Tucker Samantha R, Speer Susan A, Peters Sarah
School of Health Sciences, The University of Manchester, Oxford Road, Manchester, M13 9PL, UK.
Soc Sci Med. 2016 Aug;163:80-8. doi: 10.1016/j.socscimed.2016.07.001. Epub 2016 Jul 4.
Prostate cancer is a leading cause of cancer in men, affecting one in eight. An ageing population coupled with increased testing indicates that the incidence of early-stage prostate cancer is rising rapidly. Treatments are effective, but all can result in chronic sexual side effects and impact on the psychological, emotional and relational components of sexual functioning. Whilst the physical consequences of treatment are well documented, we lack a comprehensive picture of the effects of localised prostate cancer treatment on men's experience of sexual intimacy and how this may affect survivorship and recovery.
This study synthesises the qualitative literature related to men's experience of sexual intimacy in the context of localised prostate cancer.
A systematic search strategy identified 12 studies, which were assessed using a modified version of the Critical Appraisal Skills Programme. Using Noblit and Hare's (1988) approach, a meta-synthesis was conducted.
Findings are organised within four inter-related themes that form the basis of a new conceptual explanatory model: (i) Loss and grief: Destroyed intimacy; (ii) Going through the motions: Artificial intimacy; (iii) Fear of failure: Avoiding intimacy and (iv) Breaking barriers: Constructing an alternative intimacy.
The LMAC (Loss, Motions, Avoidance and Construction) model provides a new way of conceptualising sexual recovery following prostate cancer treatment and opportunities for health care professionals to support men and their partners.
前列腺癌是男性癌症的主要病因之一,每八名男性中就有一人受其影响。人口老龄化加上检测增加表明,早期前列腺癌的发病率正在迅速上升。治疗方法是有效的,但所有治疗都可能导致慢性性功能副作用,并影响性功能的心理、情感和关系方面。虽然治疗的身体后果有充分记录,但我们缺乏对局限性前列腺癌治疗对男性性亲密体验的影响以及这可能如何影响生存和康复的全面了解。
本研究综合了与局限性前列腺癌背景下男性性亲密体验相关的定性文献。
采用系统检索策略确定了12项研究,使用批判性评估技能计划的修改版对这些研究进行评估。采用诺布利特和黑尔(1988年)的方法进行元综合分析。
研究结果归纳为四个相互关联的主题,这些主题构成了一个新的概念性解释模型的基础:(i)失落与悲伤:亲密关系被破坏;(ii)敷衍了事:虚假的亲密关系;(iii)对失败的恐惧:回避亲密关系;(iv)打破障碍:构建另一种亲密关系。
LMAC(失落、敷衍、回避和构建)模型为前列腺癌治疗后的性康复概念化提供了一种新方法,也为医护人员支持男性及其伴侣提供了机会。