MRC Centre for Transplantation, Guy's Hospital Campus, King's College London, King's Health Partners, London, UK.
Translational Oncology and Urology Research (TOUR), School of Cancer and Pharmaceutical Sciences, King's College London, London, UK.
Support Care Cancer. 2022 Jun;30(6):5459-5468. doi: 10.1007/s00520-022-06976-w. Epub 2022 Mar 19.
There is a growing emphasis on improving quality of life of people with prostate cancer. However, those undergoing active surveillance remain underrepresented in the literature with less known about their unique challenges. Therefore, we aimed to explore their lived experiences post diagnosis and its effect on their mental, social, and physical wellbeing.
Qualitative semi-structured interviews were conducted with 13 men undergoing active surveillance for low-risk disease. Thematic analysis was used to inductively co-construct themes through the lens of the biopsychosocial model.
Mental wellbeing was strongly affected in our participants due to the overwhelming emotional impact of their diagnosis resulting in an 'Emotional Diagnostic Disequilibrium'. Informational awareness and education about prostate cancer helped patients with 'Recognition of the Impact'. Patients experienced an 'Unsettling Monitoring Cycle' due to the increased fear and anxiety around PSA monitoring appointments, with some men ignoring their mental wellbeing needs as their disease is 'A Future Problem'. 'Concealment of Diagnosis' left many feeling isolated and highlighted an important coping mechanisms in the 'Importance of a Social Support Network' theme. Finally, physical health mostly changed through alterations in health behaviour, leading to 'A Healthier Lifestyle' with increasing attribution of physical symptoms to age through 'Symptomatic Overshadowing'.
The greatest disease impact on men's wellbeing was at the time of diagnosis, with a subsequent cyclical anxiety and fear of disease progression prominent around monitoring appointments. Future research should explore ways to better support patients with these issues and at these times, improving their quality of life.
人们越来越重视提高前列腺癌患者的生活质量。然而，那些接受主动监测的患者在文献中的代表性不足，对他们所面临的独特挑战了解较少。因此，我们旨在探讨他们在诊断后的生活体验及其对他们的心理健康、社交和身体健康的影响。
对 13 名正在接受低危疾病主动监测的男性进行了定性半结构化访谈。采用主题分析方法，通过生物心理社会模式的视角，对主题进行归纳构建。
由于诊断带来的强烈情绪影响，我们的参与者心理健康受到了很大影响，导致“情绪诊断失衡”。对前列腺癌的信息意识和教育帮助患者“认识到疾病的影响”。由于对 PSA 监测预约的恐惧和焦虑增加，患者经历了“不安的监测循环”，一些男性忽视了自己的心理健康需求，因为他们的疾病是“未来的问题”。“隐瞒诊断”使许多人感到孤立，突出了“社会支持网络的重要性”主题中的一个重要应对机制。最后，通过改变健康行为，大多数人的身体健康发生了变化，导致“更健康的生活方式”，并通过“症状遮蔽”将更多的身体症状归因于年龄。
诊断时对男性健康的影响最大，随后在监测预约时会出现周期性的焦虑和对疾病进展的恐惧。未来的研究应探索如何更好地支持患者解决这些问题和这些时期的问题，从而提高他们的生活质量。
