MRC Centre for Transplantation, Guy's Hospital Campus, King's College London, King's Health Partners, London, UK.
King's College London Institute of Psychiatry, Psychology and Neuroscience, London, UK.
J Cancer Surviv. 2022 Feb;16(1):95-110. doi: 10.1007/s11764-021-01007-9. Epub 2021 May 8.
Body image, self-esteem, and masculinity are three interconnected constructs in men with prostate cancer, with profound effects on quality of life. This meta-synthesis aimed to evaluate all known qualitative studies published studying the effect of prostate cancer on these constructs.
A systematic review utilising PubMed, Embase, MEDLINE, and PsycINFO databases up to May 2020 was conducted in line with PRISMA and ENTREQ guidelines. All qualitative studies of men's experiences with body image, self-esteem, and masculinity whilst living with prostate cancer were included. A thematic meta-synthesis was conducted to identify emergent descriptive and analytical themes under the main study constructs.
Of 2188 articles identified, 68 were included. Eight descriptive themes were identified under two analytical themes: 'Becoming a Prostate Cancer Patient' and 'Becoming a Prostate Cancer Survivor'. These described the distress caused by changes to body image, sexual functioning, sense of masculinity, and self-esteem, and the subsequent discourses men engaged with to cope with and manage their disease. A key element was increased flexibility in masculinity definitions, and finding other ways to re-affirm masculinity.
Prostate cancer has an important effect on men's health post-diagnosis, and we identified strong relationships between each construct evaluated. The role of hegemonic masculinity is important when considering men's coping mechanisms and is also a key factor when addressing these constructs in counselling post-treatment.
This meta-synthesis provides key topics that uniquely affect prostate cancer survivors, enabling these patients to be effectively counselled, and have their concerns recognised by clinicians.
体像、自尊和男子气概是前列腺癌患者三个相互关联的结构，对生活质量有深远影响。本荟萃分析旨在评估所有已发表的研究前列腺癌对这些结构影响的定性研究。
根据 PRISMA 和 ENTREQ 指南，对截至 2020 年 5 月的 PubMed、Embase、MEDLINE 和 PsycINFO 数据库进行了系统评价。纳入了所有关于男性在患有前列腺癌时体像、自尊和男子气概体验的定性研究。进行了主题荟萃分析，以确定主要研究结构下出现的描述性和分析性主题。
在 2188 篇文章中，有 68 篇被纳入。在两个分析主题下确定了 8 个描述性主题：“成为前列腺癌患者”和“成为前列腺癌幸存者”。这些主题描述了体像、性功能、男子气概和自尊变化所引起的痛苦，以及男性为应对和管理疾病而进行的后续讨论。一个关键因素是男子气概定义的灵活性增加，以及寻找其他方式来重新肯定男子气概。
前列腺癌对男性诊断后的健康有重要影响，我们确定了每个评估结构之间的紧密关系。霸权男子气概的作用在考虑男性的应对机制时很重要，也是在治疗后解决这些结构时的一个关键因素。
本荟萃分析提供了独特影响前列腺癌幸存者的关键主题，使这些患者能够得到有效的咨询，并使临床医生认识到他们的担忧。
