Cancer and Chronic Disease Team, Primary Care Clinical Sciences, University of Birmingham, Edgbaston, Birmingham B15 2TT, UK.
BMJ. 2011 Oct 18;343:d5824. doi: 10.1136/bmj.d5824.
To examine the experiences of men after treatment for colorectal cancer, identify barriers to accessing services, and suggest improvements to providing information in primary and secondary care.
Semistructured, qualitative interview study with purposive sampling and thematic analysis.
28 patients treated for colorectal cancer.
West Midlands.
Most men treated for colorectal cancer experience erectile dysfunction as a consequence. Not all, however, want the same response from health professionals. Although, erectile dysfunction is profoundly stressful for most men, affecting self image, behaviour, and relationships, some do not regard it as a health priority. Many of the men were uninformed about erectile dysfunction and were unprepared for it, and the majority neither helped themselves nor asked for help. Almost none were receiving adequate, effective, and affordable care. Evidence of ageism was strong.
Unlike patients with prostate cancer, men with colorectal cancer are not routinely offered information and treatment for erectile dysfunction. Greater coordination of care and consistent strategies are needed to tackle the unmet needs of this widely diverse patient group. Currently, clinicians are inadvertently neglecting, misleading, and offending such patients; better training could improve this situation, as might the reorganisation of services. Further research is needed to determine whether trained clinical nurse specialists in colorectal cancer units could coordinate ongoing care.
探讨男性结直肠癌治疗后的体验，确定获得服务的障碍，并为初级和二级保健机构提供信息提出改进建议。
采用有目的抽样和主题分析的半结构式定性访谈研究。
28 名接受结直肠癌治疗的患者。
西米德兰兹郡。
大多数接受结直肠癌治疗的男性都会因此出现勃起功能障碍。然而，并非所有男性都希望从医疗保健专业人员那里得到相同的回应。尽管勃起功能障碍对大多数男性来说压力极大，影响了他们的自我形象、行为和人际关系，但有些男性并不认为这是健康的首要问题。许多男性对勃起功能障碍一无所知，也没有为此做好准备，大多数男性既没有自救也没有寻求帮助。几乎没有人得到充分、有效和负担得起的护理。年龄歧视的证据非常明显。
与前列腺癌患者不同，接受结直肠癌治疗的男性通常不会获得有关勃起功能障碍的信息和治疗。需要更协调的护理和一致的策略来解决这个广泛多样化的患者群体的未满足需求。目前，临床医生无意中忽视、误导和冒犯了这些患者；更好的培训可以改善这种情况，服务的重新组织也可能会有所帮助。需要进一步研究以确定结直肠癌单位的经过培训的临床护士专家是否能够协调持续护理。
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