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Hughes S, Everitt H, Stuart B, Band R. Active surveillance for prostate cancer is a shared journey: the dyadic perspective. PSYCHOL HEALTH MED 2024:1-18. [PMID: 39342965 DOI: 10.1080/13548506.2024.2407441] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Accepted: 09/15/2024] [Indexed: 10/01/2024]
Abstract
Active surveillance for prostate cancer monitors disease progression, with a view to actively treat only if progression is evident. Living with an untreated cancer can negatively impact psychological wellbeing. Partners can influence decisions to convert to active treatment in the absence of disease progression, it is, therefore, important to consider partner reactions and responses to prostate cancer treatment options. We explored the experiences of men on active surveillance and their partners and the impact partner feelings, responses and reactions to active surveillance have on the patient. Semi-structured personal communication were conducted with nine male-female couples (n = 18). All male participants were on active surveillance for prostate cancer. Data was analysed using an adapted version of the Collaco et al. (2021) Framework Method for dyadic data analysis. Dyads function as an interconnected unit with interlinked emotional responses. Differing feelings about active surveillance within the couple were common; men prioritised avoidance of active treatment side effects, partners prioritised minimising the chance of disease progression. Partner inclusion is important, but they sometimes felt excluded by their partners and/or health care professionals. More support is needed for this population. Dyadic support is bidirectional and complex with partners often less comfortable with active surveillance than their partners. More research is needed to explore how partners can be better included and supported.
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Affiliation(s)
- Stephanie Hughes
- Primary Care Research Centre, School of Primary Care, Population Sciences & Medical Education, University of Southampton, Southampton, Hants, UK
| | - Hazel Everitt
- Primary Care Research Centre, School of Primary Care, Population Sciences & Medical Education, University of Southampton, Southampton, Hants, UK
| | - Beth Stuart
- Wolfson Institute of Population Health, Queen Mary University of London, London, UK
| | - Rebecca Band
- School of Health and Social Care, Swansea University, Swansea, UK
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Wu S, Li K, Zhang Y, Wang L, Zhu B, Wang W. Men's symptom experience throughout androgen deprivation therapy for prostate cancer: A systematic review and meta-aggregation. Int J Nurs Stud 2024; 157:104796. [PMID: 38824718 DOI: 10.1016/j.ijnurstu.2024.104796] [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: 12/26/2023] [Revised: 03/20/2024] [Accepted: 05/02/2024] [Indexed: 06/04/2024]
Abstract
BACKGROUND Androgen deprivation therapy is a common treatment for men with advanced prostate cancer. They have experienced many complex symptoms that affect their quality of life. However, qualitative reviews that synthesize the symptom experience for men with prostate cancer are lacking. OBJECTIVE To explore the men's symptom experience throughout androgen deprivation therapy for prostate cancer. DESIGN A qualitative evidence synthesis using meta-aggregation. DATA RESOURCES Published and unpublished literature between January 2001 and August 2023 were identified from PubMed, Embase (Ovid), Web of Science, Cumulative Index to Nursing and Allied Health Literature (CINAHL), The Cochrane Library, ProQuest, Google Scholar, China National Knowledge Infrastructure (CNKI), Wang Fang, and VIP. REVIEW METHODS Two reviewers independently conducted screening, study selection and data extraction, and quality appraisal was performed using the Joanna Briggs Institutes Critical Appraisal Checklist for Qualitative Research. Data synthesis was conducted using meta-aggregative approach. RESULTS 24 articles of moderate to high methodological quality were included. A total of 98 findings were extracted with 59 unequivocal or equivocal findings eligible for meta-aggregation, aggregated into nine categories, and developed four synthesized findings: (1) production of symptoms: unrecognized and underestimated, (2) perception of symptoms: varied and complicated, (3) meaning of symptoms: threatened and affected, and (4) response to symptoms: push and pull. CONCLUSIONS Men throughout androgen deprivation for prostate cancer experience the four crisis-packed stages in their symptomatic journey. Health care provider need to understand the men's thoughts whether in the process of shared decision-making or in the course of the chosen therapy. Future research should develop individual suitable interventions and offer practical strategies for managing symptom. PROSPERO registration: CRD42023449129.
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Affiliation(s)
- Siyuan Wu
- Department of Nursing, The First Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China; Department of Nursing, School of Medicine, Zhejiang University, Hangzhou, China
| | - Kun Li
- Department of Nursing, The First Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China; Department of Nursing, School of Medicine, Zhejiang University, Hangzhou, China
| | - Ying Zhang
- Department of Nursing, The First Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China; Department of Nursing, School of Medicine, Zhejiang University, Hangzhou, China
| | - Lijuan Wang
- Department of Nursing, The First Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China; Department of Nursing, School of Medicine, Zhejiang University, Hangzhou, China
| | - Binbin Zhu
- Department of Nursing, The First Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China; Department of Nursing, School of Medicine, Zhejiang University, Hangzhou, China
| | - Wei Wang
- Department of Nursing, The First Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China.
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Collaço N, Wagland R, Alexis O, Gavin A, Glaser A, Watson EK. The experiences and needs of couples affected by prostate cancer aged 65 and under: a qualitative study. J Cancer Surviv 2021; 15:358-366. [PMID: 32968952 PMCID: PMC7966139 DOI: 10.1007/s11764-020-00936-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2020] [Accepted: 09/05/2020] [Indexed: 12/24/2022]
Abstract
PURPOSE Prostate Cancer (PCa) is often considered to be an illness affecting older men, however the prevalence in younger men (<=65 years) is rising. Diagnosis and treatment for PCa can have a significant impact on the lives of both the man with PCa and his partner. This study explored the experiences and needs of younger men and their partners affected by PCa. The findings will be used to inform service provision and develop interventions appropriate to need. METHODS Participants were recruited from respondents to a national PROMS study (Life After Prostate Cancer Diagnosis (LAPCD), who indicated on completed questionnaires their willingness to be interviewed. Semi-structured telephone interviews were conducted with twenty-eight couples, separately (56 participants). Data were analysed using the Framework Method. RESULTS Following the diagnosis of PCa, couples' experienced changes in their intimate relationships, parental/familial roles, work and finances, and social connections and activities. Couples adopted a range of strategies and behaviours to help their adjustment to PCa, such as communicating with each other, distancing, distraction, and adopting a positive mindset towards PCa. This, in turn, influenced how their identity as a couple evolved. CONCLUSIONS Following a diagnosis of PCa, the identity of couples are continually evolving. It is important that these couples are provided with the appropriate information, support and resources to help them transition along the cancer pathway. IMPLICATIONS FOR CANCER SURVIVORS Key areas of support identified for younger couples include: 1) couple focused support programme to foster relationship strategies/behaviours that facilitate couple adjustment; 2) age-specific support, e.g. 'buddying systems' connecting younger couples affected by PCa and providing them with tailored information (written/online/app).
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Affiliation(s)
- Nicole Collaço
- Faculty of Health Sciences, University of Southampton, Southampton, S017 1BJ, UK.
- Faculty of Health and Life Sciences, Oxford Brookes University, Jack Straws Lane, Oxford, OX3 0FL, UK.
| | - Richard Wagland
- Faculty of Health Sciences, University of Southampton, Southampton, S017 1BJ, UK
| | - Obrey Alexis
- Faculty of Health and Life Sciences, Oxford Brookes University, Jack Straws Lane, Oxford, OX3 0FL, UK
| | - Anna Gavin
- Northern Ireland Cancer Registry Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queen's University, Belfast, BT12 6BA, UK
| | - Adam Glaser
- Leeds Institute of Cancer and Pathology, Faculty of Medicine and Health, University of Leeds, Worsley Building, Leeds, LS2 9NL, UK
| | - Eila K Watson
- Faculty of Health and Life Sciences, Oxford Brookes University, Jack Straws Lane, Oxford, OX3 0FL, UK
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Pitcher S, Fakie N, Adams T, Denny L, Moodley J. Sexuality post gynaecological cancer treatment: a qualitative study with South African women. BMJ Open 2020; 10:e038421. [PMID: 32967884 PMCID: PMC7513640 DOI: 10.1136/bmjopen-2020-038421] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
OBJECTIVES This study investigated women's experiences of their sexuality post gynaecological cancer treatment. Using a holistic sexuality framework, the study explored how women felt their sexual functioning, sexual relationships and sexual identity had been affected by treatment. DESIGN The study was qualitative in nature and made use of an interpretive descriptive design. Data were analysed using thematic analysis. SETTING Data collection took place at a follow-up clinic within the gynaeoncology unit at a public-sector tertiary hospital in Cape Town, South Africa. PARTICIPANTS Purposive sampling was used to recruit participants, and the final sample consisted of 34 women aged 29-70 ([Formula: see text]=52). All women had received a gynaecological cancer diagnosis and had been treated with either surgery, chemotherapy, radiation or a combination of these. On average, the participants were between 12 and 30 months post treatment. RESULTS Women expressed how their sexual functioning post treatment was both nuanced and complex, how heteronormative gender expectations influenced their intimate relationships, and how they experienced a re-embodiment of their sexual subjectivity post treatment. Participants felt that more sexual functioning information from healthcare providers, as well as peer support groups, would assist them in navigating the sexuality changes they experienced. CONCLUSIONS The findings of this study broaden conceptualisations of sexuality post treatment by detailing the ways that it is complex, nuanced, relational and ever shifting. More research is needed about how to incorporate holistic psychosexual support post treatment into the public healthcare system in South Africa.
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Affiliation(s)
- Sorrel Pitcher
- UCT/SAMRC Gynaecological Cancer Research Centre, University of Cape Town, Cape Town, Western Cape, South Africa
| | - Nazia Fakie
- UCT/SAMRC Gynaecological Cancer Research Centre, University of Cape Town, Cape Town, Western Cape, South Africa
- Radiation Oncology, Groote Schuur Hospital, Cape Town, Western Cape, South Africa
| | - Tracey Adams
- UCT/SAMRC Gynaecological Cancer Research Centre, University of Cape Town, Cape Town, Western Cape, South Africa
- Obstetrics and Gynaecology, Groote Schuur Hospital, Cape Town, Western Cape, South Africa
| | - Lynette Denny
- UCT/SAMRC Gynaecological Cancer Research Centre, University of Cape Town, Cape Town, Western Cape, South Africa
- Obstetrics and Gynaecology, Groote Schuur Hospital, Cape Town, Western Cape, South Africa
| | - Jennifer Moodley
- UCT/SAMRC Gynaecological Cancer Research Centre, University of Cape Town, Cape Town, Western Cape, South Africa
- Cancer Research Initiative, University of Cape Town, Cape Town, Western Cape, South Africa
- Women's Health Research Unit, University of Cape Town, Cape Town, Western Cape, South Africa
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Psychometric properties of the FACT-G quality of life scale for family caregivers of cancer patients. Qual Life Res 2020; 29:2241-2252. [PMID: 32246432 PMCID: PMC7363734 DOI: 10.1007/s11136-020-02477-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/10/2020] [Indexed: 01/16/2023]
Abstract
Purpose This study aimed to examine psychometric properties of a caregiver version of the well-established Functional Assessment of Cancer Therapy-General Scale (FACT-G) after conducting focus groups and obtaining expert input. Methods We made minor wording modifications to the Patient FACT-G to enable caregivers to report how the illness affected their overall quality of life (QOL) and well-being on four subscales (physical, social, emotional, functional). We tested the acceptability, precision, factor structure, reliability and validity of the Caregiver FACT-G among partners of prostate cancer patients (N = 263) and caregivers (spouses, siblings, adult children) of patients with advanced cancer (breast, lung, colorectal, prostate) (N = 484) using data from two Randomized Clinical Trials (RCTs). Results With a factor structure similar to the Patient FACT-G, Caregiver FACT-G was acceptable and precise in measuring caregiver QOL, with high inter-factor correlations and internal consistency reliability (Cronbach’s alphas 0.81–0.91). The Caregiver FACT-G had strong convergent validity demonstrated by significant positive correlations with caregiver self-efficacy (0.25–0.63), dyadic communication (0.18–0.51), and social support (0.18–0.54) in both samples. It also had strong discriminant validity evidenced by significant inverse correlations with negative appraisal of caregiving (− 0.37 to − 0.69), uncertainty (− 0.28 to − 0.53), hopelessness (− 0.25 to − 0.60), and avoidant coping (− 0.26 to − 0.58) in both samples. Caregivers’ baseline FACT-G scores were significantly associated with their physical (0.23) and mental well-being (0.54; 4-month follow-up) and their depression (− 0.69; 3-month follow-up), indicating strong predictive validity. Conclusion This is the first study evaluating the psychometric properties of the Caregiver FACT-G. More psychometric testing is warranted, especially among caregivers of diverse sociocultural backgrounds.
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Developing a digital intervention for cancer survivors: an evidence-, theory- and person-based approach. NPJ Digit Med 2019; 2:85. [PMID: 31508496 PMCID: PMC6718425 DOI: 10.1038/s41746-019-0163-4] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2019] [Accepted: 08/09/2019] [Indexed: 12/17/2022] Open
Abstract
This paper illustrates a rigorous approach to developing digital interventions using an evidence-, theory- and person-based approach. Intervention planning included a rapid scoping review that identified cancer survivors' needs, including barriers and facilitators to intervention success. Review evidence (N = 49 papers) informed the intervention's Guiding Principles, theory-based behavioural analysis and logic model. The intervention was optimised based on feedback on a prototype intervention through interviews (N = 96) with cancer survivors and focus groups with NHS staff and cancer charity workers (N = 31). Interviews with cancer survivors highlighted barriers to engagement, such as concerns about physical activity worsening fatigue. Focus groups highlighted concerns about support appointment length and how to support distressed participants. Feedback informed intervention modifications, to maximise acceptability, feasibility and likelihood of behaviour change. Our systematic method for understanding user views enabled us to anticipate and address important barriers to engagement. This methodology may be useful to others developing digital interventions.
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Abstract
Purpose: Cancer is a chronic illness with acute episodes lasting for years. Most cancer patients have coexisting comorbidities, which affect cancer treatment outcomes and make a shared care model for chronic diseases essential. There is a considerable gap between the achievable and delivered quality of care for cancer patients. Methods: We used a case study approach to examine the complexity of cancer management, from the perspective of one person's case as interpreted by the care team. It allowed the complexity of cancer management to retain its holistic and meaningful characteristics. We interviewed the patient, caregiver, primary care physician (PCP), and oncologist. Interviews were audio recorded and analyzed with ATLASti, qualitative statistical software. Participants also completed a basic demographic survey. Common themes were identified, analyzed, and discussed. Results: Main themes were lack of longitudinal relationship with PCP, communication barriers, and ambiguous health care provider roles. Communication barriers can be associated with the other two main themes. Conclusion: Our results showed that shared care for cancer management is lacking during the acute cancer treatment phase. Communication barriers between the PCP and oncologist along with lack of continuity of care and unclear role of the PCP are major contributors for fragmented cancer care in U.S. health care system.
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Affiliation(s)
- Saima Siddiqui
- Department of Family and Community Medicine, University of Texas Health Science Center at San Antonio, San Antonio, Texas
| | - Inez Cruz
- Department of Family and Community Medicine, University of Texas Health Science Center at San Antonio, San Antonio, Texas
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Talvitie AM, Ojala H, Tammela T, Koivisto AM, Pietilä I. Factors related to self-rated health and life satisfaction one year after radical prostatectomy for localised prostate cancer: a cross-sectional survey. Scand J Caring Sci 2019; 33:688-697. [PMID: 30866074 DOI: 10.1111/scs.12664] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2018] [Accepted: 01/07/2019] [Indexed: 11/27/2022]
Abstract
BACKGROUND Localised prostate cancer affects patient's quality of life in many ways. The aim of this study was to explore factors related to self-rated health and life satisfaction for patients treated for prostate cancer, and to compare the results of these generic quality-of-life measures to the prostate cancer-specific quality-of-life measure (UCLA Prostate Cancer Index), which focuses on physical functioning. MATERIAL AND METHODS This cross-sectional survey was carried out among 183 men who underwent radical prostatectomy in 2012-2015 at a university hospital in Finland and were seen 1 year postsurgery. Approval from an ethics committee and written consents from participants were received. A questionnaire was used to evaluate patients' perceived quality of life. Logistic regression model, Spearman's correlation, Kruskal-Wallis test and Mann-Whitney U-test were used to analyse factors related to quality of life. RESULTS Of the 183 men in the study, 63% rated their health status as good, and 70% were satisfied with their lives after prostatectomy. Older age and better urinary function were the only factors that explained both better self-rated health and better satisfaction with life. The patients seemed not to interpret problems with sexual function as health-related problems. In our sample, sexual dysfunction was relatively severe, but patients considered them to be less harmful than urinary or bowel symptoms. Interestingly, 24% of the men with low sexual function did not find that dysfunction bothersome. CONCLUSIONS Objectively measured physical functioning is not necessarily in line with patients' experienced satisfaction with life and their self-ratings of health. More longitudinal and qualitative research is needed about the meanings that patients attach to physical treatment side effects and the extent to which they can adapt to them over time. With a bigger sample and longer follow-up time, it would be possible to identify men who particularly benefited from pretreatment counselling.
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Affiliation(s)
| | - Hanna Ojala
- Faculty of Social Sciences, Tampere University, Tampere, Finland
| | - Teuvo Tammela
- Faculty of Medicine and Health Technology, Tampere University Hospital and Tampere University, Tampere, Finland
| | | | - Ilkka Pietilä
- Faculty of Social Sciences, University of Helsinki, Helsinki, Finland
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Irani M, Khadivzadeh T, Asghari-Nekah SM, Ebrahimipour H. Coping Strategies of Pregnant Women with Detected Fetal Anomalies in Iran: A Qualitative Study. IRANIAN JOURNAL OF NURSING AND MIDWIFERY RESEARCH 2019; 24:227-233. [PMID: 31057640 PMCID: PMC6485026 DOI: 10.4103/ijnmr.ijnmr_97_18] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 12/02/2022]
Abstract
Background: Progressing technology has increased the detection of fetal abnormalities in the pregnancy. Detection of fetal abnormalities during pregnancy can cause significant social, physical, psychological, and emotional stress. The aim of this study was to explore the coping strategies of Iranian pregnant women with detected fetal anomalies. Materials and Methods: This qualitative content analysis study was conducted on two referral centers for fetal anomaly. The data were collected from April 2017 to January 2018 in Mashhad (Iran) through individual, semistructured, in-depth interviews with 25 pregnant women with a prenatal diagnosis of fetal anomalies. Data were analyzed using conventional content analysis based on Graneheim and Lundman's approach. Results: As a result of data analysis, the four categories of seeking information, religiousness and spirituality, cognitive avoidance, and seeking social support, and 12 subcategories emerged. Seeking information consisted of the four subcategories of personal search, visiting different doctors, performing various diagnostic tests and sonography, and seeking peers' experiences. Religiousness and spirituality contained the three subcategories of praying, acceptance of destiny, and reliance on faith. Cognitive avoidance consisted of the two subcategories of avoiding negative information and avoiding situations that remind them of their problem. Seeking social support contained the three subcategories of getting support from family, getting support from friends, and getting support from others. Conclusions: The findings showed that pregnant women with detected fetal anomalies reported a variety of coping strategies. Therefore, it is important that healthcare providers encourage mothers to use strategies that are likely to be more effective.
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Affiliation(s)
- Morvarid Irani
- Department of Midwifery, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Talat Khadivzadeh
- Nursing and Midwifery Care Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Seyyed-Mohsen Asghari-Nekah
- Department of Educational Sciences, School of Educational Sciences and Psychology, Ferdowsi University of Mashhad, Mashhad, Iran
| | - Hosein Ebrahimipour
- Social Determinants of Health Research Center, Department of Health Sciences, Mashhad University of Medical Sciences, Mashhad, Iran
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Ihrig A, Renner T, Muck T, Maatz P, Borkowetz A, Keck B, Maatouk I, Wirth MP, Huber J. Online support groups offer low-threshold backing for family and friends of patients with prostate cancer. Eur J Cancer Care (Engl) 2018; 28:e12982. [PMID: 30569592 DOI: 10.1111/ecc.12982] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2018] [Revised: 11/05/2018] [Accepted: 11/14/2018] [Indexed: 02/05/2023]
Abstract
A prostate cancer diagnosis affects not only the patients but also their family and friends. We performed a secondary analysis of a survey of users of the largest German online support group (OSG) for prostate cancer. We collected socio-demographic, psychological and disease-related data over a three-month period in 2013. Among 769 participants with a complete questionnaire, 686 were patients, and 83 were family members and friends of other patients. The family and friends group comprised 33% spouses, 31% children and 36% people with other relationships to the patient ("others"). Compared to the patient group, the family and friends group showed higher scores for anxiety and depression and described a higher rate of metastatic disease in the patients with whom they had a relationship. The children of patients showed the highest psychological burden based on their scores for anxiety and depression. Only 7% of spouses and none of the children attended face-to-face support groups, compared to 70% of people in the "others" group. OSGs offer low-threshold support for family members and friends; specifically, they meet the needs of spouses and children who do not attend face-to-face support groups. To improve counselling efforts, physicians should be aware of this online resource.
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Affiliation(s)
- Andreas Ihrig
- Division of Psychooncology, Department of General Internal Medicine and Psychosomatic, University of Heidelberg, Heidelberg, Germany
| | - Theresa Renner
- Department of Urology, Medical Faculty Carl Gustav Carus, TU Dresden, Dresden, Germany
| | - Tanja Muck
- Department of Urology, Medical Faculty Carl Gustav Carus, TU Dresden, Dresden, Germany
| | - Philipp Maatz
- Department of Urology, Medical Faculty Carl Gustav Carus, TU Dresden, Dresden, Germany
| | - Angelika Borkowetz
- Department of Urology, Medical Faculty Carl Gustav Carus, TU Dresden, Dresden, Germany
| | - Bastian Keck
- Department of Urology, University Hospital Erlangen, Erlangen, Germany
| | - Imad Maatouk
- Division of Psychooncology, Department of General Internal Medicine and Psychosomatic, University of Heidelberg, Heidelberg, Germany
| | - Manfred P Wirth
- Department of Urology, Medical Faculty Carl Gustav Carus, TU Dresden, Dresden, Germany
| | - Johannes Huber
- Department of Urology, Medical Faculty Carl Gustav Carus, TU Dresden, Dresden, Germany
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How family caregivers of cancer patients manage symptoms at home: A systematic review. Int J Nurs Stud 2018; 85:68-79. [PMID: 29857223 DOI: 10.1016/j.ijnurstu.2018.05.004] [Citation(s) in RCA: 41] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2017] [Revised: 05/05/2018] [Accepted: 05/08/2018] [Indexed: 12/22/2022]
Abstract
INTRODUCTION Cancer affects not only the patient, but also the whole family, especially when a member of the family assumes the role of the family caregiver. This puts an additional emotional, social and financial strain on the family caregivers. Family caregivers of cancer patients are actively involved in the care provided at the home setting through various ways including practical tasks, symptom management and care coordination. The focus of preceding studies on family caregivers and symptom management was either on pain or the patients' and family caregivers' experience of symptom management and coping. The aim of this review was to provide evidence on how family caregivers manage symptoms and side effects at home, in adult cancer patients throughout the disease trajectory. METHODS A systematic literature review was performed in PubMed, CINAHL, Web of Science and the Cochrane Central Register of Controlled Trials with a combination of keywords and MeSH terms for family caregivers, cancer, symptoms, side effects and management. Based on predetermined inclusion and exclusion criteria, a total of 1270 articles were screened and 20 studies were included in the analysis. A descriptive analysis was performed due to the heterogeneity of the findings. RESULTS The results showed that only a limited number of studies (3/20) explored how and what family caregivers do in symptom management as a primary outcome. Family caregivers provided psychosocial support, such as supporting and motivating the patient and maintaining social engagement. Caregivers provided physical support such as with the administration of medicine and tube feeding. As an integral part of managing the symptoms, family caregivers actively monitored and assessed symptoms to timely recognize any treatment related side effects, assess the response to therapeutic interventions and recognize possible deterioration in physical status. Furthermore, family caregivers were often the decision maker - being alert, watching and waiting and decided when to act and when not to act. CONCLUSIONS Family caregivers are doing work similar to healthcare professionals, when managing symptoms and side effects at home in patients with cancer. Advanced tasks such as assessing, monitoring and deciding when and how to act are included in the daily routine of family caregivers.
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Collaço N, Rivas C, Matheson L, Nayoan J, Wagland R, Alexis O, Gavin A, Glaser A, Watson E. Prostate cancer and the impact on couples: a qualitative metasynthesis. Support Care Cancer 2018; 26:1703-1713. [PMID: 29511952 DOI: 10.1007/s00520-018-4134-0] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2017] [Accepted: 02/25/2018] [Indexed: 12/19/2022]
Abstract
PURPOSE To review and interpret existing qualitative literature on the experiences of couples affected by prostate cancer (PCa). METHODS A metasynthesis was carried out which included a systematic search of seven databases between 2000 and 2016. A modified version of Noblit and Hare's meta-ethnographic approach was used to synthesise qualitative study findings and inform overarching interpretations. RESULTS Thirty-seven studies focusing on the experiences of men with PCa and their partner dyad were included producing seven interconnected constructs. The construct accepting change vs seeking continuity reflects the range of ways individuals within the dyad and couples adjust to the diagnosis. Cultivating connection vs disengaging illustrates how couples seek to manage the impact of PCa and its treatment on their relationship, which may lead to a threatened identity, including sexual insecurities. Shielding me, you and us reflects the ways in which couples strive to protect themselves as individuals and/or each other from the impact of PCa. Being a partner and its challenges highlights the responsibilities partners assume and the impact of their supporting role. Yet, partners sometimes report feeling unsupported and side-lined both by the man they are caring for and by healthcare professionals. Couples often recognise the value of facing PCa together. CONCLUSIONS PCa affects both members of the dyad as individuals, as well as the couple's relationship. How best to support couples and how to overcome difficulties in expressing their concerns to one another requires further consideration. Healthcare professionals should endeavour to employ a couple-focused approach where appropriate.
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Affiliation(s)
- Nicole Collaço
- Faculty of Health and Life Sciences, Oxford Brookes University, Jack Straws Lane, Oxford, OX3 0FL, UK.
| | - Carol Rivas
- Faculty of Health Sciences, University of Southampton, S017 1BJ, Southampton, UK
| | - Lauren Matheson
- Faculty of Health and Life Sciences, Oxford Brookes University, Jack Straws Lane, Oxford, OX3 0FL, UK
| | - Johana Nayoan
- Faculty of Health Sciences, University of Southampton, S017 1BJ, Southampton, UK
| | - Richard Wagland
- Faculty of Health Sciences, University of Southampton, S017 1BJ, Southampton, UK
| | - Obrey Alexis
- Faculty of Health and Life Sciences, Oxford Brookes University, Jack Straws Lane, Oxford, OX3 0FL, UK
| | - Anna Gavin
- School of Medicine, Dentistry and Biomedical Sciences, Centre for Public Health, Queen's University, Belfast, BT12 6BA, UK
| | - Adam Glaser
- Leeds Institute of Cancer and Pathology, Faculty of Medicine and Health, University of Leeds, Worsley Building, Leeds, LS2 9NL, UK
| | - Eila Watson
- Faculty of Health and Life Sciences, Oxford Brookes University, Jack Straws Lane, Oxford, OX3 0FL, UK
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Whicker M, Black J, Altwerger G, Menderes G, Feinberg J, Ratner E. Management of sexuality, intimacy, and menopause symptoms in patients with ovarian cancer. Am J Obstet Gynecol 2017; 217:395-403. [PMID: 28411144 DOI: 10.1016/j.ajog.2017.04.012] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2017] [Revised: 04/03/2017] [Accepted: 04/04/2017] [Indexed: 12/19/2022]
Abstract
Issues of sexuality, intimacy, and early menopause significantly impact the quality of life of patients following the diagnosis and treatment of ovarian cancer. These are undertreated problems. Successful treatment requires the provider's awareness of the problem, ability to identify it, and willingness to treat it. Unfortunately many providers do not address these issues in the pretreatment or perioperative period. Furthermore, patients do not often alert their providers to their symptoms. While systemic hormone therapy may improve many of the issues, they are not appropriate for all patients given their action on estrogen receptors. However, other nonhormonal treatments exist including selective serotonin reuptake inhibitors, antiepileptics, natural remedies, and pelvic floor physical therapy. In addition psychological care and the involvement of the partner can be helpful in managing the sexual health concerns of these patients. At the time of diagnosis or at initial consultation, women should be informed of the potential physiologic, hormonal, and psychosocial effects of ovarian cancer on sexuality and that there is a multimodal approach to dealing with symptoms.
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Affiliation(s)
- Margaret Whicker
- Department of Obstetrics, Gynecology, and Reproductive Sciences, Yale University, New Haven, CT
| | - Jonathan Black
- Department of Obstetrics, Gynecology, and Reproductive Sciences, Yale University, New Haven, CT.
| | - Gary Altwerger
- Department of Obstetrics, Gynecology, and Reproductive Sciences, Yale University, New Haven, CT
| | - Gulden Menderes
- Department of Obstetrics, Gynecology, and Reproductive Sciences, Yale University, New Haven, CT
| | - Jacqueline Feinberg
- Department of Obstetrics, Gynecology, and Reproductive Sciences, Yale University, New Haven, CT
| | - Elena Ratner
- Department of Obstetrics, Gynecology, and Reproductive Sciences, Yale University, New Haven, CT
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14
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Naderifar M, Zagheri Tafreshi M, Ilkhani M, Kavousi A. The outcomes of stress exposure in hemodialysis patients. J Renal Inj Prev 2017. [DOI: 10.15171/jrip.2017.52] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
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15
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Hedden L, Wassersug R, Mahovlich S, Pollock P, Sundar M, Bell RH, Goldenberg L, Higano CS. Evaluating an educational intervention to alleviate distress amongst men with newly diagnosed prostate cancer and their partners. BJU Int 2017; 120:E21-E29. [DOI: 10.1111/bju.13885] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Affiliation(s)
- Lindsay Hedden
- Centre for Clinical Epidemiology and Evaluation; University of British Columbia; Vancouver General Hospital; Vancouver BC Canada
- Vancouver Prostate Centre; Gordon and Leslie Diamond Health Care Centre, Vancouver General Hospital; Vancouver BC Canada
- School of Population and Public Health; Faculty of Medicine; University of British Columbia; Vancouver BC Canada
| | - Richard Wassersug
- Department of Urologic Sciences; Faculty of Medicine; University of British Columbia; Vancouver BC Canada
| | - Sarah Mahovlich
- Vancouver Prostate Centre; Gordon and Leslie Diamond Health Care Centre, Vancouver General Hospital; Vancouver BC Canada
| | - Phil Pollock
- Vancouver Prostate Centre; Gordon and Leslie Diamond Health Care Centre, Vancouver General Hospital; Vancouver BC Canada
| | - Monita Sundar
- Vancouver Prostate Centre; Gordon and Leslie Diamond Health Care Centre, Vancouver General Hospital; Vancouver BC Canada
| | - Robert H. Bell
- Vancouver Prostate Centre; Gordon and Leslie Diamond Health Care Centre, Vancouver General Hospital; Vancouver BC Canada
| | - Larry Goldenberg
- Vancouver Prostate Centre; Gordon and Leslie Diamond Health Care Centre, Vancouver General Hospital; Vancouver BC Canada
- Department of Urologic Sciences; Faculty of Medicine; University of British Columbia; Vancouver BC Canada
| | - Celestia S. Higano
- Vancouver Prostate Centre; Gordon and Leslie Diamond Health Care Centre, Vancouver General Hospital; Vancouver BC Canada
- Department of Urologic Sciences; Faculty of Medicine; University of British Columbia; Vancouver BC Canada
- Seattle Cancer Care Alliance; University of Washington; Seattle WA USA
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16
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Pinks D, Davis C, Pinks C. Experiences of partners of prostate cancer survivors: A qualitative study. J Psychosoc Oncol 2017; 36:49-63. [PMID: 28506193 DOI: 10.1080/07347332.2017.1329769] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Prostate cancer, Australia's leading cancer, has treatment side effects that reduce the quality of life for both survivors and partners. Limited partner research exists. This study aimed to address this gap in the literature by gathering data directly from partners to obtain a deeper understanding of their experiences of prostate cancer survivorship that helps inform healthcare service providers. A qualitative approach was taken to explore participant views (N = 16) through three focus groups and two in-depth interviews. Five themes emerged relating to caregiver burden, knowledge deficit, isolation, changes of sexual relations, and unmet needs. Possible implications for practice may include the need for specific partner-related information and interventions to assist couples to cope with the emotional distress caused by treatment side effects.
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Affiliation(s)
- Darren Pinks
- a School of Social Sciences , University of the Sunshine Coast , Sippy Downs , Australia
| | - Cindy Davis
- b Faculty of Arts, Business, and Law , University of the Sunshine Coast , Sippy Downs , Australia
| | - Clair Pinks
- a School of Social Sciences , University of the Sunshine Coast , Sippy Downs , Australia
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17
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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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18
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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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Harju E, Rantanen A, Kaunonen M, Helminen M, Isotalo T, Åstedt-Kurki P. Marital relationship and health-related quality of life after prostate cancer diagnosis. INTERNATIONAL JOURNAL OF UROLOGICAL NURSING 2016. [DOI: 10.1111/ijun.12131] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Affiliation(s)
- Eeva Harju
- School of Health Sciences, Nursing Science; University of Tampere; Arvo FI-33014 University of Tampere Finland
| | - Anja Rantanen
- University Teacher, School of Health Sciences, Nursing Science, University of Tampere; Arvo FI-33014 University of Tampere Finland
| | - Marja Kaunonen
- School of Health Sciences, Nursing Science; University of Tampere; Arvo FI-33014 University of Tampere Finland
- Department of General Administration; Pirkanmaa Hospital District; FI-33521 Tampere University Hospital Finland
| | - Mika Helminen
- School of Health Sciences, Nursing Science; University of Tampere; Arvo FI-33014 University of Tampere Finland
- Science Centre; Pirkanmaa Hospital District; FI-33521 Tampere University Hospital Finland
| | - Taina Isotalo
- Department of Surgery; Päijät-Häme Central Hospital; Keskussairaalankatu 7 FI-15850 Lahti Finland
| | - Päivi Åstedt-Kurki
- School of Health Sciences, Nursing Science; University of Tampere; Arvo FI-33014 University of Tampere Finland
- Department of General Administration; Pirkanmaa Hospital District; FI-33521 Tampere University Hospital Finland
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Abstract
BACKGROUND With the research focus on family caregiving shifting from the individual to the dyadic level, there is a need to explore cancer dyads' concerns and needs and to understand their experiences of coping together with cancer. OBJECTIVE To objectives of this study were to gain a better understanding of the experience of couples living with cancer and to explore cancer couples' concerns and needs related to the caring role and experience of spousal caregivers. METHODS The focus group study design with a purposeful sampling strategy was adopted. We conducted 4 focus group interviews with 11 cancer patients and 17 spousal caregivers in a hospital. RESULTS Four themes and 15 subthemes emerged after a conventional content analysis. The 4 themes include communication dynamics, living with changes, negative and positive impacts, and network of support. Based on the findings, we drew a preliminary conceptualization of the couples' experience of coping and living with cancer as a whole. CONCLUSIONS This study provided insights to healthcare professionals regarding daily struggles of couples living with cancer and the development of intervention programs to support these couples. IMPLICATIONS FOR PRACTICE Healthcare professionals need to (1) be sensitive to the couples' needs and concerns, (2) offer sufficient and useful information to couples who are coping with cancer, (3) encourage and help spousal caregivers to take care of themselves while coping with the changes in their spouses, and (4) instill realistic hopes in couples and help them to sustain a positive attitude with a focus on the future, not just on the present.
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21
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Rosser BRS, Capistrant B, Torres B, Konety B, Merengwa E, Mitteldorf D, West W. The Effects of Radical Prostatectomy on Gay and Bisexual Men's Mental Health, Sexual Identity and Relationships: Qualitative Results from the Restore Study. SEXUAL AND RELATIONSHIP THERAPY 2016; 31:446-461. [PMID: 27942251 DOI: 10.1080/14681994.2016.1228871] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
The effect of prostate cancer treatment in gay and bisexual men is an under-researched area. In 2015, we conducted in-depth telephone interviews with 19 gay and bisexual men who had undergone radical prostatectomies. Across the respondents' five emotional themes emerged: (1) shock at the diagnosis, (2) a reactive, self-reported "depression", (3) sex-specific situational anxiety, (4) a sense of grief, and, (5) an enduring loss of sexual confidence. Identity challenges included loss of a sense of maleness and manhood, changes in strength of sexual orientation, role-in-sex identity, and immersion into sexual sub-cultures. Relationship challenges identified included disclosing the sexual effects of treatment to partners, loss of partners, and re-negotiation of sexual exclusivity. Most to all of these effects stem from sexual changes. To mitigate these negative effects of radical prostatectomy, and to address health disparities n outcomes observed in gay and bisexual men, all these challenges need to be considered in any tailored rehabilitation program for gay and bisexual men.
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Affiliation(s)
- B R Simon Rosser
- Division of Epidemiology and Community Health, 1300 S. 2 St. #300, University of Minnesota, Minneapolis, MN, USA
| | - Benjamin Capistrant
- Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, MN, USA
| | - Beatriz Torres
- Department of Communication Studies, Gustavus Adolphus College, St. Peter, MN, USA
| | - Badrinath Konety
- Department of Urology, University of Minnesota, Minneapolis, MN, USA
| | - Enyinnaya Merengwa
- Department of Family Medicine and Community Health, University of Minnesota, Minneapolis, MN, USA
| | | | - William West
- Department of Writing Studies, University of Minnesota, Minneapolis, MN, USA
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22
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Michael C, Barnett F, Gray M. The experiences of prostate cancer survivors: Changes to physical function and its impact on quality of life. INTERNATIONAL JOURNAL OF THERAPY AND REHABILITATION 2016. [DOI: 10.12968/ijtr.2016.23.7.323] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Affiliation(s)
- Christine Michael
- Honours student, College of Healthcare Sciences, James Cook University, Townsville, Queensland, Australia, occupational therapist, Oxford University Hospitals NHS Trust, Oxford Centre for Enablement, Oxford, UK
| | - Fiona Barnett
- Associate professor and head, Sport and Exercise Science, College of Healthcare Sciences, James Cook University, Townsville, Queensland, Australia
| | - Marion Gray
- Professor and discipline lead, Occupational Therapy, School of Health and Sport Sciences, University of the Sunshine Coast, Sunshine Coast, Queensland, Australia
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23
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Gerhart J, Schmidt E, Lillis T, O’Mahony S, Duberstein P, Hoerger M. Anger Proneness and Prognostic Pessimism in Men With Prostate Cancer. Am J Hosp Palliat Care 2016; 34:497-504. [DOI: 10.1177/1049909116636358] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Aim: Anger is a common reaction to cancer diagnosis which may impact patients’ perceptions of their prognosis and goals of care. This study tested the hypothesis that men with prostate cancer who are anger prone are pessimistic regarding their cancer prognosis. Methods: Two hundred and twelve men with a history of prostate cancer completed measures of personality traits, their prostate cancer prognosis, and their perception of their doctor’s assessment of their prognosis. Anger proneness was operationally defined by the presence of high levels (ie, above the medians) of neuroticism and disagreeableness. Results: One in 4 men with prostate cancer disagreed with their doctor about prognosis. Anger-prone participants endorsed more pessimistic perceptions of prognosis ( P = .041). This significant association was maintained after accounting for potential confounders. Conclusion: Greater attention paid to patient anger regulation style and pessimistic perceptions will improve discussions about prognosis and goals of care among men with prostate cancer. Given recent calls for wider distress screening and earlier palliative care intervention in cancer settings, providers have an unprecedented opportunity to assess and respond to anger in the clinical setting. Communication could be improved through empathic statements that convey realistic optimism when appropriate, a commitment to the patient–provider relationship and a willingness to explore and address patient needs.
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Affiliation(s)
- James Gerhart
- Department of Behavioral Sciences, Rush University Medical Center, Chicago, IL, USA
| | - Eric Schmidt
- Department of Behavioral Sciences, Rush University Medical Center, Chicago, IL, USA
- Center for Innovation to Implementation (Ci2i), HSR&D, Palo Alto VA Health Care System, Menlo Park, CA, USA
- Stanford Health Policy, Stanford University, Stanford, CA, USA
| | - Teresa Lillis
- Department of Behavioral Sciences, Rush University Medical Center, Chicago, IL, USA
| | - Sean O’Mahony
- Hospice and Palliative Medicine, Rush University Medical Center, Chicago, IL, USA
| | - Paul Duberstein
- Department of Psychiatry, University of Rochester, Rochester, NY, USA
- Department of Family Medicine, University of Rochester, Rochester, NY, USA
| | - Michael Hoerger
- Department of Psychology, Tulane Cancer Center, New Orleans, LA, USA
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LeSeure P, Chongkham-Ang S. The Experience of Caregivers Living with Cancer Patients: A Systematic Review and Meta-Synthesis. J Pers Med 2015; 5:406-39. [PMID: 26610573 PMCID: PMC4695863 DOI: 10.3390/jpm5040406] [Citation(s) in RCA: 53] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2015] [Revised: 11/10/2015] [Accepted: 11/12/2015] [Indexed: 11/16/2022] Open
Abstract
The objectives of this meta-synthesis were to: (1) explore the experience of caregivers who were caring for cancer patients, including their perceptions and responses to the situation; and (2) describe the context and the phenomena relevant to the experience. Five databases were used: CINAHL, MEDLINE, Academic Search, Science Direct, and a Thai database known as the Thai Library Integrated System (ThaiLIS). Three sets of the context of the experience and the phenomena relevant to the experience were described. The contexts were (1) having a hard time dealing with emotional devastation; (2) knowing that the caregiving job was laborious; and (3) knowing that I was not alone. The phenomenon showed the progress of the caregivers’ thoughts and actions. A general phenomenon of the experience—balancing my emotion—applied to most of the caregivers; whereas, more specific phenomenon—keeping life as normal as possible and lifting life above the illness—were experienced by a lesser number of the caregivers. This review added a more thorough explanation of the issues involved in caregiving for cancer patients. A more comprehensive description of the experience of caregiving was described. The findings of this review can be used to guide clinical practice and policy formation in cancer patient care.
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Affiliation(s)
- Peeranuch LeSeure
- McCormick Faculty of Nursing, Payap University, Chiang Mai 50000, Thailand.
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25
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Bahmani A, Baghianimoghadam MH, Enjezab B, Mazloomy Mahmoodabad SS, Askarshahi M. Factors Affecting Cervical Cancer Screening Behaviors Based On the Precaution Adoption Process Model: A Qualitative Study. Glob J Health Sci 2015; 8:211-8. [PMID: 26755465 PMCID: PMC4954902 DOI: 10.5539/gjhs.v8n6p211] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2015] [Revised: 08/25/2015] [Accepted: 11/17/2015] [Indexed: 11/12/2022] Open
Abstract
One of the most preventable cancers in women is cervical cancer. Pap smear test is an effective screening program; however, it is not conducted very frequently. The aim of this study is explaining the determinants affecting women's participation in the Pap smear test based on precaution adoption process model with a qualitative approach. This study was a qualitative approach using a Directed Content Analysis methodology which was conducted in 2014. Participants were 30 rural women who participated in this study voluntarily in sarvabad, Iran. Purposive sampling was initiated and continued until data saturation. Semi-structured interviews were the primary method of data collection. Data were analyzed using qualitative content analysis and continuous comparisons. Women`s information and awareness about cervical cancer and Pap smear is insufficient and most of them believed that they were not at risk; however, they perceived the severity of the disease. Some of them had no adequate understanding of the test benefits. They pointed to the lack of time, financial difficulties, fear of test result and lack of awareness as the main barriers against the Pap smear test; however, they did not say that they were not willing to do the test. Findings could help health policy makers to find the right area and purpose to facilitate the participation of women in the Pap smear test.
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Affiliation(s)
- Afshin Bahmani
- Shahid Sadoughi University of Medical Sciences, Yazd, Iran..
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26
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Rising CJ, Bol N, Kreps GL. Age-Related Use and Perceptions of eHealth in Men With Prostate Cancer: A Web-Based Survey. JMIR Cancer 2015; 1:e6. [PMID: 28410165 PMCID: PMC5367670 DOI: 10.2196/cancer.4178] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2014] [Revised: 04/29/2015] [Accepted: 05/24/2015] [Indexed: 12/27/2022] Open
Abstract
Background Men with prostate cancer require ample information and support along the continuum of care, and eHealth is one way to meet such critical information and support needs. Currently, evidence about how age influences use and perceptions about prostate cancer eHealth information and support is lacking. Objective The aim of this paper is to explore use and perceptions about eHealth among men living with prostate cancer. Specifically, we aimed to analyze men with prostate cancer by age-specific cohorts to identify potential age-related differences in use and perceptions about prostate cancer eHealth information. Methods We used survey methodology to examine how men under 65 years old with prostate cancer differ from those aged 65 years old or older in use and perceptions about prostate cancer eHealth information and support (n=289). Results We found that men in the younger cohort used the Internet more often to be informed about treatment options (P=.04) and to learn more about staging/grading (P=.01) than men in the older cohort. Results also showed comparatively greater use of online prostate cancer information for emotional support and encouragement by the younger as compared to the older cohort (P=.001). Furthermore, the older cohort reported more negative psychosocial effects of eHealth (eg, more anxious, depressed) than younger men (P=.002). We also found that as a result of more frequent Internet use, younger men experienced more positive psychosocial effects (eg, more informed, in control) from accessing information about prostate cancer through eHealth channels (b=-0.10, 95% CI -0.28 to 0). Conclusions Men with prostate cancer have different information and support needs; our findings suggest that these needs might vary by age. Future research is needed to unravel age-related factors underlying these differences to be better able to tailor prostate cancer eHealth information to men’s information and support needs.
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Affiliation(s)
- Camella J Rising
- Center for Health and Risk Communication, Department of Communication, George Mason University, Fairfax, VA, United States
| | - Nadine Bol
- Amsterdam School of Communication Research (ASCoR), Department of Communication Science, University of Amsterdam, Amsterdam, Netherlands
| | - Gary L Kreps
- Center for Health and Risk Communication, Department of Communication, George Mason University, Fairfax, VA, United States
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27
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Mróz LW, Robertson S. Gender relations and couple negotiations of British men's food practice changes after prostate cancer. Appetite 2014; 84:113-9. [PMID: 25305464 DOI: 10.1016/j.appet.2014.09.026] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2014] [Revised: 08/29/2014] [Accepted: 09/19/2014] [Indexed: 10/24/2022]
Abstract
Nutrition plays an important role in the health of men diagnosed with prostate cancer and dietary interventions can therefore be a significant part of prostate cancer survivorship supportive care. Family food provision, however, involves complex social interactions, which shape how men engage with their diets and dietary interventions. The role that gender plays in shaping prostate cancer couples' food practices and men's diets after a prostate cancer diagnosis is thought to be important but is little understood. This study explored couples' accounts of nutrition information seeking and diet change to gain a better understanding of how gender relations shaped men's food practices after prostate cancer diagnosis. Qualitative health interviews with men and their partners were conducted and analysed using interpretive descriptive methods. Findings demonstrated how couples navigated food change journeys that involved seeking information, deciding what changes were warranted and implementing and regulating diet changes. Two overarching themes that illustrated couples' food negotiations were called 'Seeking information and deciding on food changes' and 'Monitoring food changes'. Additional sub-themes described who led food changes, women's filtering of information, and moderation or 'treats'. Throughout these food change journeys, interactions between men and women were at play, demonstrating how gender relations and dynamics acted to shape couples' food negotiations and men's food practices. Findings reveal that attention to gender relations and the men's family food dynamics should inform diet interventions for men with prostate cancer in order to improve uptake.
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Affiliation(s)
- Lawrence W Mróz
- Centre for Men's Health, Leeds Beckett University, Rm 512, Calverley Building, City Campus, Leeds LS1 3HE, UK.
| | - Steven Robertson
- Centre for Men's Health, Leeds Beckett University, Rm 512, Calverley Building, City Campus, Leeds LS1 3HE, UK
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28
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Valizadeh S, Dadkhah B, Mohammadi E, Hassankhani H. The perception of trauma patients from social support in adjustment to lower-limb amputation: a qualitative study. Indian J Palliat Care 2014; 20:229-38. [PMID: 25191013 PMCID: PMC4154173 DOI: 10.4103/0973-1075.138401] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
INTRODUCTION The effect of amputation on an individual's psychological condition as well as family and social relationships is undeniable because physical disability not just affects the psycho-social adjustment, but also the mental health. When compared to normal people, such people are mostly experiencing social isolation. On the other hand, social support is known as the most powerful force to cope with stressful situations and it allows patients to withstand problems. The present study aims to explain understanding the trauma of patients and the experience of support sources during the process of adaptation to a lower limb amputation. MATERIALS AND METHODS The present study was conducted using qualitative content analysis. Participants included 20 patients with lower limb amputation due to trauma. Sampling was purposive initially and continued until data saturation. Unstructured interviews were used as the main method of data collection. Collected data were analyzed using qualitative content analysis and constant comparison methods. RESULTS The main theme extracted from the data was support sources. The classes include "supportive family", "gaining friends' support", "gaining morale from peers", and "assurance and satisfaction with the workplace." CONCLUSION Given the high number of physical, mental and social problems in trauma patients, identifying and strengthening support sources can be effective in their adaptation with the disease and improvement of the quality of their life.
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Affiliation(s)
- Sousan Valizadeh
- Department of Child and Family Health, School of Nursing and Midwifery, Student's Research Committee, Tabriz University of Medical Sciences, Tehran, Iran
| | - Behrouz Dadkhah
- Department of Medical Surgical Nursing, School of Nursing and Midwifery, Student's Research Committee, Tabriz University of Medical Sciences, Tehran, Iran
| | - Eissa Mohammadi
- Department of Nursing, Faculty of Medicine, Tarbiat Modarres University, Tehran, Iran
| | - Hadi Hassankhani
- Department of Medical Surgical Nursing, School of Nursing and Midwifery, Student's Research Committee, Tabriz University of Medical Sciences, Tehran, Iran
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Abstract
BACKGROUND Patients with lung cancer are in need of effective strategies to modify symptom burden and improve health-related quality of life (HRQOL). One promising approach to symptom management is an 8-week mindfulness-based intervention, which incorporates meditation, breathing, and gentle yoga exercises. It requires few resources to implement, but has not been adequately tested with lung cancer patients. OBJECTIVE The purpose of this study was to obtain lung cancer patient perceptions of a mindfulness-based intervention. METHODS Eleven lung cancer patients participated in audio-taped focus group sessions led by the investigator. Discussion questions probed patient perceptions of mindfulness in terms of symptom management, including benefits and barriers to this therapy and ways the intervention may need to be adapted to accommodate them. RESULTS Three primary themes from the qualitative analysis include (1) awareness and interest, (2) perceived barriers and benefits, and (3) recommended adaptations. Specific perceptions included the importance of targeting key symptoms such as dyspnea, worry, and insomnia, whereas recommendations pointed out the need for a shorter duration than the standard 8-week protocol and a home-based approach for greater accessibility. CONCLUSIONS The design of mindfulness-based intervention protocols must consider unique characteristics of this vulnerable group, such as targeting specific symptoms, reducing the 8-week protocol, and a home-based offering. IMPLICATIONS FOR PRACTICE Nurses are integral to optimizing HRQOL and independent functioning for lung cancer patients. As lung cancer survivorship is extended, it becomes increasingly imperative that a range of supportive resources is available for patients to manage symptoms and improve HRQOL.
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Abstract
BACKGROUND Spouses play an important role in how well patients with prostate cancer manage their illness. Whereas earlier studies mostly included both patients and spouses, this study focuses on the spouses' experiences during the course of the illness. OBJECTIVE The objective of this study was to explore how the daily life of female spouses is affected by their husband's prostate cancer. METHODS Qualitative interviews were conducted with 9 spouses of men receiving potential curative treatment for prostate cancer. RESULTS Prostate cancer in men had significant impact on spouses' everyday life. The results showed that spouses strived to achieve a balance between focusing on their own needs and meeting their husbands' needs along the course of the illness. Four themes emerged: strong and optimistic versus vulnerable and overstrained, maintaining the partner's sense of manhood, being on the sideline, and the need for relationships outside the immediate family. CONCLUSION Being a spouse to a man with prostate cancer is emotionally and practically demanding. There is a danger of the spouses suppressing their own needs in the process of supporting their husbands. Those spouses living in the situation over a period of years expressed fatigue and a shift in focus from their husbands' needs to their own needs for support. IMPLICATIONS FOR PRACTICE Healthcare providers should provide support for spouses during the course of the illness, encourage spouses to participate in seminars for couples living with prostate cancer, and be aware of the potential for situational fatigue in spouses many years after the diagnosis.
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Perz J, Ussher JM, Gilbert E. Feeling well and talking about sex: psycho-social predictors of sexual functioning after cancer. BMC Cancer 2014; 14:228. [PMID: 24673768 PMCID: PMC3986691 DOI: 10.1186/1471-2407-14-228] [Citation(s) in RCA: 78] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2014] [Accepted: 03/17/2014] [Indexed: 01/25/2023] Open
Abstract
BACKGROUND Changes to sexual wellbeing are acknowledged to be a long-term negative consequence of cancer and cancer treatment. These changes can have a negative effect on psychological well-being, quality of life and couple relationships. Whilst previous conclusions are based on univariate analysis, multivariate research can facilitate examination of the complex interaction between sexual function and psycho-social variables such as psychological wellbeing, quality of life, and relationship satisfaction and communication in the context of cancer, the aim of the present study. METHOD Six hundred and fifty seven people with cancer (535 women, 122 men) and 148 partners (87 women, 61 men), across a range of sexual and non-sexual cancers, completed a survey consisting of standardized measures of sexual functioning, depression and anxiety, quality of life, relationship satisfaction, dyadic sexual communication, and self-silencing, as well as ratings of the importance of sex to life and relationships. RESULTS Men and women participants, reported reductions in sexual functioning after cancer across cancer type, for both people with cancer and partners. Multiple regression analysis examined psycho-social predictors of sexual functioning. Physical quality of life was a predictor for men and women with cancer, and for male partners. Dyadic sexual communication was a predictor for women with cancer, and for men and women partners. Mental quality of life and depression were also predictors for women with cancer, and the lower self-sacrifice subscale of self-silencing a predictor for men with cancer. CONCLUSION These results suggest that information and supportive interventions developed to alleviate sexual difficulties and facilitate sexual renegotiation should be offered to men and women with both sexual and non-sexual cancers, rather than primarily focused on individuals with sexual and reproductive cancers, as is the case currently. It is also important to include partners in supportive interventions. Interventions aimed at improving sexual functioning should include elements aimed at improving physical quality of life and sexual communication, with a focus on psychological wellbeing also being important for women with cancer.
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Affiliation(s)
- Janette Perz
- Centre for Health Research, University of Western Sydney, Locked Bag 1797, Penrith South 2751, Australia
| | - Jane M Ussher
- Centre for Health Research, University of Western Sydney, Locked Bag 1797, Penrith South 2751, Australia
| | - Emilee Gilbert
- Centre for Health Research, University of Western Sydney, Locked Bag 1797, Penrith South 2751, Australia
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Partners' long-term appraisal of their caregiving experience, marital satisfaction, sexual satisfaction, and quality of life 2 years after prostate cancer treatment. Cancer Nurs 2014; 36:104-13. [PMID: 22728952 DOI: 10.1097/ncc.0b013e3182567c03] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Partners of men treated for prostate cancer report more emotional distress associated with a diagnosis of prostate cancer than the men report; the duration of distress for partners is seldom examined. OBJECTIVES The purpose of this study was to determine the long-term effects of prostate cancer treatment on partners' appraisal of their caregiving experience, marital satisfaction, sexual satisfaction, and quality of life (QOL) and factors related to these variables. METHODS This exploratory study evaluated QOL among spouses of prostate cancer survivors at 24 months after treatment. Partners completed a battery of self-report questionnaires in a computer-assisted telephone interview. RESULTS The sample consisted of 121 partners with average age of 60 years. There was a significant relationship between partners' perceptions of bother about the man's treatment outcomes and negative appraisal of their caregiving experience and poorer QOL. Younger partners who had a more negative appraisal of caregiving also had significantly worse QOL. CONCLUSIONS Men's treatment outcomes continued to bother the partner and resulted in more negative appraisal and lower QOL 2 years after initial prostate cancer treatment. Younger partners may be at greater risk of poorer QOL outcomes especially if they have a more negative view of their caregiving experience. IMPLICATIONS FOR PRACTICE Findings support prior research indicating that prostate cancer affects not only the person diagnosed with the disease but also his partner. Partners may benefit from tailored interventions designed to decrease negative appraisal and improve symptom management and QOL during the survivorship period.
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Silk KJ, Perrault EK, Nazione S, Pace K, Hager P, Springer S. Localized prostate cancer treatment decision-making information online: improving its effectiveness and dissemination for nonprofit and government-supported organizations. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2013; 28:709-716. [PMID: 23907786 DOI: 10.1007/s13187-013-0515-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
The current study reports findings from evaluation research conducted to identify how online prostate cancer treatment decision-making information can be both improved and more effectively disseminated to those who need it most. A multi-method, multi-target approach was used and guided by McGuire's Communication Matrix Model. Focus groups (n = 31) with prostate cancer patients and their family members, and in-depth interviews with physicians (n = 8), helped inform a web survey (n = 89). Results indicated that physicians remain a key information source for medical advice and the Internet is a primary channel used to help make informed prostate cancer treatment decisions. Participants reported a need for more accessible information related to treatment options and treatment side effects. Additionally, physicians indicated that the best way for agencies to reach them with new information to deliver to patients is by contacting them directly and meeting with them one-on-one. Advice for organizations to improve their current prostate cancer web offerings and further ways to improve information dissemination are discussed.
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Affiliation(s)
- Kami J Silk
- Michigan State University, 404 Wilson Road-CAS 477, East Lansing, MI, 48824, USA,
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Keogh JWL, Patel A, MacLeod RD, Masters J. Perceived barriers and facilitators to physical activity in men with prostate cancer: possible influence of androgen deprivation therapy. Eur J Cancer Care (Engl) 2013; 23:263-73. [PMID: 24134506 DOI: 10.1111/ecc.12141] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/06/2013] [Indexed: 11/29/2022]
Abstract
While physical activity is beneficial for men with prostate cancer, too few perform sufficient activity for such benefit. This study examined perceptions of men with prostate cancer of their barriers and facilitators to physical activity, and how androgen deprivation therapy (ADT) may influence these perceptions. Two focus groups were conducted, involving six ADT and eight non-ADT patients respectively. Data were transcribed verbatim and themes developed using a general inductive thematic approach. Facilitators to physical activity common to both groups of cancer survivors included clinician and spousal involvement, with pre-existing co-morbidities and increased age cited as barriers by both groups. The ADT subgroup cited personal involvement as a facilitator to physical activity, with fatigue, reduced motivation and a relative lack of specific advice from their clinician as additional barriers. The non-ADT subgroup had no additional facilitators to physical activity but cited time constraints as a barrier. These results highlight the important role that cancer clinicians and spouses play in promoting physical activity for men with prostate cancer and how ADT may influence their other facilitators and barriers. As physical activity is beneficial for prostate cancer survivors, especially those on ADT, cancer clinicians should regularly discuss physical activity with their patients.
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Affiliation(s)
- J W L Keogh
- Exercise and Sports Sciences, Faculty of Health Sciences and Medicine, Bond University, Robina, Qld, Australia; Human Potential Centre, AUT University, Auckland, New Zealand; Cluster for Health Improvement, Faculty of Science, Health, Education and Engineering, University of the Sunshine Coast, Sippy Downs, Qld, Australia
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McCoy M, Stinson MA, Bermúdez JM, Gladney LA. Utilizing a Narrative Approach to Increasing Intimacy After Prostate Cancer. JOURNAL OF CREATIVITY IN MENTAL HEALTH 2013. [DOI: 10.1080/15401383.2013.763684] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Bjoernes CD, Laursen BS, Delmar C, Cummings E, Nøhr C. A dialogue-based Web application enhances personalized access to healthcare professionals--an intervention study. BMC Med Inform Decis Mak 2012; 12:96. [PMID: 22947231 PMCID: PMC3519767 DOI: 10.1186/1472-6947-12-96] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2011] [Accepted: 08/23/2012] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND In today's short stay hospital settings the contact time for patients is reduced. However, it seems to be more important for the patients that the healthcare professionals are easy to get in contact with during the whole course of treatment, and to have the opportunity to exchange information, as a basis for obtaining individualized information and support. Therefore, the aim was to explore the ability of a dialogue-based application to contribute to accessibility of the healthcare professionals and exchangeability of information. METHOD An application for online written and asynchronous contacts was developed, implemented in clinical practice, and evaluated. The qualitative effect of the online contact was explored using a Web-based survey comprised of open-ended questions. RESULTS Patients valued the online contacts and experienced feelings of partnership in dialogue, in a flexible and calm environment, which supported their ability to be active partners and feelings of freedom and security. CONCLUSION The online asynchronous written environment can contribute to accessibility and exchangeability, and add new possibilities for dialogues from which the patients can benefit. The individualized information obtained via online contact empowers the patients. The Internet-based contacts are a way to differentiate and expand the possibilities for contacts outside the few scheduled face-to-face hospital contacts.
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Affiliation(s)
- Charlotte D Bjoernes
- Department of Development and Planning, Danish Centre for Health Informatics, Aalborg University, Vestre Havnepromenade 5 1, sal, DK-9000, Aalborg, Denmark.
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Rivers BM, August EM, Quinn GP, Gwede CK, Pow-Sang JM, Green BL, Jacobsen PB. Understanding the psychosocial issues of African American couples surviving prostate cancer. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2012; 27:546-558. [PMID: 22544536 PMCID: PMC4497555 DOI: 10.1007/s13187-012-0360-1] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
African Americans are disproportionately affected by prostate cancer, yet less is known about the most salient psychosocial dimensions of quality of life. The purpose of this study was to explore the perceptions of African American prostate cancer survivors and their spouses of psychosocial issues related to quality of life. Twelve African American couples were recruited from a National Cancer Institute Comprehensive Cancer Center registry and a state-based non-profit organization to participate in individual interviews. The study was theoretically based on Ferrell's Quality of Life Conceptual Model. Common themes emerged regarding the psychosocial needs of African American couples. These themes were categorized into behavioral, social, psychological, and spiritual domains. Divergent perspectives were identified between male prostate cancer survivors and their female spouses. This study delineated unmet needs and areas for future in-depth investigations into psychosocial issues. The differing perspectives between patients and their spouses highlight the need for couple-centered interventions.
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Affiliation(s)
- Brian M Rivers
- Health Outcomes & Behavior Program, H. Lee Moffitt Cancer Center & Research Institute, 12902 Magnolia Drive, Tampa, FL, 33612, USA.
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Chambers SK, Ferguson M, Gardiner RA, Aitken J, Occhipinti S. Intervening to improve psychological outcomes for men with prostate cancer. Psychooncology 2012; 22:1025-34. [PMID: 22549800 DOI: 10.1002/pon.3095] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2011] [Revised: 01/25/2012] [Accepted: 04/03/2012] [Indexed: 11/11/2022]
Abstract
BACKGROUND Prostate cancer is the most common cancer in men in the Western world with well-described negative effects from treatments. However, outcomes are highly heterogeneous. A Phase 3 trial of a psycho-educational intervention was undertaken, aiming to reduce cancer-specific and decision-related distress and improve quality of life for men newly diagnosed with localised prostate cancer. METHODS Seven hundred forty (81.7%) men were recruited after diagnosis and before treatment and randomised to a tele-based nurse-delivered five-session psycho-educational intervention (N = 372) or usual care (N = 368). Participants were assessed before treatment and 2, 6, 12 and 24 months post-treatment. Outcome measures included cancer-specific and decision-related distress, cognitive judgmental adjustment, subjective well-being, and domain-specific and health-related quality of life. Social support was assessed as a potential moderator. RESULTS No unconditioned effects were found. Classification analyses on pre-randomisation measures distinguished three subgroups: younger, higher education and income men (N = 90); younger, lower education and income men (N = 106); and older men (N = 344). Younger, higher education and income men showed positive intervention effects for cancer-specific distress (p = 0.008) and mental health (p = 0.042). By contrast, for younger, lower education men, participation in the intervention was associated with decreases in cognitive judgmental adjustment over time (p = 0.006). CONCLUSIONS Response to intervention and adjustment over time varied according to previous sexual functioning, age, educational level and income. How to best intervene with younger, low education, low income men with prostate cancer is a critical future research question.
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Stenberg U, Ruland CM, Olsson M, Ekstedt M. To live close to a person with cancer--experiences of family caregivers. SOCIAL WORK IN HEALTH CARE 2012; 51:909-926. [PMID: 23151286 DOI: 10.1080/00981389.2012.714847] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
The purpose of this study was to obtain a deeper understanding of the experiences of Family Caregivers (FC) living close to a patient with cancer. This article reports on the findings from individual interviews with 15 FCs of patients with cancer. The interview transcripts were analyzed using qualitative hermeneutic analysis. This study revealed that living close to a cancer patient over the course of his or her illness affected many aspects of FCs lives in significant ways. Their experiences can be summarized with two major themes: (1) living in an ever changing life world and (2) balancing between conflicting interests and dilemmas. This study contributed to deeper insights into FC's experiences than previously reported in the literature.
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Affiliation(s)
- Una Stenberg
- Center for Shared Decision Making and Collaborative Care Research, Oslo University Hospital, Oslo, Norway.
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Préau M, Bouhnik AD, Rey D, Mancini J. Two years after cancer diagnosis, which couples become closer? Eur J Cancer Care (Engl) 2011; 20:380-8. [PMID: 20477859 DOI: 10.1111/j.1365-2354.2010.01191.x] [Citation(s) in RCA: 56] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
The aim of this study was to determine characteristics of patients who reported a strengthening of their couple relationship 2 years after cancer diagnosis. Using a cross-sectional design, data were obtained from a representative sample of patients with a primary diagnosis of cancer. Medical and reported data were collected by physicians and a patient telephone interview respectively. Among the 3221 participants who were living with the same partner as at the time of their cancer diagnosis, 32.8% of men and 41.5% of women declared their illness had brought them closer to their partner. The following factors were independently associated with closer couple relationships for women: high monthly monetary resources, chemotherapy treatment, sequelae, increased consumption of psychotropic drugs since cancer diagnosis, satisfaction with information provided by medical staff, specialised psychological support at the time of diagnosis and regular sexual activity. Independently associated factors for men were as follows: younger age, financial difficulties since diagnosis, cancer other than gastrointestinal tract/upper GI tract or lung cancer, progressive disease, satisfaction with information provided by medical staff and specialised psychological support at the time of diagnosis. Our findings underline the importance for healthcare workers to provide adequate information and psychological support in order to help couples facing cancer. Comprehensive care and not simply supplying medicines is crucial in order to better manage their experience.
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Affiliation(s)
- M Préau
- Psychology Department, Nantes University, Nantes, France.
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Pros and cons of focal therapy for localised prostate cancer. Prostate Cancer 2011; 2011:584784. [PMID: 22110990 PMCID: PMC3200263 DOI: 10.1155/2011/584784] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2010] [Revised: 02/13/2011] [Accepted: 03/09/2011] [Indexed: 12/13/2022] Open
Abstract
In prostate cancer, an interesting and intriguing option to overcome the risks of whole-gland treatment is focal therapy, with the aim of eradicating known cancer foci and reducing collateral damages to the structures essential for maintaining normal urinary and sexual function. Ablation of all known lesions would favorably alter the natural history of the cancer without impacting health-related quality of life and allows for safe retreatment with repeated focal therapy or whole-gland approaches if necessary. Our objective is to reassess the possibilities and criticisms of such procedure: the rationale for focal therapy and the enthusiasm come from the success of conservative approaches in treating other malignancies and in the high incidence of overtreatment introduced by prostate cancer screening programs. One of the challenges in applying such an approach to the treatment of prostate cancer is the multifocal nature of the disease and current difficulties in accurate tumor mapmaking.
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Chaparro L. How a "Special Caring Bond" is Formed Between the Chronically ill Patient and the Family Caregiver. AQUICHAN 2011. [DOI: 10.5294/aqui.2011.11.1.1] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
La formación de vínculos en el ser humano tiene su origen en las relaciones de cuidado existentes a lo largo de la vida. Existen teorías que aplican para las situaciones en que el ser humano se encuentra en riesgo o al límite como la situación de enfermedad crónica. Objetivo: describir la forma como se constituye el “vínculo especial” de cuidado entre la díada cuidador familiar-persona con enfermedad crónica. Método: corresponde a la conclusión central de una investigación cualitativa en la que se construyó una teoría sustantiva que describe el proceso por el cual se constituye el “vínculo especial” que surgió con un abordaje de teoría fundamentada. Hallazgos: una estructura teórica que muestra el patrón construido en las díadas frente al significado del cuidado en un diagrama representativo producto de una investigación doctoral. Conclusiones: el esquema construido muestra al inicio una separación entre las dos personas de la díada, y a medida que se comparte la experiencia y van haciéndose más cercanos los intereses, la díada alcanza mayor expansión de su conciencia en el cuidado. En el mismo sentido, la funcionalidad de la persona con enfermedad crónica disminuye y el nivel de habilidad de cuidado aumenta.
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Rivers BM, August EM, Gwede CK, Hart A, Donovan KA, Pow-Sang JM, Quinn GP. Psychosocial issues related to sexual functioning among African-American prostate cancer survivors and their spouses. Psychooncology 2011; 20:106-10. [PMID: 20187071 DOI: 10.1002/pon.1711] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
OBJECTIVE Focus on cancer survivorship and quality of life (QOL) is a growing priority. The aim of this study was to identify and describe the most salient psychosocial concerns related to sexual functioning among African-American (AA) prostate cancer survivors and their spouses. METHODS Twelve AA prostate cancer survivors and their spouses participated in semi-structured individual interviews. The interviews assessed couples' experiences with psychosocial adjustment and sexual functioning posttreatment for localized prostate cancer. The data were analyzed using the constant comparison method and content analysis. RESULTS In this qualitative study of couples surviving prostate cancer, there were divergent views between the male prostate cancer survivors and their female partners, particularly regarding sexual functioning. For the males, QOL issues emerged as the primary area of concern, whereas survival of their husbands was considered most important among the female spouses. The male respondents expressed unease with the sexual side effects of their cancer treatment, such as erectile dysfunction and decreased sexual desire and satisfaction. Female spouses recognized decreased sexual desire in their partners following treatment, but this was not considered a primary concern. CONCLUSIONS Patients and their spouses may have differing perceptions regarding QOL and the impact of sexual functioning on survivorship. This study points to the need for further research and intervention development to address these domains with a goal to improve QOL.
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Affiliation(s)
- Brian M Rivers
- Moffitt Cancer Center and Research Institute, Department of Health Outcomes and Behavior, 12902 Magnolia Drive, Tampa, FL 33612, USA.
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Tanner T, Galbraith M, Hays L. From a Woman's Perspective: Life as a Partner of a Prostate Cancer Survivor. J Midwifery Womens Health 2011; 56:154-60. [DOI: 10.1111/j.1542-2011.2010.00017.x] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Stenberg U, Ruland CM, Miaskowski C. Review of the literature on the effects of caring for a patient with cancer. Psychooncology 2011; 19:1013-25. [PMID: 20014159 DOI: 10.1002/pon.1670] [Citation(s) in RCA: 537] [Impact Index Per Article: 41.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE To adequately help family caregivers (FCs) of cancer patients, clinicians need to understand the complexity of the problems and responsibilities associated with cancer patients illness that FCs experience. METHODS This systematic review identified the types of problems and burdens that FCs of cancer patients experience during the patient's illness. We also analyzed the language caregivers use to communicate their problems and responsibilities related to caregiving for the cancer patient. RESULTS Of 2845 titles identified, 192 articles met the inclusion criteria and are included in this review. Of these, 164 were research-based. In addition to FC responsibilities and the impact of being a caregiver on daily life, a number of other physical, social, and emotional problems related to caregiving for these FCs were identified. CONCLUSION A substantial evidence base supports the conclusion that FCs experience many difficult problems and increased responsibilities during and after the patient is undergoing treatment and rehabilitation for cancer. The insights gained from this review will help researchers and clinicians to understand the complexity of problems and responsibilities FCs experience. This understanding may encourage them to include support for FCs as part of total or holistic patient care. However, more research is needed to better understand the variations in caregiving experiences over time; how the caregiving perspective is influenced by different cultural, ethnic, or socioeconomic backgrounds as well as gender and age; and how problems and responsibilities related to caregiving interfere with daily life.
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Affiliation(s)
- Una Stenberg
- Center for Shared Decision Making and Nursing Research, Oslo University Hospital, Rikshospitalet, Oslo, Norway.
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Manne SL, Kissane DW, Nelson CJ, Mulhall JP, Winkel G, Zaider T. Intimacy-enhancing psychological intervention for men diagnosed with prostate cancer and their partners: a pilot study. J Sex Med 2011; 8:1197-209. [PMID: 21210958 DOI: 10.1111/j.1743-6109.2010.02163.x] [Citation(s) in RCA: 105] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
INTRODUCTION Few couple-focused interventions have been developed to improve distress and relationship outcomes among men diagnosed with localized prostate cancer and their partners. AIMS We examined the effects of a five-session Intimacy-Enhancing Therapy (IET) vs. Usual Care (UC) on the psychological and relationship functioning of men diagnosed with localized prostate cancer and their partners. Pre-intervention levels of psychological and relationship functioning were evaluated as moderators of intervention effects. METHODS Seventy-one survivors and their partners completed a baseline survey and were subsequently randomly assigned to receive five sessions of IET or UC (no treatment). Eight weeks after the baseline assessment, a follow-up survey was administered to survivor and partner. MAIN OUTCOME MEASURES Distress, well-being, relationship satisfaction, relationship intimacy, and communication were investigated as the main outcomes. RESULTS IET effects were largely moderated by pre-intervention psychosocial and relationship factors. Those survivors who had higher levels of cancer concerns at pretreatment had significantly reduced concerns following IET. Similar moderating effects for pre-intervention levels were reported for the effects of IET on self-disclosure, perceived partner disclosure, and perceived partner responsiveness. Among partners beginning the intervention with higher cancer-specific distress, lower marital satisfaction, lower intimacy, and poorer communication, IET improved these outcomes. CONCLUSIONS IET had a marginally significant main effect upon survivor well-being but was effective among couples with fewer personal and relationship resources. Subsequent research is needed to replicate these findings with a larger sample and a longer follow-up.
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Affiliation(s)
- Sharon L Manne
- University of Medicine and Dentistry of New Jersey-Robert Wood Johnson Medical School-The Cancer Institute of New Jersey Section of Population Studies, New Brunswick, NJ, USA.
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Kazer MW, Harden J, Burke M, Sanda MG, Hardy J, Bailey DE. The experiences of unpartnered men with prostate cancer: a qualitative analysis. J Cancer Surviv 2010; 5:132-41. [PMID: 21113818 DOI: 10.1007/s11764-010-0157-3] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2010] [Accepted: 10/19/2010] [Indexed: 12/22/2022]
Abstract
PURPOSE The purpose of this study was to examine how men without partners make decisions about prostate cancer treatment, manage treatment side effects, and obtain information and support. BACKGROUND In 2009, it was projected that over 230,000 men were diagnosed with prostate cancer. While treatment options vary, these options result in changes within the man that can affect his quality of life. Research has shown that often spouses play a central role in men's choice of treatment and in maintaining men's quality of life. In addition, spouses are the major providers of emotional support and physical care. However, little is known about how men without partners cope with prostate cancer. Prior research seldom addresses how diagnosis and treatment for prostate cancer affects the quality of life of men without partners. METHODS Because very little is known about the needs of men without partners managing prostate cancer, qualitative analysis of data obtained during semi-structure interviews provided respondents with an opportunity to share the lived experience of prostate cancer. A semi-structured interview was conducted with selected, consenting men. The sample was drawn from the ongoing R01 study of men with prostate cancer (PROSTQA). RESULTS The sample for this study included 17 unpartnered prostate cancer survivors. The ages of participants ranged from 47 to 72 with a mean age of 63. The participants had between zero and two co-morbidities with an average of one co-morbidity per participant. The sample was 82% Caucasian and 17% Black. A total of 35% of the participants reported "some college" (n = 6), 30% graduated from college (n = 5), and 23% went to graduate school (n = 4). One participant reported that he was a high school graduate and one had less than a high school education. Five themes emerged from the data: going it alone, diagnosis and prostate cancer treatment decision-making, sources of information and support, the aftermath of prostate cancer, and coping strategies. CONCLUSIONS This study provides information about unpartnered men's prostate cancer experience. This information will help health care professionals to meet the needs of unpartnered more effectively and help them to assist men as they adapt to living with this chronic illness.
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