O'Shaughnessy Peter K, Ireland Colin, Pelentsov Lemuel, Thomas Laws A, Esterman Adrian J
School of Nursing and Midwifery, Division of Health Sciences, University of South Australia, Adelaide, SA, Australia.
J Clin Nurs. 2013 Dec;22(23-24):3492-502. doi: 10.1111/jocn.12190.
To explore issues related to sexual function and relationships, for men and their wives or partners, following diagnosis and treatment for prostate cancer.
A diagnosis of prostate cancer and subsequent treatment result in a significant number of men experiencing some impairment to their sexual function. There is scant research into the impact of changed sexual function on these men's masculinity, sexuality, intimate relationships and their needs regarding counselling and supportive care.
Internet-based survey.
Focus groups and couple interviews were used to improve validity for questionnaire items designed to provide insight into men's experiences of prostate cancer in areas such as sexual function and relationships. The questionnaire included both closed and open-ended questions and had the option for the wife or partner to complete a section.
Qualitative research revealed 17 specific categories within three key themes: sexual dysfunction, loss of libido and masculinity. The questionnaire found, unexpectedly, the majority of men said that they had sufficient emotional and psychological support. Wives/partners confirmed cancer had impacted on their partner's feelings of masculinity (71%), compared to 42% of men who felt that this was the case. Predictors of loss of libido, erectile dysfunction and 'feeling less of a man' were developed. Univariate predictors included hormone therapy, regrets about treatment choice, cancer having impacted on masculinity and distress during the last week.
Men are not able to clearly identify the challenges prostate cancer brings especially changes to their masculinity.
The findings strongly suggest that for men with prostate cancer, nursing assessments of men's sexual health be augmented by information gained from their partners; further, these assessments should be augmented with a careful exploration of these men's psyche guided by the knowledge that masculinity influences perceptions of self (being a man) and help seeking.
探讨前列腺癌诊断与治疗后，男性及其妻子或伴侣在性功能和两性关系方面的相关问题。
前列腺癌的诊断及后续治疗导致大量男性性功能出现一定程度的损害。关于性功能改变对这些男性的男子气概、性取向、亲密关系以及他们在咨询和支持性护理方面需求的影响，研究较少。
基于网络的调查。
采用焦点小组和夫妻访谈来提高问卷项目的效度，这些问卷项目旨在深入了解男性在性功能和两性关系等方面的前列腺癌经历。问卷包括封闭式和开放式问题，妻子或伴侣也可选择完成其中一部分。
定性研究在三个关键主题下揭示了17个具体类别：性功能障碍、性欲丧失和男子气概。问卷调查意外发现，大多数男性表示他们获得了足够的情感和心理支持。妻子/伴侣确认癌症影响了伴侣的男子气概（71%），而认为如此的男性为42%。确定了性欲丧失、勃起功能障碍和“感觉不像个男人”的预测因素。单因素预测因素包括激素治疗、对治疗选择的后悔、癌症对男子气概的影响以及上周的痛苦。
男性无法明确识别前列腺癌带来的挑战，尤其是对其男子气概的改变。
研究结果强烈表明，对于前列腺癌男性患者，护士对男性性健康的评估应通过从其伴侣处获得的信息加以补充；此外，这些评估应辅以对这些男性心理的仔细探索，要认识到男子气概会影响自我认知（作为男人）和寻求帮助的行为。
