The Ecology of Patients' Sexual Health Adjustment After Prostate Cancer Treatment: The Influence of the Social and Healthcare Environment

Family Wellbeing and Sexual Health of Patients Receiving Treatment for Prostate Cancer

Purpose

Prostate cancer and its treatment may affect patients' sexual function and social wellbeing. This study investigated the relationship between social/family wellbeing and sexual health in patients with prostate cancer. Additionally, the moderating effect of clinical characteristics on this relationship was also explored.

Patients and Methods

This is a descriptive correlational study using baseline data of a longitudinal study enrolling 137 patients with prostate cancer. Sexual Function (SF) and Sexual Function Distress (SFD) data were collected using the Symptom Index questionnaire. Demographic data were obtained during study intake and clinical data were obtained from chart review. Bivariate correlation determined the correlations among continuous demographic/clinical data, social/family wellbeing, and sexual health. Moderated regression analysis determined the moderating effects of clinical characteristics on the relationship of social/family wellbeing and sexual health.

Results

Moderate positive correlation was found between social/family wellbeing and SF, whereas a weak negative correlation was noted between social/family wellbeing and SFD. Depression was significantly correlated with social/family wellbeing and SFD. Both sexual health domains were significantly correlated with Gleason score. A significant difference was noted in the social/family wellbeing and both SF and SFD in participants receiving androgen deprivation therapy (ADT) compared to those not receiving ADT. Concomitant ADT use was the only clinical characteristic found to be a significant moderator of the relationship between social/family wellbeing and SFD, but none of the clinical characteristics was found to have a moderating effect on the relationship of social/family wellbeing and SF. Among patients who were not receiving ADT, high social/family wellbeing was associated with low SFD. Patients who were receiving ADT reported slightly higher SFD despite having higher social/family wellbeing.

Conclusion

Ensuring sexual health in patients with prostate cancer requires a comprehensive approach to address factors contributing to sexual health such as side effects of treatment and family wellbeing.

Factors influencing self-esteem after radical prostatectomy in older adult patients

Older adult patients with prostate cancer experience symptoms such as uncontrolled sexual and urinary dysfunction after radical prostatectomy, which lowers self-esteem. Lack of access to information about the illness increases uncertainty, requiring interventions from healthcare providers. This study aimed to identify factors affecting the self-esteem of older adult patients who underwent prostate cancer surgery and provided data for establishing nursing strategies to promote healthy lifespans. This cross-sectional study examined participants over 65 years old who underwent radical prostatectomy at two university hospitals in 2017. The results indicated that the most influential factor for self-esteem was inconsistency-related uncertainty, followed by postoperative symptom experience and healthcare provider support. These variables explained 43% of the variance in self-esteem. To improve self-esteem among older adult patients who undergo radical prostatectomy, integrated programs that include sexual-related symptom management, such as erectile dysfunction and incontinence, and healthcare provider support should be developed to reduce inconsistency-related uncertainty.

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

Purpose

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

Methods

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

Results

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

Conclusions

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

Supplementary Information

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