, participated in one of four focus groups. Thematic analysis was used to identify the primary themes.

RESULTS

Average age was 59 years (standard deviation = 7); mean time since surgery was 26 months (standard deviation = 6). Six primary themes emerged: (1) frustration with the lack of information about postsurgery ED; (2) negative emotional impact of ED and avoidance of sexual situations; (3) negative emotional experience with penile injections and barriers leading to avoidance; (4) the benefit of focusing on the long-term advantage of ER versus short-term anxiety; (5) using humor to help cope; and (6) the benefit of support from partners and peers.

CONCLUSIONS

Men's frustration surrounding ED can lead to avoidance of sexual situations and ED treatments, which negatively impact men's adherence to an ER program. The theoretical construct of acceptance and commitment therapy was used to place the themes into a framework to conceptualize the mechanisms underlying both avoidance and adherence in this population. As such, acceptance and commitment therapy has the potential to serve as a conceptual underpinning of a psychological intervention to help men reduce avoidance to penile injections and adhere to an ER program.

Prostate cancer and supportive care: a systematic review and qualitative synthesis of men's experiences and unmet needs

Prostate cancer is the second most common cancer in men worldwide, accounting for an estimated 1.1 million new cases diagnosed in 2012 (www.globocan.iarc.fr). Currently, there is a lack of specific guidance on supportive care for men with prostate cancer. This article describes a qualitative systematic review and synthesis examining men's experience of and need for supportive care. Seven databases were searched; 20 journal articles were identified and critically appraised. A thematic synthesis was conducted in which descriptive themes were drawn out of the data. These were peer support, support from partner, online support, cancer specialist nurse support, self‐care, communication with health professionals, unmet needs (emotional support, information needs, support for treatment‐induced side effects of incontinence and erectile dysfunction) and men's suggestions for improved delivery of supportive care. This was followed by the development of overarching analytic themes which were: uncertainty, reframing, and the timing of receiving treatment, information and support. Our results show that the most valued form of support men experienced following diagnosis was one‐to‐one peer support and support from partners. This review highlights the need for improved access to cancer specialist nurses throughout the care pathway, individually tailored supportive care and psychosexual support for treatment side effects.

Patient experiences at diagnosis and psychological well-being in prostate cancer: A Finnish national survey

PURPOSE

Most cases of prostate cancer are diagnosed at an early stage, and men live for many years after diagnosis. Thus, their well-being and quality of life are of great importance. This study investigated patient experiences and psychological well-being in a Finnish national sample of prostate cancer patients who received various types of treatment.

METHOD

In a national sample (50%) of prostate cancer patients diagnosed in Finland in 2004, information was collected on the patients' experiences at diagnosis and choice of treatment (e.g. treatment selection, patient satisfaction with care and information, psychological reactions). In 2009, participants were asked about their experiences, and psychological well-being (psychological symptoms, satisfaction with life) was measured. In total, 1239 completed questionnaires (73%) were accepted for the study. Differences between treatments and predictors of psychological well-being were investigated using descriptive statistics and regression analysis.

RESULTS

Half of the respondents were satisfied with the care and information they received about the cancer and side effects of treatment. Experiences and psychological well-being were most positive among patients who received brachytherapy and poorest among patients who received hormonal therapy. Patients who underwent prostatectomy or brachytherapy were most likely to have been involved in treatment selection. Negative experiences, such as learning of the diagnosis in an impersonal way and dissatisfaction with the information and care received, were predictive of poorer well-being.

CONCLUSIONS

Unmet supportive care and informational needs were common. Experiences and well-being varied between treatments. Patients tended to prefer prostatectomy and brachytherapy. Unmet needs, which would probably be reduced by improvements in care, appear to have a long-lasting impact on patients' psychological well-being.

The meaning of life and health experience for the Chinese elderly with chronic illness: a qualitative study from positive health philosophy

Ageing and the concurrent prevalence of chronic disease in older adults produce a great burden and challenge for family, society and individuals. There is a definite need to build the science about caring for older Chinese adults from their perspective to inform health-care professionals. The aim of the study was to investigate the meaning of life and health experience of Chinese elderly with chronic illness and identify health potential from a positive perspective. A qualitative descriptive study was undertaken to interview 11 older adults ages 64-92 in a day centre. In 2011, the data were collected and analysed by thematic analysis. Four interrelated themes indicated a rich meaning of life and health experience from the older adults: (i) happiness lies in contentment; (ii) sense of responsibility; (iii) letting nature take its course; (iv) and proactive self-balance. These interrelated themes with partial conflict presented a dialectic meaning of life and were interpreted from traditional Chinese culture and compared with positive health philosophy. The significance of finding will encourage nursing practice work with clients and identify the potential and self-help strength of the elderly.

Health care professionals' views on discussing sexual wellbeing with patients who have had a stroke: a qualitative study

Objectives

To examine the experiences of health care professionals discussing sexual wellbeing with patients who have had a stroke.

Design

In-depth qualitative interview study with purposive sampling and thematic analysis.

Participants

30 health care professionals purposively recruited to include different roles and settings along the stroke patient pathway in secondary and primary care.

Setting

Two hospitals and three general practices in the West Midlands, UK.

Results

Sexual wellbeing was a topic that participants did not raise with patients and was infrequently raised by patients. Barriers to raising discussion were on four levels: structural, health care professional, patient, and professional-patient interface. Barriers within these levels included: sexual wellbeing not present within hospital stroke policy; the perception that sexual wellbeing was not within participants' role; participants' concern that raising the issue could cause harm to the patient; and the views that discussion would be inappropriate with older people or unimportant to women. Resources exist to aid discussion but many participants were unaware of them, and most of those that were, did not use them routinely.

Conclusions

Participants lacked motivation, ownership, and the confidence and skills to raise sexual wellbeing routinely after stroke. Similar findings have been reported in cancer care and other taboo subjects such as incontinence potentially resulting in a sub-optimal experience for patients. Normalisation of the inclusion of sensitive topics in discussions post-stroke does not seem to need significant structural intervention and simple changes such as information provision and legitimisation through consideration of the issue in standard care policies may be all that is required. The experiences recounted by professionals in this study suggest that such changes are needed now.

The Influence of Family Ties on Men’s Prostate Cancer Screening, Biopsy, and Treatment Decisions

Extensive research has focused on understanding family dynamics of men with prostate cancer. However, little qualitative work has examined the role of family ties on men’s prostate cancer decisions across the spectrum of screening, diagnosis, and treatment. Using data from a larger study, we qualitatively explored the influence of family ties on men’s prostate cancer decisions. Semistructured interviews were conducted with men ages ≥50 ( N = 64), and data were analyzed using a grounded theory approach and a series of immersion/crystallization cycles. Three major themes of spousal/family member influence were identified: (a) spousal/family member alliance marked by open communication and shared decision making, (b) men who actively opposed spouse/family member pressure and made final decisions themselves, and (c) men who yielded to spouse/family member pressure. Our findings provide insights into men’s relational dynamics that are important to consider for the shared decision-making process across the prostate cancer spectrum.

A dialogue-based Web application enhances personalized access to healthcare professionals--an intervention study

BACKGROUND

In today's short stay hospital settings the contact time for patients is reduced. However, it seems to be more important for the patients that the healthcare professionals are easy to get in contact with during the whole course of treatment, and to have the opportunity to exchange information, as a basis for obtaining individualized information and support. Therefore, the aim was to explore the ability of a dialogue-based application to contribute to accessibility of the healthcare professionals and exchangeability of information.

METHOD

An application for online written and asynchronous contacts was developed, implemented in clinical practice, and evaluated. The qualitative effect of the online contact was explored using a Web-based survey comprised of open-ended questions.

RESULTS

Patients valued the online contacts and experienced feelings of partnership in dialogue, in a flexible and calm environment, which supported their ability to be active partners and feelings of freedom and security.

CONCLUSION

The online asynchronous written environment can contribute to accessibility and exchangeability, and add new possibilities for dialogues from which the patients can benefit. The individualized information obtained via online contact empowers the patients. The Internet-based contacts are a way to differentiate and expand the possibilities for contacts outside the few scheduled face-to-face hospital contacts.

Men's experience of erectile dysfunction after treatment for colorectal cancer: qualitative interview study

OBJECTIVES

To examine the experiences of men after treatment for colorectal cancer, identify barriers to accessing services, and suggest improvements to providing information in primary and secondary care.

DESIGN

Semistructured, qualitative interview study with purposive sampling and thematic analysis.

PARTICIPANTS

28 patients treated for colorectal cancer.

SETTING

West Midlands.

RESULTS

Most men treated for colorectal cancer experience erectile dysfunction as a consequence. Not all, however, want the same response from health professionals. Although, erectile dysfunction is profoundly stressful for most men, affecting self image, behaviour, and relationships, some do not regard it as a health priority. Many of the men were uninformed about erectile dysfunction and were unprepared for it, and the majority neither helped themselves nor asked for help. Almost none were receiving adequate, effective, and affordable care. Evidence of ageism was strong.

CONCLUSIONS

Unlike patients with prostate cancer, men with colorectal cancer are not routinely offered information and treatment for erectile dysfunction. Greater coordination of care and consistent strategies are needed to tackle the unmet needs of this widely diverse patient group. Currently, clinicians are inadvertently neglecting, misleading, and offending such patients; better training could improve this situation, as might the reorganisation of services. Further research is needed to determine whether trained clinical nurse specialists in colorectal cancer units could coordinate ongoing care.

Post-prostatectomy incontinence: implications for home health clinicians

Prostate cancer is the most frequently diagnosed cancer in men in the United States, often requiring a prostatectomy. Incontinence is an almost inevitable consequence of this surgery, either temporary or ongoing. It is important that this quality-of-life issue be considered preoperatively and that patients considering surgery have information about the potential for incontinence. Teaching about noninvasive management of incontinence can begin before surgery and continue in the postoperative period. Home healthcare clinicians and Wound, Ostomy and Continence (WOC) nurses can play a pivotal role in educating patients on the potential sequela of surgery and ways to prevent or treat these conservatively.

Cytoprotective effects of vitamin E homologues against glutamate-induced cell death in immature primary cortical neuron cultures: Tocopherols and tocotrienols exert similar effects by antioxidant function

Glutamate plays a critical role in pathological cell death within the nervous system. Vitamin E is known to protect cells from glutamate cytotoxicity, either by direct antioxidant action or by indirect nonantioxidant action. Further, α-tocotrienol (α-T3) has been reported to be more effective against glutamate-induced cytotoxicity than α-tocopherol (α-T). To shed more light on the function of vitamin E against glutamate toxicity, the protective effects of eight vitamin E homologues and related compounds, 2,2,5,7,8-pentamethyl-6-chromanol (PMC) and 2-carboxy-2,5,7,8-pentamethyl-6-chromanol (Trolox), against glutamate-induced cytotoxicity on immature primary cortical neurons were examined using different protocols. Glutamate induced the depletion of glutathione and generation of reactive oxygen species and lipid hydroperoxides, leading to cell death. α-, β-, γ-, and δ-T and -T3; PMC; and Trolox all exerted cytoprotective effects against glutamate-induced cytotoxicity, and a longer preincubation time increased both the cellular content and the cytoprotective effects of T more significantly than those of T3, the effect of preincubation being relatively small for T3 and PMC. The protective effect of Trolox was less potent than that of PMC. The cytoprotective effects of α-T and α-T3 corresponded to their intracellular content. Further, lipid peroxidation products were measured after reduction with triphenylphosphine followed by saponification with potassium hydroxide. It was found that glutamate treatment increased the formation of hydroxyeicosatetraenoic acid, hydroxyoctadecadienoic acid, and 8-F(2)-isoprostane 2α, which was suppressed by α-T. This study shows that vitamin E protects cells from glutamate-induced toxicity primarily by direct antioxidant action and that the apparent higher capacity of T3 compared to T is ascribed to the faster uptake of T3 compared to T into the cells. It is suggested that, considering the bioavailability, α-T should be more effective than α-T3 against glutamate toxicity in vivo.

Men's experiences of radical prostatectomy as treatment for prostate cancer

PURPOSE OF THE RESEARCH

The aim of this study was to provide a retrospective view of men's experiences of the prostate cancer treatment journey from initial diagnosis through to completion of their surgery and beyond.

METHOD AND SAMPLE

A qualitative, descriptive design was employed. A volunteer sample (n = 8) of men 15 years or less post radical prostatectomy was recruited through a prostate cancer support group M.A.C. (Men Against Cancer). Interviews were taped and transcribed verbatim. Data were analysed using qualitative thematic content analysis.

KEY RESULTS

Men identified a number of themes related to their prostate cancer diagnosis, subsequent surgery and life post surgery. These included the process of diagnosis, support, normalisation, the importance of information, defining moments and primary concerns.

CONCLUSIONS

Qualitative, descriptive research provides a platform for men to share their experiences of the prostate cancer journey. Healthcare professionals should be alert to the factors which patients consider important during their treatment trajectory. These qualitative interviews provide much needed knowledge in relation to men's experience of the prostate cancer treatment trajectory. In a healthcare system which increasingly values the 'patients view' this type of information is vital in order to tailor healthcare services to meet the unique needs of each patient.

Patient-centred care: What are the experiences of prostate cancer patients and their partners?

OBJECTIVE

To gain an in depth understanding of the experiences of care of men with prostate cancer and their partners.

METHODS

The study design was a qualitative analysis of semi-structured interviews of men (35) who had been diagnosed and treated for prostate cancer and their partners (10). They were recruited from two hospitals in the East Midlands of England and two charities.

RESULTS

The interviews showed that although there was no widespread dissatisfaction with care, patients reported problems throughout care. The two main problems were that throughout care patients' and partners' information needs were often not identified or met, and patients' preferred role in decision-making about testing and treatment was not explored.

CONCLUSIONS

If patients' experiences of prostate cancer care are to be improved, clinicians need to identify, and respond to, the information and decision-making needs of individual patients and their partners.

PRACTICE IMPLICATIONS

Clinicians should identify and meet the needs of patients individually, use appropriate language and formats for communicating information, fully prepare patients for tests, explore and meet the needs of patients for involvement in decision-making, and recognise the important role that their partner plays. Systems and pathways of care should be designed to enable patients and partners to obtain information and participate in decision-making throughout all stages of care.