Managing the Impact of Illness: The Experiences of Men with Prostate Cancer and their Spouses

Abstract

This qualitative study explored issues of support and coping for couples where the man had been diagnosed with prostate cancer. Thirty-four men with prostate cancer and their spouses were interviewed separately at three points in time: prior to surgery; 8 to 10 weeks post-surgery; and 11 to 13 months post-surgery. The core category for the couples' experience with diagnosis and treatment for prostate cancer was Managing the Impact of Illness. Five major domains emerged, including: dealing with the practicalities; stopping illness from interfering with everyday life; keeping relationships working; managing feelings; and making sense of it all. While it was clearly important for couples to manage illness and to reduce its potential intrusion into everyday life, this strategy had psychological costs as well as benefits. Men struggled to stay in control of their emotions and their lives, typically vacillating between the pulls of fierce self-reliance and fearful neediness. Women were constrained from employing their usual strategies of coping and were distressed by the complicated requirements of being supportive while also honoring their partners' need for self-reliance.

“I wish I’d told them”: A qualitative study examining the unmet psychosexual needs of prostate cancer patients during follow-up after treatment

“…Most prostate cancer patients seek support for sexual dysfunction at an early stage following treatment [52]. However, the data presented here show that the psychological consequences of the loss of sexual function may only manifest years after treatment when the imminent threat to survival passes [6,53]. These data have important implications for the delivery of psychosexual support during follow-up, as current recommendations suggest that assessment of psychosexual needs should be targeted around the period close to diagnosis [54] and in the early months after treatment [9,55,56].…”

“…Prostate cancer patients are likely to share common concerns with other cancer sufferers [3,4], but have reported some specific unmet psychosocial needs [5][6][7][8][9][10][11][12][13][14].…”

The influence of developmental life stage on quality of life in survivors of prostate cancer and their partners

“…Fatigue and stress associated with caregiving can diminish the quality of life of the caregiver [20]. Equally important, research suggests that the quality of life of the partner also can affect the quality of life of the patient [21,27,[37][38][39].…”

Intimacy and relationship processes in couples' psychosocial adaptation to cancer

“…For example, in the months after a new diagnosis, these stressors include negotiating changes in occu- pational and family roles, interference with future life plans, and managing household and childcare responsibilities. [15][16][17][18] For couples dealing with advanced disease, cancer causes additional life stresses, such as declining functional abilities that bring about the necessity for couples to discuss how care and assistance with daily activities will be provided to the ill partner. 19,20 Couples also typically negotiate difficult choices regarding end-of-life treatments and care, cope with anticipatory grief regarding the loss of one's partner, manage child and family reactions, and talk about the ill partner's legacy in psychologic and practical matters.…”