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Rondanina G, Siri G, Marra D, DeCensi A. Effect of sex on psychological distress and fatigue over time in a prospective cohort of cancer survivors. J Cancer Surviv 2024; 18:586-595. [PMID: 36344904 DOI: 10.1007/s11764-022-01291-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Accepted: 11/01/2022] [Indexed: 11/09/2022]
Abstract
BACKGROUND Studies indicate a higher level of distress in women than men with cancer, but whether this difference is retained over time is unknown. We studied the frequency and level of distress and fatigue during time according to gender in a cohort of cancer survivors. PATIENTS AND METHODS In this prospective study, cancer survivors were invited to undergo a psychological session immediately before the medical visit. Distress was assessed by the distress thermometer, and fatigue was assessed by the ESAS-r scale. Patients underwent follow-up visits to assess changes over time. RESULTS A total of 305 patients and 568 visits were performed with a median follow-up of 15.8 months. At baseline, females, young age, and breast cancer patients had significantly higher distress. However, there was an increase in distress of 0.29 points every 6 months in males (95% CI, 0.09-0.50) versus no change in females (0.03 points, 95% CI, - 0.09-0.15; p-interaction = 0.01). The different behavior of cancer distress during time according to gender was more evident in subjects aged 68 or older due to increasing physical problems in men (p-interaction = 0.005). There was no change in fatigue with time according to sex. CONCLUSIONS Women, younger age, and breast cancer patients had increased cancer distress at the initial visit. However, women tend to stabilize during follow-up, whereas men tend to worsen their distress, especially because of physical and emotional problems, suggesting different coping capabilities. TRIAL REGISTRATION The study is registered at ClinicalTrials.gov NCT05122052. IMPLICATIONS FOR CANCER SURVIVORS Interventions aimed at improving recognition of emotions related to disease experience in male cancer survivors appear necessary.
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Affiliation(s)
- Gabriella Rondanina
- E.O. Ospedali Galliera, 16128, Genoa, Italy.
- Villa Serena Hospital, GVM, 16145, Genoa, Italy.
| | | | | | - Andrea DeCensi
- E.O. Ospedali Galliera, 16128, Genoa, Italy
- Villa Serena Hospital, GVM, 16145, Genoa, Italy
- Wolfson Institute of Preventive Medicine, Queen Mary University of London, London, UK
- European Institute of Oncology, IRCCS, 20141, Milan, Italy
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Myers JS, Manson A, Billinger SA, Hamilton-Reeves J, Parker W, Maliski SL. Staying Strong and Healthy During Androgen Deprivation Therapy. Cancer Nurs 2024; 47:43-55. [PMID: 35984916 PMCID: PMC10232673 DOI: 10.1097/ncc.0000000000001151] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
BACKGROUND Androgen deprivation therapy (ADT) for prostate cancer is associated with cardiovascular comorbidities and numerous adverse effects decreasing health-related quality of life. Both exercise and dietary interventions have shown promise in reducing ADT-related negative sequelae. However, feasibility for personalized combined exercise/nutrition/education interventions is not well established. OBJECTIVE The purpose of this randomized, controlled, mixed-methods pilot study was to evaluate the feasibility of a nurse-led, telephone-delivered education, exercise, and nutrition intervention, Staying Strong & Healthy, to minimize ADT-related cardiovascular/metabolic risks and symptoms. METHODS Staying Strong & Healthy involves individually tailored education, exercise (aerobic and resistance), and nutrition intervention delivered over 6 months and was compared with attention control. The primary quantitative outcome measure was change from baseline in low-density lipoprotein. Secondary outcomes included change in lipid levels (total cholesterol, high-density lipoprotein, low-density lipoprotein, and triglycerides), fasting blood glucose, hemoglobin A 1c , health-related quality of life, and diet quality. Assessments were performed at baseline, 6 months, and 12 months. RESULTS Feasibility was demonstrated by low attrition rates and high participant satisfaction. No between-group differences were demonstrated in the cardiovascular/metabolic outcomes. Significant within-group improvements were noted for high-density lipoprotein and hemoglobin A 1c in the intervention group. CONCLUSION The study results indicate that participation in a personalized, nurse-delivered exercise, nutrition, and educational intervention is feasible and acceptable to men with prostate cancer receiving ADT. IMPLICATIONS FOR PRACTICE Future randomized controlled research powered to detect significant differences is needed to confirm the impact of the Staying Strong & Healthy intervention on reduction of the cardiovascular/metabolic impact of ADT for men with prostate cancer.
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Affiliation(s)
- Jamie S Myers
- Author Affiliations: University of Kansas School of Nursing (Drs Myers, Manson, and Maliski); University of Kansas School of Health Professions (Dr Billinger); and University of Kansas Medical Center (Drs Hamilton-Reeves and Parker), Kansas City
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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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Body talk and resilience: Aging men's experiences with mastectomy and prostatectomy. J Aging Stud 2022; 61:101010. [DOI: 10.1016/j.jaging.2022.101010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Revised: 02/10/2022] [Accepted: 02/11/2022] [Indexed: 11/23/2022]
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Kivlighan M, Bricker J, Aburizik A. Boys Don't Cry: Examining Sex Disparities in Behavioral Oncology Referral Rates for AYA Cancer Patients. Front Psychol 2022; 13:826408. [PMID: 35250767 PMCID: PMC8891651 DOI: 10.3389/fpsyg.2022.826408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Accepted: 01/17/2022] [Indexed: 11/16/2022] Open
Abstract
Psychosocial distress is highly prevalent in cancer patients, approaching rates around 40% across various cancer sites according to multicenter studies. As such, distress screening procedures have been developed and implemented to identify and respond to cancer patients' psychosocial distress and concerns. However, many cancer patients continue to report unmet psychosocial needs suggesting gaps in connecting patients with psychosocial services. Presently, there is a paucity of research examining sex-based disparities in referral rates to behavioral oncology services, particularly for adolescent and young adult (AYA) cancer patients. Informed by gender role conflict and empirical literature documenting disparities in cancer care and treatment based on a variety of sociocultural variables, this study aimed to examine the presence of sex disparities in referral rates to behavioral oncology services for AYA cancer patients. Data for this study consisted of 1,700 AYA cancer patients (age 18–39) who completed a distress screening at a large cancer center of a teaching hospital in the Midwestern United. Results indicated that patient sex significantly predicted the odds of behavioral oncology referral (γ50 = −0.95, Odds ratio = 2.60, p < 0.001). This finding indicates that female AYA cancer patients are 2.5 times more likely to be referred to behavioral oncology services compared to male AYA cancer patients after controlling for psychosocial distress and emotional, family, and practical problems. Additionally, we found that emotional problems significantly moderated the odds of referral for males and females (γ60 = 0.37, Odds ratio = 1.44, p < 0.001), however the odds of referral for males who endorsed emotional problems were lower than males who did not endorse emotional problems. This contrasted with female AYA cancer patients where the endorsement of emotional problems increased the odds of referral to behavioral oncology services. Findings are discussed with particular focus on how to enhance equitable care and reduce sex and other sociocultural-based disparities in AYA psychosocial oncology.
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Affiliation(s)
- Martin Kivlighan
- Department of Psychological and Quantitative Foundations, College of Education, The University of Iowa, Iowa City, IA, United States
| | - Joel Bricker
- Department of Psychiatry, Carver College of Medicine, The University of Iowa, Iowa City, IA, United States
| | - Arwa Aburizik
- Department of Internal Medicine (Hematology-Oncology), Carver College of Medicine, The University of Iowa, Iowa City, IA, United States
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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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Fry SL, Hopkinson J, Kelly D. "We're talking about black men here, there's a difference"; cultural differences in socialised knowledge of prostate cancer risk: A qualitative research study. Eur J Oncol Nurs 2021; 56:102080. [PMID: 34915423 DOI: 10.1016/j.ejon.2021.102080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Revised: 11/03/2021] [Accepted: 11/25/2021] [Indexed: 11/19/2022]
Abstract
PURPOSE To detail social knowledge of prostate cancer risk amongst cultural groups. Prostate cancer is the most common cancer in men, and black men are at the highest risk. Despite this, black men are the least likely to be diagnosed early with prostate cancer. It is important to understand why this is so that these men can receive early access to effective treatment and support. METHODS A constructivist grounded theory methodology was used. Data were collected between December 2015 and October 2017; seventeen men were interviewed, and eighteen men took part in focus groups. RESULTS There were differences in the way the men constructed their understanding of risks for prostate cancer. The social construction of prostate cancer risk knowledge was mediated by the way the men were socialised to understand and accept this risk. The Somali and African Caribbean men placed social importance on the healthy body, whereas the white working class men seemed to find social value through the unwell body. This research proposes the theory that social constructions of knowledge mediate the way men perceive and accept their risk for prostate cancer. CONCLUSION Understanding socially-derived knowledge of risk may mediate the acceptance of factors relating to prostate cancer. This knowledge may help health providers and third sector organisations produce targeted health-related information. Health practitioners may also benefit from understanding how socially constructed ideas of the body could influence the way men respond to conversations about prostate cancer so that tailored and culturally appropriate support can be offered.
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Affiliation(s)
- Sarah Louise Fry
- School of Healthcare Sciences, College of Biomedical and Life Sciences, Cardiff University, Room. 2.14 2nd Floor Ty Dewi Sant, Heath Park Campus, Heath Park, Cardiff, CF14 4XN, UK.
| | - Jane Hopkinson
- School of Healthcare Sciences, College of Biomedical and Life Sciences, Cardiff University, Room. 13.10, 13th Floor, Eastgate House, 35 - 43 Newport Road, Cardiff, CF24 0AB, UK
| | - Daniel Kelly
- School of Healthcare Sciences, College of Biomedical and Life Sciences, Cardiff University, Room. 13.10, 13th Floor, Eastgate House, 35 - 43 Newport Road, Cardiff, CF24 0AB, UK
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Brüggemann J. Redefining masculinity - Men's repair work in the aftermath of prostate cancer treatment. HEALTH SOCIOLOGY REVIEW : THE JOURNAL OF THE HEALTH SECTION OF THE AUSTRALIAN SOCIOLOGICAL ASSOCIATION 2021; 30:143-156. [PMID: 34018917 DOI: 10.1080/14461242.2020.1820367] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/10/2020] [Accepted: 09/02/2020] [Indexed: 06/12/2023]
Abstract
Treatments for prostate cancer have many potential side effects such as a loss of erection, weaker orgasms, and incontinence. These are all bodily changes that may challenge dominant masculine ideals. In this article, I use Persson's repair work to describe how men tackle these side effects, and I describe the trouble their repair work elicits in terms of masculinity. I analyse interviews with eleven Swedish men, all treated for prostate cancer, and show that such work is done in three ways. Bodily repair work elicits the work men do to restore bodily functions, often through medical technologies. Relational repair work describes how relations with (potential) others shape men's bodily and sexual concerns, and the ways relations redefine such concerns. Age marking as repair emphasises how age is used in the redefinitions of norms about masculinities and aging bodies, both in relation to oneself and others. The analysis highlights how men's repair work is multifaceted, and is performed against the backdrop of dominant discourses on masculinity, medicine and old age. The analysis of such repair work is valuable to research on how masculinity is constructed in the light of treatment side effects and older age.
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Affiliation(s)
- Jelmer Brüggemann
- Department of Thematic Studies - Technology and Social Change, Linköping University, Linköping, Sweden
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Coping strategies in active and inactive men with prostate cancer: a qualitative study. J Cancer Surviv 2021; 16:421-431. [PMID: 33835392 PMCID: PMC8964636 DOI: 10.1007/s11764-021-01037-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Accepted: 03/26/2021] [Indexed: 10/24/2022]
Abstract
PURPOSE Prostate cancer can result in a shift in the way men perceive their masculinity. Despite the interest in exercise as a treatment strategy to address masculinity concerns, there is insufficient information about how perceptions may differ in active and inactive men. The aim of this study was to explore how exercise might influence self-perceptions of masculinity in men across the exercise continuum (from active to inactive) and in men receiving different forms of treatment for their prostate cancer, including androgen deprivation therapy. METHODS Individual, semi-structured interviews were conducted with 15 men. Ten men met aerobic and/or resistance guidelines and were considered active, while five men, considered inactive, reached neither guideline. This study used a grounded theory approach to data analysis, examining masculinity issues in active men and compared them to inactive men. RESULTS Redefining masculinity emerged as an overarching theme. Subthemes were the various coping strategies men used to redefining masculinity and directly related to their exercise habits. Coping subthemes included re-establishing control, tapping into competition, remaining socially connected, rationalization, and acceptance. CONCLUSIONS In the active men, dominant coping strategies achieved from exercise included control through active participation, acceptance, competition, and leadership. In inactive men, control was observed with knowledge-seeking behaviors, rationalization, and acceptance. IMPLICATIONS FOR CANCER SURVIVORS A tailored approach to exercise counseling based upon specific masculine traits and motivations could lead to improved exercise engagement.
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Abstract
Prostate cancer is the most common malignancy diagnosed in North American men. Although medical advances have improved survival rates, men treated for prostate cancer experience side-effects that can reduce their work capacity, increase financial stress, and affect their career and/or retirement plans. Working-age males comprise a significant proportion of new prostate cancer diagnoses. It is important, therefore, to understand the connections between prostate cancer and men’s work lives. This scoping review aimed to summarize and disseminate current research evidence about the impact of prostate cancer treatment on men’s work lives. Electronic databases were searched to identify peer-reviewed articles published between 2006 and 2020 that reported on the impact of prostate cancer treatment on men’s work. Following scoping review guidelines, 21 articles that met inclusion criteria were identified and analyzed. Evidence related to the impact of prostate cancer on work was grouped under three themes: (1) work outcomes after prostate cancer treatment; (2) return to work considerations, and (3) impact of prostate cancer treatment on men’s finances. Findings indicate that men’s return to work may be more gradual than expected after prostate cancer treatment. Some men may feel pressured by financial stressors and masculine ideals to resume work. Diverse factors including older age and social benefits appear to play a role in shaping men’s work-related plans after prostate cancer treatment. The findings provide direction for future research and offer clinicians a synthesis of current knowledge about the challenges men face in resuming work in the aftermath of prostate cancer treatment.
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Affiliation(s)
- Wellam F Yu Ko
- University of British Columbia, School of Nursing, Vancouver, BC, Canada
| | - John L Oliffe
- University of British Columbia, School of Nursing, Vancouver, BC, Canada
| | - Joan L Bottorff
- University of British Columbia, School of Nursing, Kelowna, BC, Canada
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Okoro FO, Song L, Auten B, Whitaker-Brown C, Cornelius J. African-American survivors of prostate cancer: a meta-synthesis of qualitative studies. J Cancer Surviv 2020; 15:40-53. [PMID: 32666419 DOI: 10.1007/s11764-020-00909-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2019] [Accepted: 06/22/2020] [Indexed: 11/29/2022]
Abstract
PURPOSE The purpose of this study is to systematically review the current literature on the post-treatment survivorship experiences of African-American men with prostate cancer by exploring qualitative studies to gain a deep understanding of their survivorship experiences. METHOD We searched five databases for studies published from 2008 to 2018. We identified ten relevant qualitative studies, conducted a meta-synthesis using Noblit and Hare's meta-ethnography approach, and evaluated their quality appraisal using the validated Critical Appraisal Skills Program. RESULTS This review generated a total of four main themes and nine subthemes. The Four main themes included coping strategy, psychophysical impact, health system influence, and socioeconomic impact. Spirituality, healthy behaviors, supportive care of spouse/family/friends and non-communicating/reticent were subthemes identified in the coping strategy theme; physical well-being and sexuality and masculinity were subthemes in the psychophysical impact theme; healthcare provider interaction and treatment decision-making were subthemes identified in the health system influence theme, and health insurance status was the subtheme in the socioeconomic impact theme. CONCLUSION Our findings reveal that the experiences of African-American prostate cancer survivors are complex and multidimensional. IMPLICATIONS FOR CANCER SURVIVORS This review highlights the need for further studies with African-American prostate cancer survivors, precisely identify their needs and plan a culturally appropriate intervention to meet those needs.
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Affiliation(s)
- Florence Osita Okoro
- School of Nursing, The University of North Carolina at Charlotte, Charlotte, NC, 28223, USA.
| | - Lixin Song
- School of Nursing, University of North Carolina, Chapel Hill, NC, USA
- Lineberger Comprehensive Cancer Center, UNC-CH, Chapel Hill, NC, 27599, USA
| | - Beth Auten
- J. Murrey Atkins Library, The University of North Carolina at Charlotte, Charlotte, NC, USA
| | | | - Judy Cornelius
- School of Nursing, The University of North Carolina at Charlotte, Charlotte, NC, 28223, USA
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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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13
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Wang AWT, Hoyt MA. Cancer-related masculinity threat in young adults with testicular cancer: the moderating role of benefit finding. ANXIETY STRESS AND COPING 2020; 33:207-215. [PMID: 31928079 DOI: 10.1080/10615806.2020.1713447] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Background and Objectives: Perceiving benefit from a health-related stressor such as cancer has been associated with better psychological adjustment in various cancer populations; however, it has not been studied in the context of young adulthood or gender-related cancer threat. This study investigated the role of benefit finding in psychological adjustment among young adults with testicular cancer, and whether BF moderates cancer-related masculine threat.Design: This study utilizes a cross-sectional design with a diverse sample of young adult testicular cancer survivors.Methods: Men with a history of testicular cancer (N = 171; M age = 25.2, SD = 3.32) completed questionnaires of benefit finding, cancer-related masculine threat, and indicators of psychological adjustment.Results: Multiple regression analysis revealed that cancer-related masculine threat was associated with worse adjustment across indicators and that benefit finding was related to higher positive affect and lower depressive symptoms. Benefit finding attenuated the potentially adverse effect of cancer-related masculine threat on negative affect and depressive symptoms such that cancer-related masculine threat demonstrated a stronger association with negative affect and depressive symptoms for people with relatively low BF.Conclusions: For young adult men with testicular cancer, finding benefit appears to promote well-being in the face of masculine cancer threat.
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Affiliation(s)
| | - Michael A Hoyt
- Population Health and Disease Prevention, University of California, Irvine, CA, USA.,Chao Family Comprehensive Cancer Center, University of California, Irvine, CA, USA.,Interdisciplinary Institute for Salivary Bioscience Research, University of California, Irvine, CA, USA
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Maharaj N, Kazanjian A. Exploring patient narratives of intimacy and sexuality among men with prostate cancer. COUNSELLING PSYCHOLOGY QUARTERLY 2019. [DOI: 10.1080/09515070.2019.1695582] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Affiliation(s)
- Nandini Maharaj
- School of Population, University of British Columbia, Vancouver, Canada
| | - Arminée Kazanjian
- School of Population, University of British Columbia, Vancouver, Canada
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15
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Wagland R, Nayoan J, Matheson L, Rivas C, Brett J, Collaco N, Alexis O, Gavin A, Glaser AW, Watson E. Adjustment strategies amongst black African and black Caribbean men following treatment for prostate cancer: Findings from the Life After Prostate Cancer Diagnosis (LAPCD) study. Eur J Cancer Care (Engl) 2019; 29:e13183. [PMID: 31642565 DOI: 10.1111/ecc.13183] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2019] [Revised: 09/24/2019] [Accepted: 10/02/2019] [Indexed: 12/24/2022]
Abstract
OBJECTIVE To explore adjustment strategies adopted by Black African (BA) and Black Caribbean (BC) men in the UK as a response to the impact of PCa diagnosis and treatment effects. METHODS Men were recruited through the UK-wide 'Life After Prostate Cancer Diagnosis' (LAPCD) survey. Telephone interviews were conducted with men (n = 14) with BA and BC backgrounds between 18 and 42 months post-diagnosis. Data were analysed using a Framework approach. RESULTS Most men (n = 12) were born outside the UK, were married (n = 9) and employed (n = 9). Median age was 66 years (range: 55-85). Six overarching themes emerged: a strong reliance upon faith beliefs; maintaining a 'positive' front; work as distraction; non-disclosure of diagnosis even amongst family members, influenced by stigma and masculinity concerns; active awareness-raising amongst a minority and support-seeking from close community. A few men emphasised a need to 'pitch' awareness-raising messages appropriately. Potential links existed between faith beliefs, presenting a positive front, community support-seeking and local awareness-raising. CONCLUSION The provision of patient-centred care requires cultural sensitivity. Interventions that challenge stigma and men's reluctance to disclose problems associated with PCa and treatment may encourage help-seeking for symptom support. Research is needed to determine how best awareness-raising messages should be conveyed to black men.
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Affiliation(s)
| | - Johana Nayoan
- Health Psychology Research Group, University College London, London, UK
| | - Lauren Matheson
- Faculty of Health and Life Sciences, Oxford Brookes University, Oxford, UK
| | - Carol Rivas
- Social Science Research Unit, University College London, London, UK
| | - Jo Brett
- Faculty of Health and Life Sciences, Oxford Brookes University, Oxford, UK
| | - Nicole Collaco
- Faculty of Health and Life Sciences, Oxford Brookes University, Oxford, UK
| | - Obrey Alexis
- Faculty of Health and Life Sciences, Oxford Brookes University, Oxford, UK
| | - Anna Gavin
- Northern Ireland Cancer Registry, Centre for Public Health, Queen's University Belfast, Belfast, UK
| | - Adam W Glaser
- Leeds Institute of Data Analytics, University of Leeds, Leeds, UK
| | - Eila Watson
- Faculty of Health and Life Sciences, Oxford Brookes University, Oxford, UK
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16
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Manson A, Myers J, Billinger S, Ward J, Parker W, Hamilton-Reeves J, Michel C, Maliski SL. Feasibility of an intervention for men on androgen deprivation therapy: A research protocol. Res Nurs Health 2019; 42:324-333. [PMID: 31389621 DOI: 10.1002/nur.21977] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2019] [Accepted: 07/20/2019] [Indexed: 11/11/2022]
Abstract
Androgen deprivation therapy (ADT) is a treatment used across the prostate cancer disease spectrum and works by suppressing testicular androgen production to castrate levels. Although ADT can provide survival benefits, it is also associated with increased risk for cardiovascular disease, metabolic syndrome, increased visceral fat mass, dyslipidemia, decreased arterial compliance, and diminished health-related quality of life. The Staying Strong And Healthy protocol is a telephone-delivered intervention led by a nurse coordinator to minimize the increased cardiovascular and metabolic risks associated with ADT. This study will evaluate the feasibility of the protocol and provides the foundation for future behavioral interventions across diverse populations of men on ADT.
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Affiliation(s)
- Alana Manson
- School of Nursing, University of Kansas Medical Center, Kansas City, Kansas
| | - Jamie Myers
- School of Nursing, University of Kansas Medical Center, Kansas City, Kansas
| | - Sandra Billinger
- Department of Physical Therapy and Rehabilitation Science, University of Kansas Medical Center, Kansas City, Kansas
| | - Jaimie Ward
- Department of Physical Therapy and Rehabilitation Science, University of Kansas Medical Center, Kansas City, Kansas
| | - William Parker
- Department of Urology, University of Kansas Medical Center, Kansas City, Kansas
| | | | - Carrie Michel
- Department of Urology, University of Kansas Medical Center, Kansas City, Kansas
| | - Sally L Maliski
- School of Nursing, University of Kansas Medical Center, Kansas City, Kansas
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17
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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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Manne SL, Kashy DA, Zaider T, Kissane D, Lee D, Kim IY, Heckman CJ, Penedo FJ, Murphy E, Virtue SM. Couple-focused interventions for men with localized prostate cancer and their spouses: A randomized clinical trial. Br J Health Psychol 2019; 24:396-418. [PMID: 30852854 DOI: 10.1111/bjhp.12359] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2018] [Revised: 02/11/2019] [Indexed: 01/21/2023]
Abstract
OBJECTIVES Few couple-focused interventions have improved psychological and relationship functioning among men diagnosed with localized prostate cancer and their spouses. This study compared the impact of intimacy-enhancing therapy (IET), a general health and wellness intervention (GHW), and usual care (UC) on the psychological and relationship functioning of localized prostate cancer patients and their partners. Relationship length, relationship satisfaction, and patient masculinity were evaluated as moderators. DESIGN This study was a randomized clinical trial with three study arms and four assessment time points. METHODS A total of 237 patients and partners were randomly assigned to receive IET, GHW, or UC. Participants completed measures of psychological functioning and relationship satisfaction at baseline, 5 weeks, 3 months, and 6 months post-baseline. Primary outcomes were psychological adjustment, depression, cancer-specific distress, cancer concerns, and relationship satisfaction. RESULTS Spouses in IET showed greater increases in relationship satisfaction than spouses in GHW and UC between the baseline and 5-week follow-up. Among patients in longer relationships, significant increases in psychological adjustment were found in both treatments compared to UC. Among spouses in longer relationships, psychological adjustment increased in both IET and UC but declined in GHW. CONCLUSIONS Intimacy-enhancing therapy did not show an impact on general or cancer-specific distress, but did show an early impact on relationship satisfaction among spouses. IET was superior to UC for patients in longer relationships. It will be important for researchers to understand which couple-focused interventions benefits both patients and spouses and to identify characteristics of patients, partners, and couples who may not benefit from psychological treatments. Statement of contribution What is already known on this subject? Men diagnosed with localized prostate cancer report lower health-related quality of life and both patients and spouses report elevated distress. Relationship communication plays a role in couples' psychological adaptation to prostate cancer. Couple-focused interventions have illustrated an impact on relationship communication. There are no studies comparing different couple-focused interventions. What does this study add? Intimacy-enhancing therapy was not superior to no treatment or a comparison treatment for the broad range of psychological and relationship outcomes. Intimacy-enhancing therapy was superior to no treatment for patients in longer-term relationship. The general health and wellness intervention was not beneficial for men in shorter relationships and for men who did not endorse traditional masculine norms.
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Affiliation(s)
- Sharon L Manne
- Rutgers Cancer Institute of New Jersey, New Brunswick, New Jersey, USA
| | | | - Talia Zaider
- Department of Psychiatry & Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, USA
| | - David Kissane
- Department of Psychiatry & Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, USA.,Department of Psychiatry, Monash Medical Center, Monash University, Clayton, Victoria, Australia
| | - David Lee
- Penn Urology, Penn Presbyterian Medical Center, Philadelphia, Pennsylvania, USA
| | - Isaac Y Kim
- Rutgers Cancer Institute of New Jersey, New Brunswick, New Jersey, USA
| | - Carolyn J Heckman
- Rutgers Cancer Institute of New Jersey, New Brunswick, New Jersey, USA.,Fox Chase Cancer Center, Philadelphia, Pennsylvania, USA
| | - Frank J Penedo
- Robert H. Lurie Comprehensive Cancer Center of Northwestern University, Chicago, Illinois, USA
| | - Evangelynn Murphy
- Rutgers Cancer Institute of New Jersey, New Brunswick, New Jersey, USA
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19
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Milenkovic U, Campbell J, Roussel E, Albersen M. An update on emerging drugs for the treatment of erectile dysfunction. Expert Opin Emerg Drugs 2018; 23:319-330. [DOI: 10.1080/14728214.2018.1552938] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Affiliation(s)
- U. Milenkovic
- Department of Urology, University Hospitals Leuven, Leuven, Belgium
| | - J. Campbell
- Department of Surgery, Division of Urology, University of Western Ontario, London, ON, Canada
| | - E. Roussel
- Department of Urology, University Hospitals Leuven, Leuven, Belgium
| | - M. Albersen
- Department of Urology, University Hospitals Leuven, Leuven, Belgium
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20
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Alexis O, Worsley AJ. A Meta-Synthesis of Qualitative Studies Exploring Men’s Sense of Masculinity Post–Prostate Cancer Treatment. Cancer Nurs 2018; 41:298-310. [DOI: 10.1097/ncc.0000000000000509] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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21
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Maghen A, Vargas GB, Connor SE, Nassiri S, Hicks EM, Kwan L, Waterman AD, Maliski SL, Veale J. Spirituality and religiosity of non-directed (altruistic) living kidney donors. J Clin Nurs 2018; 27:1662-1672. [PMID: 29266612 PMCID: PMC6686899 DOI: 10.1111/jocn.14223] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/09/2017] [Indexed: 11/29/2022]
Abstract
AIMS AND OBJECTIVES To describe the spirituality and religiosity of 30 non-directed (altruistic) living kidney donors in the USA and explore how they may have affected their motivations to donate and donation process experiences. BACKGROUND The rise in non-directed donors and their ability to initiate kidney chains offer a novel approach to help alleviate the overextended kidney transplant wait list in the USA. However, little is known about the non-directed donors' motivations, characteristics and experiences. DESIGN We conducted a qualitative-dominant study and used a grounded theory approach to analyse data. METHODS Thirty participants completed in-depth interviews between April 2013-April 2015. Three analysts independently read and coded interview transcripts. Grounded theory techniques were used to develop descriptive categories and identify topics related to the non-directed donors donation experience. RESULTS Sixteen of the 30 non-directed donorss discussed the topic of spirituality and religiosity when describing their donation experiences, regardless of whether they were actively practising a religion at the time of donation. Specifically, three themes were identified within spirituality and religiosity: motivation to donate, support in the process, and justification of their donation decisions postdonation. CONCLUSIONS Findings from this study are the first to describe how spirituality and religiosity influenced the experiences of U.S. non-directed donorss and may help improve non-directed donors educational resources for future spiritual or religious non-directed donors, and the overall non-directed donors donation experience in efforts to increase the living donor pool. RELEVANCE TO CLINICAL PRACTICE Spirituality and religiosity are often overlooked yet potentially influential factors in Western medicine, as demonstrated through the experiences of Jehovah's Witnesses and their religious restrictions while undergoing surgery and the beliefs of Christian Scientists against taking medications and receiving medical procedures. Understanding needs of non-directed donors specifically with spirituality and religiosity can better position kidney transplant centres and teams to improve predonation screening of non-directed donor candidates and provide support services during the donation process.
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Affiliation(s)
- Ariella Maghen
- Department of Urology, David Geffen School of Medicine at UCLA, 650 Charles Young Dr. South #66-118, Los Angeles, California, 90095-1738 USA
| | - Grecia B. Vargas
- Department of Urology, David Geffen School of Medicine at UCLA, 650 Charles Young Dr. South #66-118, Los Angeles, California, 90095-1738 USA
| | - Sarah E. Connor
- Department of Urology, David Geffen School of Medicine at UCLA, 650 Charles Young Dr. South #66-118, Los Angeles, California, 90095-1738 USA
| | - Sima Nassiri
- Department of Urology, David Geffen School of Medicine at UCLA, 650 Charles Young Dr. South #66-118, Los Angeles, California, 90095-1738 USA
| | - Elisabeth M. Hicks
- Department of Family Medicine, Research Section, Oregon Health and Science University, 3181 SW Sam Jackson Park Road, Portland, Oregon, 97239-3098 USA
| | - Lorna Kwan
- Department of Urology, David Geffen School of Medicine at UCLA, 650 Charles Young Dr. South #66-118, Los Angeles, California, 90095-1738 USA
| | - Amy D. Waterman
- Division of Nephrology, David Geffen School of Medicine at UCLA, 1018 Westwood Boulevard, Los Angeles, California, 90024 USA
- Terasaki Research Institute, 1018 Westwood Boulevard, Los Angeles, California, 90024 USA
| | - Sally L. Maliski
- Office of the Dean, University of Kansas Medical Center School of Nursing, Mailstop 2006, 3901 Rainbow Boulevard, Kansas City, Kansas, 66160 USA
| | - Jeffrey Veale
- Department of Urology, David Geffen School of Medicine at UCLA, 650 Charles Young Dr. South #66-118, Los Angeles, California, 90095-1738 USA
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22
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Machirori M, Patch C, Metcalfe A. Study of the relationship between Black men, culture and prostate cancer beliefs. COGENT MEDICINE 2018. [DOI: 10.1080/2331205x.2018.1442636] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Affiliation(s)
- Mavis Machirori
- Florence Nightingale Faculty of Nursing, Midwifery, Palliative Care, King’s College London, 1.32 James Clerk Maxwell Building, 57 Waterloo Road, London SE1 8WA, UK
| | - Christine Patch
- Florence Nightingale Faculty of Nursing, Midwifery, Palliative Care, King’s College London, 1.32 James Clerk Maxwell Building, 57 Waterloo Road, London SE1 8WA, UK
| | - Alison Metcalfe
- Florence Nightingale Faculty of Nursing, Midwifery, Palliative Care, King’s College London, 1.32 James Clerk Maxwell Building, 57 Waterloo Road, London SE1 8WA, UK
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23
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Flurey C, White A, Rodham K, Kirwan J, Noddings R, Hewlett S. 'Everyone assumes a man to be quite strong': Men, masculinity and rheumatoid arthritis: A case-study approach. SOCIOLOGY OF HEALTH & ILLNESS 2018; 40:115-129. [PMID: 29034486 PMCID: PMC5813274 DOI: 10.1111/1467-9566.12628] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Current literature has overlooked the impact of chronic illness on masculine identity. We therefore aimed to investigate the impact of rheumatoid arthritis (a long term condition, affecting more women than men) on masculine identity. Six focus groups with 22 men with rheumatoid arthritis (RA) (data reported elsewhere) followed by five one-to-one interviews with men (English, mean age: 59 years) sampled to reflect a heterogeneous experience of life with RA based on knowledge gained from the focus groups. Transcripts were analysed using thematic analysis and are presented as individual case studies. Whilst the case studies provide five distinct experiences, common themes can be drawn across them, such as the importance of paid work. The men needed to renegotiate their masculine identity to deal with their RA. Two dealt with this by pushing through pain to retain masculine activities, two replaced masculine roles they could no longer do with other roles, and one rejected masculinity completely. Men with long term conditions may need to re-write their masculinity scripts to enable them to accept and adapt to their condition. However, some men struggle with this, which should be taken into consideration when designing self-management services for men with long term conditions.
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Affiliation(s)
- Caroline Flurey
- Academic RheumatologyUniversity of the West of EnglandBristolUK
| | - Alan White
- Centre for Men's Health, Faculty of Health & Social SciencesLeeds Beckett UniversityLeedsUK
| | - Karen Rodham
- Psychology, sports and exerciseStaffordshire UniversityUK
| | | | | | - Sarah Hewlett
- Academic RheumatologyUniversity of the West of EnglandBristolUK
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24
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Spendelow JS, Eli Joubert H, Lee H, Fairhurst BR. Coping and adjustment in men with prostate cancer: a systematic review of qualitative studies. J Cancer Surviv 2017; 12:155-168. [PMID: 29063497 PMCID: PMC5884891 DOI: 10.1007/s11764-017-0654-8] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2017] [Accepted: 10/07/2017] [Indexed: 01/04/2023]
Abstract
Purpose Prostate cancer (PCa) is one of the most common forms of cancer amongst males. Men’s coping responses are an important determinant of functioning and adjustment to this disease. Previous qualitative research exists in this area, but the current review sought to systematically review and summarise these studies. Methods A systematic review was conducted to identify studies concerned with men’s coping strategies in their attempts to live with PCa. A search of relevant electronic databases was conducted to identify studies that met inclusion criteria for this review. Methodological quality assessment was also undertaken for each included study. Results One hundred twenty-one publications were identified for initial screening, and 18 studies were included in the review. A total of five coping strategy categories or ‘meta-themes’ were identified across included studies. These categories were labelled ‘avoidance, minimisation, and withdrawal’, ‘directing cognition and attention’, ‘reframing masculinity and seeking support’, ‘retain pre-illness identity and lifestyle’, and ‘symptom/side-effect management’. Conclusions A range of coping strategies were reported by men with PCa. Some of these strategies appear to be partially influenced by gender roles and masculinities. Coping meta-themes reported in this review have also been found in other research on men’s coping. Strategies relating to flexible interpretation of gender roles/masculinities may be a particularly relevant category of coping responses due to the hypothesised beneficial impact of flexibility on psychological well-being. Implications for cancer survivors PCa survivors utilise a range of coping strategies, and the types of strategies used may have implications for men’s well-being. The ability to be flexible in both coping responses used, and in the view of oneself as a man may be particularly important skills in meeting the challenges associated with this disease.
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Affiliation(s)
| | - H Eli Joubert
- School of Psychology, University of Surrey, Guildford, GU2 7XH, UK
| | - Haymond Lee
- School of Psychology, University of Surrey, Guildford, GU2 7XH, UK
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25
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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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26
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Darabos K, Hoyt MA. Masculine norms about emotionality and social constraints in young and older adult men with cancer. J Behav Med 2017; 40:259-270. [PMID: 27033539 PMCID: PMC5553069 DOI: 10.1007/s10865-016-9739-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2015] [Accepted: 03/22/2016] [Indexed: 12/17/2022]
Abstract
Beliefs that men should restrict their display of emotions, or restrictive emotionality, might contribute to adjustment to cancer and this might be sensitive to social receptivity to disclosure. The present research examined relationships of restrictive emotionality, social constraints, and psychological distress in young adults with testicular cancer (N = 171; Study 1) and older men with prostate cancer (N = 66; Study 2). Study 1: positive associations were observed for social constraints and restrictive emotionality with depressive symptoms. Social constraints moderated the relationship, such that high restrictive emotionality was associated with higher depressive symptoms in those with high constraints. Study 2: only social constraints (and not restrictive emotionality) was positively associated with depressive symptoms and cancer-related intrusive thoughts. The social constraints × restrictive emotionality interaction approached significance with depressive symptoms, such with high social constraints low restrictive emotionality was associated with higher depressive symptoms compared to those with less constraints. No significant associations were found for intrusive thoughts in either study. Findings demonstrate unique relationships with psychological distress across the lifespan of men with cancer given perception of constraints and adherence to masculine norms about emotionality.
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Affiliation(s)
- Katie Darabos
- Department of Psychology, The Graduate Center, City University of New York, 365 Fifth Avenue, New York, NY, 10016, USA
- Department of Psychology, Hunter College, City University of New York, 695 Park Avenue, New York, NY, 10065, USA
| | - Michael A Hoyt
- Department of Psychology, The Graduate Center, City University of New York, 365 Fifth Avenue, New York, NY, 10016, USA.
- Department of Psychology, Hunter College, City University of New York, 695 Park Avenue, New York, NY, 10065, USA.
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27
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Wood AW, Barden S, Terk M, Cesaretti J. The influence of stigma on the quality of life for prostate cancer survivors. J Psychosoc Oncol 2017; 35:451-467. [PMID: 28318410 DOI: 10.1080/07347332.2017.1307896] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
The purpose of the present study was to investigate the influence of stigma on prostate cancer (PCa) survivors' quality of life. Stigma for lung cancer survivors has been the focus of considerable research (Else-Quest & Jackson, 2014); however, gaps remain in understanding the experience of PCa stigma. A cross-sectional correlational study was designed to assess the incidence of PCa stigma and its influence on the quality of life of survivors. Eighty-five PCa survivors were administered survey packets consisting of a stigma measure, a PCa-specific quality of life measure, and a demographic survey during treatment of their disease. A linear regression analysis was conducted with the data received from PCa survivors. Results indicated that PCa stigma has a significant, negative influence on the quality of life for survivors (R2 = 0.33, F(4, 80) = 11.53, p < 0.001). There were no statistically significant differences in PCa stigma based on demographic variables (e.g., race and age). Implications for physical and mental health practitioners and researchers are discussed.
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Affiliation(s)
- Andrew W Wood
- a Department of Clinical Mental Health Counseling , Antioch University Seattle , Seattle , WA , USA
| | - Sejal Barden
- b Department of Child, Family, and Community Sciences , University of Central Florida , Orlando , FL , USA
| | - Mitchell Terk
- c Southpoint Cancer Center , Jacksonville , FL , USA
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Martinez Tyson DD, Vázquez-Otero C, Medina-Ramirez P, Arriola NB, McMillan SC, Gwede CK. Understanding the supportive care needs of Hispanic men cancer survivors. ETHNICITY & HEALTH 2017; 22:1-16. [PMID: 27350450 PMCID: PMC5351415 DOI: 10.1080/13557858.2016.1196649] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
OBJECTIVE To date, there is a paucity of research and information on Hispanic men cancer survivors (HMCS), who comprise part of the largest and fastest growing racial/ethnic minority group in the country. The purpose of this paper is to provide a deeper understanding of the supportive care needs of HMCS. DESIGN Three focus groups with a community sample of HMCS (n = 18) and interviews with providers (n = 5) were conducted to explore the supportive care needs of Hispanic men who had been diagnosed with cancer within the last five years. The data were analyzed using applied thematic analysis techniques. RESULTS Findings from focus groups and interviews are presented concurrently. The overarching themes that emerged were the need for: culturally sensitive cancer care and better communication with providers; cancer treatment-related information and comprehensive survivorship care; support and to connect with other cancer survivors and the need to negotiate changing gender role expectations and still provide for their family. CONCLUSION Study findings contribute to the literature by presenting the supportive care needs of HMCS and illustrate the need for continued research to address disparities in access to cancer information and in the provision of culturally sensitive care. We provide recommendations and suggestions to address the supportive care needs of HMCS.
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Affiliation(s)
- Dinorah Dina Martinez Tyson
- a Department of Community and Family Health, College of Public Health , University of South Florida , Tampa , FL , USA
| | - Coralia Vázquez-Otero
- a Department of Community and Family Health, College of Public Health , University of South Florida , Tampa , FL , USA
| | - Patricia Medina-Ramirez
- a Department of Community and Family Health, College of Public Health , University of South Florida , Tampa , FL , USA
| | - Nora B Arriola
- b Center of Innovation on Disability & Rehabilitation Research (CINDRR) , James A. Haley VA Hospital , Tampa , FL , USA
| | - Susan C McMillan
- c College of Nursing, USF Health , University of South Florida , Tampa , FL , USA
| | - Clement K Gwede
- d Population Science, Health Outcomes & Behavior , Moffitt Cancer Center & Research Institute , Tampa , FL , USA
- e College of Medicine, Department of Oncologic Sciences , University of South Florida , Tampa , FL , USA
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29
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Chambers SK, Chung E, Wittert G, Hyde MK. Erectile dysfunction, masculinity, and psychosocial outcomes: a review of the experiences of men after prostate cancer treatment. Transl Androl Urol 2017; 6:60-68. [PMID: 28217451 PMCID: PMC5313306 DOI: 10.21037/tau.2016.08.12] [Citation(s) in RCA: 57] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Prostate cancer (PC) treatment side-effects such as erectile dysfunction (ED) can impact men’s quality of life (QoL), psychosocial and psycho-sexual adjustment. Masculinity (i.e., men’s identity or sense of themselves as being a man) may also be linked to how men respond to PC treatment and ED however the exact nature of this link is unclear. This review aims to provide a snapshot of the current state of evidence regarding ED, masculinity and psychosocial impacts after PC treatment. Three databases (Medline/PsycINFO, CINHAL, and EMBASE) were searched January 1st 1980 to January 31st 2016. Study inclusion criteria were: patients treated for PC; ED or sexual function measured; masculinity measured in quantitative studies or emerged as a theme in qualitative studies; included psychosocial or QoL outcome(s); published in English language, peer-reviewed journal articles. Fifty two articles (14 quantitative, 38 qualitative) met review criteria. Studies were predominantly cross-sectional, North American, samples of heterosexual men, with localised PC, and treated with radical prostatectomy. Results show that masculinity framed men’s responses to, and was harmed by their experience with, ED after PC treatment. In qualitative studies, men with ED consistently reported lost (no longer a man) or diminished (less of a man) masculinity, and this was linked to depression, embarrassment, decreased self-worth, and fear of being stigmatised. The correlation between ED and masculinity was similarly supported in quantitative studies. In two studies, masculinity was also a moderator of poorer QoL and mental health outcomes for PC patients with ED. In qualitative studies, masculinity underpinned how men interpreted and adjusted to their experience. Men used traditional (hegemonic) coping responses including emotional restraint, stoicism, acceptance, optimism, and humour or rationalised their experience relative to their age (ED inevitable), prolonged life (ED small price to pay), definition of sex (more than erection and penetration), other evidence of virility (already had children) or sexual prowess (sown a lot of wild oats). Limitations of studies reviewed included: poorly developed theoretical and context-specific measurement approaches; few quantitative empirical or prospective studies; moderating or mediating factors rarely assessed; heterogeneity (demographics, sexual orientation, treatment type) rarely considered. Clinicians and health practitioners can help PC patients with ED to broaden their perceptions of sexual relationships and assist them to make meaning out of their experience in ways that decrease the threat to their masculinity. The challenge going forward is to better unpack the relationship between ED and masculinity for PC patients by addressing the methodological limitations outlined so that interventions for ED that incorporate masculinity in a holistic way can be developed.
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Affiliation(s)
- Suzanne K Chambers
- Menzies Health Institute Queensland, Griffith University, Gold Coast, QLD, Australia;; Cancer Council Queensland, Fortitude Valley, QLD, Australia;; Exercise Medicine Research Institute, Edith Cowan University, Perth, Australia;; Prostate Cancer Foundation of Australia, St Leonards, NSW, Australia;; The University of Queensland Centre for Clinical Research, The University of Queensland, Brisbane, Australia
| | - Eric Chung
- Department of Urology, Princess Alexandra Hospital, University of Queensland, Brisbane, QLD, Australia;; AndroUrology Centre, St Andrew's War Memorial Hospital, Brisbane, QLD, Australia
| | - Gary Wittert
- Freemasons Foundation Centre for Men's Health, School of Medicine, University of Adelaide, Adelaide, South Australia, Australia
| | - Melissa K Hyde
- Menzies Health Institute Queensland, Griffith University, Gold Coast, QLD, Australia;; Cancer Council Queensland, Fortitude Valley, QLD, Australia
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Zanchetta MS, Cognet M, Lam-Kin-Teng MR, Dumitriu ME, Renaud L, Rhéaume J. From early detection to rehabilitation in the community: reading beyond the blog testimonies of survivors' quality of life and prostate cancer representation. Health Qual Life Outcomes 2016; 14:171. [PMID: 27986091 PMCID: PMC5162078 DOI: 10.1186/s12955-016-0568-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2016] [Accepted: 11/29/2016] [Indexed: 11/20/2022] Open
Abstract
Background Survivors’ testimonies can reveal much about men’s experiences of prostate cancer and impacts on their quality of life (QOL) during the clinical trajectory of the disease. These survivors’ shared thoughts and views were hypothesized to reflect salient features of their lived social representation of prostate cancer. Context We explored the content of testimonies posted by men to a public blog hosted by a French national prostate cancer patients’ association. The study question, “What do French bloggers’ testimonies reveal about their lived experiences with prostate cancer, especially regarding their quality of life in community settings, that underpin their social representation of prostate cancer?” guided the exploration and analysis of the textual data. The aims were to better understand men’s experiences and predominant thoughts and views, to elucidate patients’ behaviours, and to enlighten medical policy and practice. Purpose Explore issues of QOL as reported by French prostate cancer survivors in a public blog by: (a) identifying the salient aspects and issues of the experience of living with prostate cancer from the perspective of survivors; and (b) analyzing the content in the posted testimonies regarding perceived and lived impacts of prostate cancer on QOL. Methods A critical ethnographic study guided the selection of textual data from 196 male bloggers’ testimonies about prostate cancer posted in the period from 2008 to 2013. Media content analysis method was undertaken on blog testimonies, framed by a multidimensional conceptual framework of QOL. Results Testimonies focused mainly on medical care and rehabilitation, recovery, health education and self-care, as well as on a global vision of prostate cancer and its impacts on personal views of manhood and masculinity. The language used indicated that political, educative and compassionate discourses were intertwined to create a complex representation of the experience and effects of prostate cancer; this multi-faceted representation can inform the public and professional debate about men’s capacity to provide emotional support and problem-solve within a community of interest. Conclusion Findings, while based on data limited to mostly one-time entries to a French blog, contribute to understanding a unique, collective expression of men’s lived experiences of prostate cancer. These anonymous survivors shared their varied reactions, ways of coping, and thoughts on needed change.
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Affiliation(s)
- Margareth Santos Zanchetta
- Ryerson University- Faculty of Community Services, Daphne Cockwell School of Nursing, 350 Victoria St. office POD 470C, Toronto, ON, M5B 2K3, Canada.
| | - Marguerite Cognet
- Université Denis Diderot- UFR Sciences sociales, Unité de recherche Migrations et Sociétés, Paris, France
| | - Mary Rachel Lam-Kin-Teng
- Ryerson University- Faculty of Community Services, Daphne Cockwell School of Nursing, 350 Victoria St. office POD 470C, Toronto, ON, M5B 2K3, Canada
| | - Marie Elisabeth Dumitriu
- Ryerson University- Faculty of Community Services, Daphne Cockwell School of Nursing, 350 Victoria St. office POD 470C, Toronto, ON, M5B 2K3, Canada
| | - Lise Renaud
- Université du Québec à Montréal, CSSS de la Montagne, Ministère de la santé et des services sociaux du Québec, Montréal, Québec, Canada
| | - Jacques Rhéaume
- CSSS de la Montagne, Ministère de la santé et des services sociaux du Québec, Montréal, Québec, Canada
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Hawkins J, Watkins DC, Kieffer E, Spencer M, Piatt G, Nicklett EJ, Lebron A, Espitia N, Palmisano G. An Exploratory Study of the Impact of Gender on Health Behavior Among African American and Latino Men With Type 2 Diabetes. Am J Mens Health 2016; 11:344-356. [PMID: 27923970 PMCID: PMC5675282 DOI: 10.1177/1557988316681125] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
This study explores gender values and beliefs among Latino and African American men with diabetes and examines how these values and beliefs may influence their health behaviors. Participants were recruited from individuals who participated in one of three Racial and Ethnic Approaches to Community Health Detroit Partnership diabetes self-management interventions. One focus group was conducted with African American men ( n = 10) and two focus groups were conducted with Latino men ( n = 12) over a 3-month period. Sessions lasted 90 minutes, were audiotaped, and analyzed using thematic content analysis techniques. Two themes emerged that characterize gender identity and its relationship to health behavior in men: (a) men's beliefs about being men (i.e., key aspects of being a man including having respect for themselves, authority figures, and peers; fulfilling the role as breadwinner; being responsible for serving as the leader of the family; and maintaining a sense of chivalry) and (b) influence of gender values and beliefs on health behavior (i.e., the need to maintain a strong image to the outside world, and the need to maintain control of themselves served as barriers to seeking out and engaging in diabetes self-management behaviors). Results suggest that gender values and beliefs may have implications for how health behaviors among men with diabetes. Future research should study the direct impact masculine identity has on health behaviors among men with diabetes.
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Affiliation(s)
| | | | | | | | | | | | | | | | - Gloria Palmisano
- 2 University of Michigan, Ann Arbor, MI, USA.,3 Community Health and Social Services Center, Detroit, MI, USA
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Rivas C, Matheson L, Nayoan J, Glaser A, Gavin A, Wright P, Wagland R, Watson E. Ethnicity and the prostate cancer experience: a qualitative metasynthesis. Psychooncology 2016; 25:1147-1156. [PMID: 27416079 PMCID: PMC5096040 DOI: 10.1002/pon.4222] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2016] [Revised: 07/10/2016] [Accepted: 07/11/2016] [Indexed: 12/29/2022]
Abstract
Objectives To summarize black and minority ethnic (BME) patients' and partners experiences of prostate cancer by examining the findings of existing qualitative studies. Methods We undertook a systematic metasynthesis of qualitative studies using a modified version of Noblit and Hare's “meta‐ethnography” approach, with a 2000‐2015 search of 7 databases. Results Thirteen studies of men from US and UK BME groups were included. We explored constructs with BME‐specific features. Health care provider relationships, formation of a spiritual alliance with God (which enhanced the participants' feeling of empowerment and ability to cope with the cancer), and living on for others (generally to increase cancer awareness), often connected to spiritual regrowth, were the 3 constructs most commonly reported. A magnified effect from erectile dysfunction was also common. Initially, this affected men's disclosure to others about their cancer and their sexual problems, but eventually men responded by shifting their conceptualizations of masculinity to sustain self and social identities. There was also evidence of inequality resulting from financial constraints and adversity that necessitated resilience in coping. Conclusions The prostate cancer experience of BME men and their partners is affected by a complex intersection of ethnicity with other factors. Health care services should acknowledge this. If providers recognize the men's felt masculinities, social identities, and spiritual beliefs and their shifting nature, services could be improved, with community as well as individual benefits. More studies are needed in diverse ethnic groups.
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Affiliation(s)
- Carol Rivas
- Faculty of Health Sciences, University of Southampton, Southampton, UK.
| | - Lauren Matheson
- Faculty of Health and Life Sciences, Oxford Brookes University, Oxford, UK
| | - Johana Nayoan
- Faculty of Health Sciences, University of Southampton, Southampton, UK
| | - Adam Glaser
- Leeds Institute of Cancer and Pathology, Faculty of Medicine and Health, University of Leeds, Leeds, UK
| | - Anna Gavin
- School of Medicine, Dentistry and Biomedical Sciences, Centre for Public Health, Queen's University Belfast, Belfast, UK
| | - Penny Wright
- Leeds Institute of Cancer and Pathology, Faculty of Medicine and Health, University of Leeds, Leeds, UK
| | - Richard Wagland
- Faculty of Health Sciences, University of Southampton, Southampton, UK
| | - Eila Watson
- Faculty of Health and Life Sciences, Oxford Brookes University, Oxford, UK
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Ussher JM, Perz J, Gilbert E. Perceived causes and consequences of sexual changes after cancer for women and men: a mixed method study. BMC Cancer 2015; 15:268. [PMID: 25885443 PMCID: PMC4407322 DOI: 10.1186/s12885-015-1243-8] [Citation(s) in RCA: 62] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2014] [Accepted: 03/23/2015] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Previous research on cancer and sexuality has focused on physical aspects of sexual dysfunction, neglecting the subjective meaning and consequences of sexual changes. This has led to calls for research on cancer and sexuality to adopt an "integrative" approach, and to examine the ways in which individuals interpret sexual changes, and the subjective consequences of sexual changes. METHOD This study examined the nature and subjective experience and consequences of changes to sexual well-being after cancer, using a combination of quantitative and qualitative analysis. Six hundred and fifty seven people with cancer (535 women, 122 men), across a range of reproductive and non-reproductive cancer types completed a survey and 44 (23 women, 21 men) took part in an in-depth interview. RESULTS Sexual frequency, sexual satisfaction and engagement in a range of penetrative and non-penetrative sexual activities were reported to have reduced after cancer, for both women and men, across reproductive and non-reproductive cancer types. Perceived causes of such changes were physical consequences of cancer treatment, psychological factors, body image concerns and relationship factors. Sex specific difficulties (vaginal dryness and erectile dysfunction) were the most commonly reported explanation for both women and men, followed by tiredness and feeling unattractive for women, and surgery and getting older for men. Psychological and relationship factors were also identified as consequence of changes to sexuality. This included disappointment at loss of sexual intimacy, frustration and anger, sadness, feelings of inadequacy and changes to sense of masculinity of femininity, as well as increased confidence and self-comfort; and relationship strain, relationship ending and difficulties forming a new relationship. Conversely, a number of participants reported increased confidence, re-prioritisation of sex, sexual re-negotiation, as well as a strengthened relationship, after cancer. CONCLUSION The findings of this study confirm the importance of health professionals and support workers acknowledging sexual changes when providing health information and developing supportive interventions, across the whole spectrum of cancer care. Psychological interventions aimed at reducing distress and improving quality of life after cancer should include a component on sexual well-being, and sexual interventions should incorporate components on psychological and relational functioning.
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Affiliation(s)
- Jane M Ussher
- Centre for Health Research, University of Western Sydney, Locked Bag 1797, Penrith South, 2751, Australia.
| | - Janette Perz
- Centre for Health Research, University of Western Sydney, Locked Bag 1797, Penrith South, 2751, Australia.
| | - Emilee Gilbert
- School of Social Sciences and Psychology, University of Western Sydney, Locked Bag 1797, Penrith South, 2751, Australia.
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McCaughan E, McKenna S, McSorley O, Parahoo K. The experience and perceptions of men with prostate cancer and their partners of the CONNECT psychosocial intervention: a qualitative exploration. J Adv Nurs 2015; 71:1871-82. [PMID: 25818026 DOI: 10.1111/jan.12648] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/27/2015] [Indexed: 11/30/2022]
Abstract
AIM To explore the experience of prostate cancer survivors and their partners of the CONNECT psychosocial intervention. BACKGROUND There is a scarcity of evidence relating to interventions to help men and their partners cope with the after affects of prostate cancer treatment. DESIGN This study employed a qualitative design for in depth exploration through couple interviews. The addition of a short process evaluation questionnaire was used to supplement the qualitative data. METHODS Semi-structured interviews were conducted between January 2012-October 2012 with a purposive sample of 11 couple dyads who had participated in the CONNECT intervention. Data were analysed using inductive content analysis. Simple descriptive statistics were used to analyse the findings from the questionnaire data. RESULTS Couples perceived benefits of participating in the intervention to include: opportunities to share experiences, gain validation, obtain information and engage in couple care. The expertise of the professional facilitator and group dynamics were highlighted as factors influencing the success of the intervention. Potential areas for improvement of the intervention were identified as being: further development of the sexual dysfunction component; incorporation of a partner specific session to better address their needs; determination of optimal delivery format and timing; and further tailoring of the components of the intervention. CONCLUSION Although there were areas that could be further improved, this psychosocial intervention was valued by the participants. The insight gained from this qualitative exploration can be used to make the necessary changes before the intervention can be tested in a large randomised controlled trial.
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Affiliation(s)
- Eilis McCaughan
- Institute of Nursing and Health Research, University of Ulster, Coleraine, UK
| | - Suzanne McKenna
- Institute of Nursing and Health Research, University of Ulster, Coleraine, UK
| | - Oonagh McSorley
- Institute of Nursing and Health Research, University of Ulster, Coleraine, UK
| | - Kader Parahoo
- Institute of Nursing and Health Research, University of Ulster, Coleraine, UK
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Gonzalez BD, Jim HSL, Cessna JM, Small BJ, Sutton SK, Jacobsen PB. Concealment of lung cancer diagnosis: prevalence and correlates. Psychooncology 2015; 24:1774-83. [PMID: 25753772 DOI: 10.1002/pon.3793] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2014] [Revised: 01/30/2015] [Accepted: 02/08/2015] [Indexed: 01/22/2023]
Abstract
BACKGROUND Lung cancer has a commonly understood behavioral etiology. Thus, lung cancer patients are often blamed for their illness and may seek to avoid this blame by concealing their diagnosis from others. This study sought to determine the prevalence of concealment and identify demographic, clinical, and psychosocial correlates of concealment among lung cancer patients. METHODS A sample of 117 lung cancer patients receiving chemotherapy for non-small cell or small cell lung cancer was recruited and completed self-report demographic questionnaires, a measure of diagnosis concealment designed and pilot tested for this study, and standard measures of psychosocial variables. Clinical factors were assessed via a medical chart review. RESULTS Thirty participants (26%) reported concealing their diagnosis in the previous month, most frequently from casual friends and close friends. Reported reasons for concealment largely reflected concern for others. Univariate analyses indicated that those who concealed their lung cancer diagnosis reported more internalized shame related to their illness and use of positive reappraisal as a coping strategy (ps ≤ 0.02). In addition, those who concealed were more likely to have used alcohol in the previous month and have a more recent recurrence, among those who had a recurrence (ps ≤ 0.04). Multivariate analyses indicated that internalized shame and use of positive reappraisal accounted for significant unique variance in concealment above and beyond that accounted for by use of alcohol (ps < 0.05). CONCLUSIONS Future research should aim to replicate and extend these findings with longitudinal designs to elucidate the directionality of the associations observed in this study.
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Affiliation(s)
- Brian D Gonzalez
- Health Outcomes and Behavior Program, Moffitt Cancer Center, Tampa, FL, USA
| | - Heather S L Jim
- Health Outcomes and Behavior Program, Moffitt Cancer Center, Tampa, FL, USA
| | - Julie M Cessna
- Health Outcomes and Behavior Program, Moffitt Cancer Center, Tampa, FL, USA.,Department of Psychology, University of South Florida, Tampa, FL, USA
| | - Brent J Small
- School of Aging Studies, University of South Florida, Tampa, FL, USA
| | - Steven K Sutton
- Department of Biostatistics and Bioinformatics, Moffitt Cancer Center, Tampa, FL, USA
| | - Paul B Jacobsen
- Health Outcomes and Behavior Program, Moffitt Cancer Center, Tampa, FL, USA
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King AJL, Evans M, Moore THM, Paterson C, Sharp D, Persad R, Huntley AL. Prostate cancer and supportive care: a systematic review and qualitative synthesis of men's experiences and unmet needs. Eur J Cancer Care (Engl) 2015; 24:618-34. [PMID: 25630851 PMCID: PMC5024073 DOI: 10.1111/ecc.12286] [Citation(s) in RCA: 122] [Impact Index Per Article: 13.6] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/09/2014] [Indexed: 12/02/2022]
Abstract
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.
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Affiliation(s)
- A J L King
- Centre for Academic Primary Care, School of Social and Community Medicine, University of Bristol, Bristol, UK
| | - M Evans
- Centre for Academic Primary Care, School of Social and Community Medicine, University of Bristol, Bristol, UK
| | - T H M Moore
- Centre for Academic Primary Care, School of Social and Community Medicine, University of Bristol, Bristol, UK
| | - C Paterson
- Centre for Academic Primary Care, School of Social and Community Medicine, University of Bristol, Bristol, UK
| | - D Sharp
- Centre for Academic Primary Care, School of Social and Community Medicine, University of Bristol, Bristol, UK
| | - R Persad
- Urology, Bristol Urological Institute Southmead Hospital, Bristol, UK
| | - A L Huntley
- Centre for Academic Primary Care, School of Social and Community Medicine, University of Bristol, Bristol, UK
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Appleton L, Wyatt D, Perkins E, Parker C, Crane J, Jones A, Moorhead L, Brown V, Wall C, Pagett M. The impact of prostate cancer on men's everyday life. Eur J Cancer Care (Engl) 2014; 24:71-84. [DOI: 10.1111/ecc.12233] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/29/2014] [Indexed: 01/10/2023]
Affiliation(s)
- L. Appleton
- The Clatterbridge Cancer Centre NHS Foundation Trust; Wirral UK
| | - D. Wyatt
- University of Chester/Clatterbridge Cancer Centre; Faculty of Health and Social Care; University of Chester; Chester UK
| | - E. Perkins
- Health and Community Care Research Unit; Institute of Psychology, Health and Society; University of Liverpool; Liverpool UK
| | - C. Parker
- Urology; Aintree University Hospital; Liverpool UK
| | - J. Crane
- School of Health Sciences; University of Liverpool; Liverpool UK
| | | | | | - V. Brown
- Hospice of the Good Shepherd; Chester UK
| | - C. Wall
- Faculty of Education Health and Community; Liverpool John Moores University; Liverpool UK
| | - M. Pagett
- The Clatterbridge Cancer Centre NHS Foundation Trust; Wirral UK
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Williams KC, Hicks EM, Chang N, Connor SE, Maliski SL. Purposeful normalization when caring for husbands recovering from prostate cancer. QUALITATIVE HEALTH RESEARCH 2014; 24:306-316. [PMID: 24590418 DOI: 10.1177/1049732314523842] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Despite a growing awareness that prostate cancer is a "couple's disease," the coping strategies, subjective distress, and emotional needs of partners are not adequately addressed. To better understand wives' experiences and processes they enact, we recruited 28 low-income Latinas caring for husbands recovering from prostatectomies to participate in interviews at three time points. Their narratives destabilize a common focus on physical side effects and an implicit bias toward men's reactions. We critically examine an overarching process of normalization, with underlying themes working both toward and against normality. We identified dissonance between detailed accounts of major lifestyle changes and professed normalization. We detail the women's purposeful methods to counteract negative impacts on their lives while seeking support externally. A better understanding of women's strategies and coping is critical to design interventions and education to both capitalize on partners' role in recovery while also addressing hidden causes of increased subjective distress.
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Bergman J, Litwin MS. Quality of life in men undergoing active surveillance for localized prostate cancer. J Natl Cancer Inst Monogr 2013; 2012:242-9. [PMID: 23271780 DOI: 10.1093/jncimonographs/lgs026] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
Active surveillance is an important arrow in the quiver of physicians advising men with prostate cancer. Quality-of-life considerations are paramount for patient-centered decision making. Although the overall deleterious impact on health is less dramatic than for those who pursue curative treatment, men on active surveillance also suffer sexual dysfunction and distress. Five-year outcomes revealed more erectile dysfunction (80% vs 45%) and urinary leakage (49% vs 21%) but less urinary obstruction (28% vs 44%) in men undergoing prostatectomy. Bowel function, anxiety, depression, well-being, and overall health-related quality of life (HRQOL) were similar after 5 years, but at 6-8 years, other domains of HRQOL, such as anxiety and depression, deteriorated significantly for those who chose watchful waiting. Further research is needed to compare prospectively HRQOL outcomes in men choosing active surveillance and those never diagnosed with prostate cancer, in part to help weigh the potential benefits and harms of prostate cancer screening.
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Affiliation(s)
- Jonathan Bergman
- UCLA Department of Urology, University of California-Los Angeles, CA 90095-1738, USA.
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40
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Gilbert E, Ussher JM, Perz J, Wong WKT, Hobbs K, Mason C. Men's experiences of sexuality after cancer: a material discursive intra-psychic approach. CULTURE, HEALTH & SEXUALITY 2013; 15:881-895. [PMID: 23656602 DOI: 10.1080/13691058.2013.789129] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
Men can experience significant changes to their sexuality following the onset of cancer. However, research on men's sexuality post-cancer has focused almost exclusively on those with prostate and testicular cancer, despite evidence that the diagnosis and treatment for most cancers can impact on men's sexuality. This Australian qualitative study explores the experiences of changes to sexuality for 21 men across a range of cancer types and stages, sexual orientations and relationship contexts. Semi-structured interviews were analysed with theoretical thematic analysis guided by a material discursive intra-psychic approach, recognising the materiality of sexual changes, men's intrapsychic experience of such changes within a relational context and the influence of the discursive construction of masculine sexuality. Material changes included erectile difficulty, decreased desire, and difficulty with orgasm. The use of medical aids to minimise the impact of erectile difficulties was shaped by discursive constructions of 'normal' masculine sexuality. The majority of men reported accepting the changes to their sexuality post-cancer and normalised them as part of the natural ageing process. Men's relationship status and context played a key role managing the changes to their sexuality. We conclude by discussing the implications for clinical practice.
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Affiliation(s)
- Emilee Gilbert
- a Centre for Health Research , University of Western Sydney , Sydney , Australia
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Maliski SL, Connor SE, Litwin MS. Purposeful interaction: ways Latino men communicate about prostate cancer. Oncol Nurs Forum 2012; 39:603-8. [PMID: 23107854 PMCID: PMC3686632 DOI: 10.1188/12.onf.603-608] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE/OBJECTIVES To develop a descriptive framework of the communication processes used by Latinos with prostate cancer to communicate about their diagnosis. RESEARCH APPROACH A constructivist grounded theory approach was used to analyze and build a descriptive framework from semistructured interviews. SETTING A university-affiliated urban hospital in southern California. PARTICIPANTS 30 Latinos treated for prostate cancer, who had at least one first-degree male relative (FDMR), and who lived near the medical center. METHODOLOGIC APPROACH Semistructured interviews with bilingual Latinos were conducted in participants' homes in the language they preferred. Individual and collaborative analyses of translated transcripts were guided by constructivist grounded theory. FINDINGS Analysis uncovered an overarching process of purposeful interacting. Components of the process included occasionally overlapping spheres of communication, which were connected to purposes and content. Balanced in and influenced by the spheres were cross-cutting processes of respectful silence and selective disclosure. CONCLUSIONS Men communicated different content about their prostate cancer to people representing different reference groups. Respectful silence and selective disclosure could be viewed as men's enactment of social interaction-using and choosing words based on the symbolic meaning the men perceived would have their intended meaning for the people in each of the spheres. INTERPRETATION Culturally sensitive educational interventions should be targeted at Latinos with prostate cancer to understand risk and encourage disclosure to FDMRs.
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Affiliation(s)
- Sally L Maliski
- School of Nursing, University of California, Los Angeles, CA, USA.
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Maliski SL, Husain M, Connor SE, Litwin MS. Alliance of support for low-income Latino men with prostate cancer: God, doctor, and self. JOURNAL OF RELIGION AND HEALTH 2012; 51:752-62. [PMID: 20625832 PMCID: PMC3444699 DOI: 10.1007/s10943-010-9369-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
Utilizing qualitative methods, this study describes the perceptions of and reliance on spirituality among indigent Latino men with prostate cancer. Sixty men were interviewed in Spanish. Transcripts were transcribed verbatim, translated, and analyzed using grounded theory techniques. Common across all men was a process involving the formation of an alliance of support that included God, doctors, and self. From this alliance, men drew strength to manage their disease, maintained hope for the future, and found new existential meaning. By recognizing the potential value of this alliance, health care professionals may tap into a beneficial empowering resource for some Latino men.
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Affiliation(s)
- Sally L Maliski
- School of Nursing, University of California, Los Angeles (UCLA), 2-256 Factor Bldg, BOX 956918, Los Angeles, CA 90095-6918, USA.
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Konradsen H, Kirkevold M, McCallin A, Cayé-Thomasen P, Zoffmann V. Breaking the silence: integration of facial disfigurement after surgical treatment for cancer. QUALITATIVE HEALTH RESEARCH 2012; 22:1037-1046. [PMID: 22673089 DOI: 10.1177/1049732312448545] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Little is known about the psychosocial effects of facial disfigurement. We present the results of a qualitative study following 15 patients who had been surgically treated for head, neck, or eye cancer over the course of their first postoperative year. Taped nurse-patient conversations and individual interviews were analyzed using the grounded theory method. The findings revealed that the main concern of the patients was feeling isolated, which was resolved using a process of interactional integration. Interactional integration begins by breaking the silence to enable the progression from a disfigured person to a person with a disfigurement. The model explains the process of adjustment and demonstrates various elements that could be used in interventions targeting patients who experience psychosocial problems.
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Getrich CM, Sussman AL, Helitzer DL, Hoffman RM, Warner TD, Sánchez V, Solares A, Rhyne RL. Expressions of machismo in colorectal cancer screening among New Mexico Hispanic subpopulations. QUALITATIVE HEALTH RESEARCH 2012; 22:546-59. [PMID: 22138258 PMCID: PMC3636712 DOI: 10.1177/1049732311424509] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
Although national colorectal cancer (CRC) incidence rates have steadily decreased, the rate for New Mexico Hispanics has been increasing, and screening rates are low. We conducted an exploratory qualitative study to determine barriers to CRC screening for New Mexico Hispanics. We found that machismo served as a dynamic influence on men's health-seeking behaviors; however, it was conceptualized differently by two distinct Hispanic subpopulations, and therefore appeared to play a different role in shaping their screening attitudes and behaviors. Machismo emerged as more of an influence for Mexican men, who expressed concern over colonoscopies being potentially transformative and/or stigmatizing, but was not as salient for Hispanos, who viewed the colonoscopy as "strictly medical," and were more concerned with discomfort and pain. Findings from the study highlight the importance of identifying varying characteristics among subpopulations to better understand screening barriers and provide optimal CRC screening counseling in primary care settings.
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Long-term quality of life in disadvantaged men with prostate cancer on androgen-deprivation therapy. Prostate Cancer Prostatic Dis 2012; 15:237-43. [PMID: 22289781 DOI: 10.1038/pcan.2011.71] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND To explore the effects of androgen-deprivation therapy (ADT) on general, disease-specific and hormone-specific health-related quality of life (HRQOL) among minority men. METHODS Men enrolled in a state-funded program, providing free prostate cancer treatment for underserved men, were recruited, if they had received at least 3 months of continuous ADT and/or other forms of primary treatment. HRQOL was assessed with validated measures including the RAND Medical Outcomes Study 12-item Health Short Form Survey (SF-12), the UCLA Prostate Cancer Index Survey and the Expanded Prostate Cancer Index Composite Survey. Repeated measures analysis was performed to evaluate the association between clinical and sociodemographic covariates with HRQOL. RESULTS We enrolled 322 men, including 94 on ADT and 228 who received other forms of treatment. When controlling for patient characteristics, men receiving ADT had poorer outcomes relative to sexual function (P<0.01), sexual bother (P<0.01), hormonal function (P<0.01) and hormonal bother (P=0.02). ADT use was significantly associated with worsening sexual function (P<0.01) and sexual bother (P=0.01) over two years compared with non-ADT users. Analysis also demonstrated significant differences between whites, Hispanics and Others (African American (n=43, 16%), Asian (n=13, 5%), multiracial (n=1, 0.4%), Native American (n=1, 0.4%) and other (n=9, 3%)) relative to urinary bother (P=0.01), urinary function (P=0.01) and hormonal bother (P=0.03). ADT users had better urinary function and less bother than non-ADT users among the Other group, while the opposite was true for whites and Hispanics. For hormonal bother, ADT use was associated with worse outcomes across all three race/ethnicity groups; however, Hispanics were less bothered by their hormonal symptoms than whites or Others. CONCLUSION Men of disadvantaged backgrounds on hormone therapy for prostate cancer experience declines in sexual and hormonal HRQOL. Whites and non-whites on ADT have significantly different HRQOL outcomes.
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CORBOY DENISE, MCDONALD JOHN, MCLAREN SUZANNE. Barriers to Accessing Psychosocial Support Services among Men with Cancer Living in Rural Australia: Perceptions of Men and Health Professionals. ACTA ACUST UNITED AC 2011. [DOI: 10.3149/jmh.1002.163] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Social and clinical predictors of prostate cancer treatment decisions among men in South Carolina. Cancer Causes Control 2011; 22:1597-606. [PMID: 21877121 DOI: 10.1007/s10552-011-9836-2] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2011] [Accepted: 08/19/2011] [Indexed: 10/17/2022]
Abstract
OBJECTIVE To assess social and clinical influences of prostate cancer treatment decisions among white and black men in the Midlands of South Carolina. METHODS We linked data collected on treatment decision making in men diagnosed with prostate cancer from 1996 through 2002 with clinical and sociodemographic factors collected routinely by the South Carolina Central Cancer Registry (SCCCR). Unconditional logistic regression was used to assess social and clinical influences on treatment decision. RESULTS A total of 435 men were evaluated. Men of both races who chose surgery (versus radiation) were more likely to be influenced by their physician and by family/friends. Black men who chose surgery also were ~5 times more likely to make independent decisions (i.e., rather than be influenced by their doctor). White men who chose surgery were twice as likely to be influenced by the desire for cure and less likely to consider the side effects of impotence (odds ratio (OR) = 0.40; 95% confidence interval (CI): 0.18, 0.88) and incontinence (OR = 0.27; 95% CI: 0.12, 0.63); by contrast, there was a suggestion of an opposite effect in black men, whose decision regarding surgery tended to be more strongly influenced by these side effects. CONCLUSION Results suggest that both clinical and social predictors play an important role for men in choosing a prostate cancer treatment, but these influences may differ by race.
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Wassersug RJ, Gray R. The health and well-being of prostate cancer patients and male-to-female transsexuals on androgen deprivation therapy: a qualitative study with comments on expectations and estrogen. PSYCHOL HEALTH MED 2011; 16:39-52. [PMID: 21218363 DOI: 10.1080/13548506.2010.516364] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Both male-to-female transsexuals and advanced prostate cancer (PCa) patients are treated with androgen-suppressing drugs that have emasculating effects. Additionally, transsexuals take estrogenic compounds to feminize their bodies. We explore the quality of life of these populations, based on interviews with 12 individuals from each group. Overall, the transsexuals had a better psychological response to chemical castration than the PCa patients. The transsexuals showed more enthusiasm about the changes in their life; they viewed their lives as beginning anew, accepted their reduced libido, and were more comfortable with their increased emotionality. Different responses in the two groups are not surprising given that they undergo androgen deprivation under very different medical contexts. However, the fact that the transwomen are able to conceptualize the effects as positive suggests that some androgen-deprived PCa patients may benefit from reconceptualizing their changes within a positive framework. Additionally, difference in the two populations may be attributed, in part, to the fact that the transsexuals take supplemental estrogen. Circumstantial evidence suggests that estrogen in androgen-deprived males may improve sleep quality, help retain sexual interest, and protect cognitive function. This suggests that PCa patients may benefit from using estradiol for androgen suppression.
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Affiliation(s)
- Richard J Wassersug
- Department of Anatomy and Neurobiology, Dalhousie University, Halifax, Nova Scotia, Canada.
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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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