Mastery of postprostatectomy incontinence and impotence: his work, her work, our work.

PURPOSE/OBJECTIVES: To describe couples' experiences of postprostatectomy incontinence and impotence.

DESIGN

Descriptive, qualitative.

SETTING

Northeastern U.S. metropolitan area.

SAMPLE

Subsample of 20 (10 control and 10 intervention) couples from a large quantitative clinical trial of a Standardized Nursing Intervention Protocol (SNIP) postprostatectomy.

METHODS

Interviews were conducted using a semistructured guide. Data were analyzed using grounded theory techniques.

MAIN RESEARCH VARIABLE

Couples' experiences of coping with postprostatectomy incontinence and impotence.

FINDINGS

Managing postprostatectomy incontinence and impotence required work. Men's work focused on regaining mastery and encompassed understanding incontinence as healing, mastering incontinence, networking, confronting impotence and putting it into perspective, and prioritizing. Wives were supportive by managing anxiety, encouraging mastery, putting impotence into perspective, and reassuring their spouses. Established routines brought couples through the experience together while strengthening intimacy. SNIP couples found the nurses to be sources of information, support, and affirmation.

CONCLUSIONS

Couples worked to deal with postprostatectomy incontinence and impotence within the context of surviving cancer and maintaining a loving relationship. This gave unique meaning to their symptoms and led the couples to value the fact that the men were alive and work toward regaining mastery. Mastery emerged as a key concept from the findings.

IMPLICATIONS FOR NURSING PRACTICE

Nurses can gain from an enhanced understanding of postprostatectomy incontinence and impotence as meaningful within the greater context of patients having had cancer. Nurses can hasten couples' abilities to regain a sense of mastery by providing information, supporting couples' work, providing positive affirmation, and being available.