Middle-class-self and the embodiment of benign prostate enlargement or prostate cancer: a reading of how ‘onco-economics’ affect a Japanese onco-self

Patient-centred care has different dimensions, necessitating a clear definition to facilitate consistent measurement and evaluation of patient-centred care in clinical settings. This systematic literature review aims to identify and compare measuring tools related to patient-centred care in clinical settings. The Prisma framework was employed to explore six databases (i.e., Google Scholar, PubMed, Science Direct, Springer, MDPI, and Sage Journal) for literature review in identifying instruments used to measure patient-centred care in clinical settings. Result Of 13 articles included in this review, 13 articles documented different questionnaires measuring patient-centred care. These questionnaires included The Person-centred Primary Care Measure (PCPCM), Person-centred maternity care (PCMC), Chloe's-Card, Korean version of the Person-centred Care Assessment Tool (K-P-CAT), Health Education Impact Questionnaire (HEI-Q), Patient-centred Matching (PCPM), Quality of Interactions Schedule (QuIS), Person-centred Critical Nursing Care Scale, Patient-centred Quality of Cancer Care Questionnaire (PCQCCQ), Patient-reported Experience Measures (PREMs), Patient-centred Survivorship Care Index (PC-SCI), and Vietnamese Patient-centred Care measure (VPCC). Each instrument had different criteria according to the patient's background and contextual setting. Existing questionnaires have engaged various perspectives in measuring patient-centred care and distinct adjustment to the patient's condition. Some of the reviewed instruments were modified from existing instruments to meet particular settings. Keywords: Measuring, Patient-Centred Care, Clinical Care, Instruments

BackgroundSurvivors’ testimonies can reveal much about men’s experiences of prostate cancer and impacts on their quality of life (QOL) during the clinical trajectory of the disease. These survivors’ shared thoughts and views were hypothesized to reflect salient features of their lived social representation of prostate cancer.ContextWe explored the content of testimonies posted by men to a public blog hosted by a French national prostate cancer patients’ association. The study question, “What do French bloggers’ testimonies reveal about their lived experiences with prostate cancer, especially regarding their quality of life in community settings, that underpin their social representation of prostate cancer?” guided the exploration and analysis of the textual data. The aims were to better understand men’s experiences and predominant thoughts and views, to elucidate patients’ behaviours, and to enlighten medical policy and practice.PurposeExplore issues of QOL as reported by French prostate cancer survivors in a public blog by: (a) identifying the salient aspects and issues of the experience of living with prostate cancer from the perspective of survivors; and (b) analyzing the content in the posted testimonies regarding perceived and lived impacts of prostate cancer on QOL.MethodsA critical ethnographic study guided the selection of textual data from 196 male bloggers’ testimonies about prostate cancer posted in the period from 2008 to 2013. Media content analysis method was undertaken on blog testimonies, framed by a multidimensional conceptual framework of QOL.ResultsTestimonies focused mainly on medical care and rehabilitation, recovery, health education and self-care, as well as on a global vision of prostate cancer and its impacts on personal views of manhood and masculinity. The language used indicated that political, educative and compassionate discourses were intertwined to create a complex representation of the experience and effects of prostate cancer; this multi-faceted representation can inform the public and professional debate about men’s capacity to provide emotional support and problem-solve within a community of interest.ConclusionFindings, while based on data limited to mostly one-time entries to a French blog, contribute to understanding a unique, collective expression of men’s lived experiences of prostate cancer. These anonymous survivors shared their varied reactions, ways of coping, and thoughts on needed change.

This exploratory study was designed to examine partners' understanding of patients' experience with prostate or breast cancer and to assess the congruence between patient and partner perceptions regarding social support and the cancer experience. Partner understanding of patient mood was assessed by comparing the Profile of Mood States (POMS) questionnaire scores of patients with the POMS scores of their partners (who were instructed to complete the questionnaire as patient proxies). A semistructured interview with corresponding questions for patients and partners assessed the congruency between patient and partner perceptions regarding social support and the cancer experience. Twenty-three couples participated. Eight couples were woman with breast cancer and their husbands, and 15 couples were men with prostate cancer and their wives. The patients with breast cancer and their partners were an average age of 48 years and had been married for 20 years, while the patients with prostate cancer and their partners were 67 years of age and had been married for 40 years, on average. Overall, female partners possessed a more accurate understanding of their husbands' experience with prostate cancer than male partners had of women's breast cancer experience. These men tended to overestimate the breast cancer patients' self-reported levels of distress. Patient and partner perceptions regarding social support in the relationship and the cancer experience were also more congruent in prostate couples than in breast couples. This may be a factor not only of gender but also of age and the length of time that these couples had been together, which was twice as long for the prostate couples. Overall, however, patients were well adjusted and felt understood by their partners and satisfied with the support their partners provided.

The experience of prostate cancer is for most men a major life stress with the psychological burden of this disease falling more heavily on those who are younger. Despite this, being young as it applies to prostate cancer is not yet clearly defined with varied chronological approaches applied. However, men’s responses to health crises are closely bound to life course and masculinities from which social roles emerge. This paper applied qualitative methodology (structured focus groups and semistructured interviews with expert informants) using interpretative phenomenological analysis to define what it means to be young and have prostate cancer. Structured focus groups were held with 26 consumer advisors (men diagnosed with prostate cancer who provide support to other men with prostate cancer or raise community awareness) and health professionals. As well, 15 men diagnosed with prostate cancer and in their 40s, 50s, or 60s participated in semi-structured interviews. Participants discussed the attributes that describe a young man with prostate cancer and the experience of being young and diagnosed with prostate cancer. Chronological definitions of a young man were absent or inconsistent. Masculine constructions of what it means to be a young man and life course characteristics appear more relevant to defining young as it applies to prostate cancer compared with chronological age. These findings have implications for better understanding the morbidities associated with this illness, and in designing interventions that are oriented to life course and helping young men reconstruct their identities after prostate cancer.

The purpose of this study was to examine how men without partners make decisions about prostate cancer treatment, manage treatment side effects, and obtain information and support. In 2009, it was projected that over 230,000 men were diagnosed with prostate cancer. While treatment options vary, these options result in changes within the man that can affect his quality of life. Research has shown that often spouses play a central role in men's choice of treatment and in maintaining men's quality of life. In addition, spouses are the major providers of emotional support and physical care. However, little is known about how men without partners cope with prostate cancer. Prior research seldom addresses how diagnosis and treatment for prostate cancer affects the quality of life of men without partners. Because very little is known about the needs of men without partners managing prostate cancer, qualitative analysis of data obtained during semi-structure interviews provided respondents with an opportunity to share the lived experience of prostate cancer. A semi-structured interview was conducted with selected, consenting men. The sample was drawn from the ongoing R01 study of men with prostate cancer (PROSTQA). The sample for this study included 17 unpartnered prostate cancer survivors. The ages of participants ranged from 47 to 72 with a mean age of 63. The participants had between zero and two co-morbidities with an average of one co-morbidity per participant. The sample was 82% Caucasian and 17% Black. A total of 35% of the participants reported "some college" (n = 6), 30% graduated from college (n = 5), and 23% went to graduate school (n = 4). One participant reported that he was a high school graduate and one had less than a high school education. Five themes emerged from the data: going it alone, diagnosis and prostate cancer treatment decision-making, sources of information and support, the aftermath of prostate cancer, and coping strategies. This study provides information about unpartnered men's prostate cancer experience. This information will help health care professionals to meet the needs of unpartnered more effectively and help them to assist men as they adapt to living with this chronic illness.

Agreement in Infant Growth Indicators and Overweight/Obesity between Community and Clinical Care Settings

The purpose of this phenomenological qualitative study was to explore the lived experience of men with prostate cancer. Fifteen men in Western Canada who had received treatment for prostate cancer were interviewed and encouraged to provide their stories about experiencing prostate cancer from the initial diagnosis on. Men narrated the experience of prostate cancer as a journey, starting with the shock and soul-searching of initial diagnosis, continuing on as they “fumbled in the dark” for information and coped with the various threats to their masculinity, and concluding with lessons they had learned along the way. Although some men minimized the experience of prostate cancer as merely something to be “fixed,” other men saw the illness as a potentially transformative experience. For them, prostate cancer gave them a “second chance” to re-evaluate their priorities in life, and to experience their lives as men in a changed and transformed manner. This paper adds to the existing literature by not only offering a mapping out the “patient careers” of men with prostate cancer, but also by re-focusing men’s experiences of prostate cancer as a means by which to grow as persons and men.

Introduction. Prostate cancer is the most common malignant neoplasia among men in Lithuania, though it presents a low mortality rate. In 2007 more than 3 500 Lithuanians were diagnosed with prostate cancer. Many patients were treated with radiotherapy. Unfortunately, after several years the number of cases of prostate cancer recurrence after radiotherapy started to grow. This new problem requires the following difficult decision to make: which treatment method to choose? Radical prostatectomy, high-dose radiotherapy, cryotherapy, high-intensityfocused ultrasound, active surveillance or hormone therapy – all are viable salvage methods. In 2012 we performed the first cryotherapy procedures. Now we want to present our first clinical experience in prostate cancer salvage cryotherapy. Materials and methods. Five patients diagnosed with prostate cancer were selected for prostate cryotherapy. Four patients were treated only with radiotherapy, one patient was treated with radiotherapy plus neoadjuvant hormonal treatment. Prostate cancer recurrences were diagnosed by multiparametric MRI and ultrasound guided transrectal or transperineal biopsies. MRI findings were validated with the Magnetic Resonance Prostate Imaging Reporting and Data System (PI-RADS). CT, MRI, ultrasound scanning, and bone scintigraphy were performed for patients before treatment. No pathological bone changes were detected. All patients received 2-cycle cryotherapy with real-time ultrasound guidance and temperature change tracking. Results. The described treatment scheme for these patients enables to deliver two freezing-thawing cycles with 10–12 probes and a urethra-warming catheter. All procedures were completed succesfully without any intraoperative complications. Urinal obstruction was observed after 1 week for 1 of 5 patients. He had to stay with epicystostomy and overwent prostate transurethral resection. After these procedures the patient could urinate normally. One patient had biochemical progression due to metastasis in parailiacal lymph nodes, and he got external beam therapy to lymph-node projection. After 6 months there was no cancer progresion signs on MRI and PSA was 1.77 ng/ml. No patients suffered from urinary incontinence. Conclusions. Our initial experience shows that cryotherapy can be a viable alternative for patients with disease progression after radiotherapy. Currently the biggest advantages of cryotherapy are as follows: possibility to treat patients not suitable for salvage prostatectomy, short hospitalization, low complication risk and lower overall cost than other methods. Short term data seems to be promising but longer follow-up is necessary to verify oncological and functional results.

The purpose of this study was to provide in-depth insight into men's experiences of prostate cancer, specifically: perceived stigma and self-blame, social isolation, unmet need and help-seeking. A qualitative descriptive approach was used. Semi-structured interviews were undertaken with 20 men diagnosed with prostate cancer, and thematic analysis was undertaken. Some participants perceived a stigma associated with prostate cancer and cancer in general, which sometimes acted as a barrier to disclosure. Self-blame and internalisation of cause was not a prominent issue. Participants' descriptions of emotional distress, social isolation and anxiety demonstrated the impact of prostate cancer. Social isolation was most commonly reported as a physical consequence of treatment and/or side effects. Participants felt both support and ongoing care were limited at post-treatment. Most did not seek or receive help for emotional or psychosocial problems from a formal source due to anticipated awkwardness, autonomous coping, not burdening others, unwanted sympathy and retaining privacy. Prostate cancer can cause considerable emotional and social burden for some men, and many are unlikely to seek or receive help. Men, and their support networks, require active encouragement throughout diagnosis, treatment and follow-up to overcome barriers and access additional support, particularly for sexual, emotional and psychosocial issues.

Following a diagnosis of, and treatment for prostate cancer, there is an expectation that men will cope with, adjust to and accept the psychosocial impact on their lives and relationships. Yet, there is a limited qualitative world literature investigating the psychosocial experience of prostate cancer, and almost no literature exploring how masculinity mediates in such an experience. This paper will suggest that the experience of prostate cancer, the process by which it is investigated, and the way in which it is understood has been shaped by an essentialist interpretation of gender, exemplified by hegemonic masculinity as the archetypal mechanism of male adaptation. In response to this static and limiting view of masculinity, this paper will offer a reframe of hegemonic masculinity. This reframe, being more aligned with common experience, will portray masculinity as a dynamic and contextual construct, better understood as one of a number of cultural reference points around which each man organises and adopts behaviour. It will be suggested that the extant literature, in being organised around hegemonic masculinity, obfuscates the experience of prostate cancer and acts to render covert any collateral masculinities, public or private, that may also be operating.

It is well documented that prostate cancer presents a significant health problem for middle-aged and elderly men in the UK, with further evidence suggesting that the disease is more prevalent in men of African and Afro-Caribbean (AAC) ethnicity. There is also evidence that these men are diagnosed much later and that the disease is more aggressive than in Caucasian men. To explore AAC men's experiences of prostate cancer and their understanding of its associated risks. The purpose was to gain an insight from these men's perspectives and ascertain whether a more focused health promotion strategy, and specific UK-based research, was needed in this area. A purposive sample of seven AAC men was recruited from a hospital trust's patient list after gaining approval from a research ethics committee. In-depth face-to-face interviews were carried out and the transcripts analysed thematically. The four main themes that emerged were: disease-prompted awareness, checking up as a necessary evil, defining and constructing factors influencing prostate cancer screening uptake, and appraising perceived myths about prostate cancer through personal beliefs. Among this group of AAC men, socioeconomic status, such as education and professional background, were factors that influenced their level of awareness of prostate cancer and prompted their decisions to seek help. However, it is evident from these men's perspectives that a more specific health education strategy that promotes early detection and management, targeting AAC men, would help in demystifying prostate cancer and encourage them to seek help earlier. Further research studies and health education in prominent social outlets are recommended in increasing AAC men's awareness of prostate cancer and its associated risks.

(036) Understanding Prostate Cancer Disparities in Transgender Women: A Scoping Review

Prostate cancer is among the most prevalent forms of cancer worldwide and is reported to have the highest incidence, mortality, and 5-year prevalence rate of all cancers among men living in Africa. Despite this widespread burden in the African continent, little is known about the perspectives and experience of prostate cancer among African men. To further understand experiences among patients living in urban South Africa, we conducted in-depth, semi-structured qualitative interviews to examine the perceptions and experiences of 28 Black African prostate cancer patients receiving treatment at a major tertiary hospital in Johannesburg, South Africa. Our data explored four major areas of patients’ experiences with prostate cancer: detection, diagnosis, treatment, and follow-up care. Our results showed that the experience of living with prostate cancer among low-income, Black South African men is a stressful and emotionally painful experience due in part to men feeling that they had insufficient knowledge about their own condition and feeling disempowered or ill-equipped to manage their cancer. These feelings were strongly associated with distrust or dissatisfaction with physicians and the health care system. Resilience factors include social support from family, friends, and religious communities, acceptance of their diagnosis, religion, and positive appraisals of their medical care.

The aim of this research was to ascertain General Practitioners’ (GPs) perceptions and experiences of prostate cancer (PCa) diagnosis, treatment, and care in metropolitan Melbourne and in a regional area of Victoria, Australia, associated with poorer PCa outcomes. Semi-structured qualitative interviews were conducted with GPs (N= 10) practising in the selected region and in metropolitan Melbourne, Australia. GPs thought that most men wanted PSA testing and were willing to undergo rectal examination. Some GPs were troubled by inconsistent screening guidelines from different professional bodies. They identified a need for resources to support them in educating patients about PCa. GPs thought it might be more difficult for young female GPs to care for patients in relation to PCa screening; differences were evident between younger female GPs and older male GPs in the approach they adopted in interviews. Regional GPs often referred patients to services in larger centres because no local specialists were available. GPs also found it hard to explain differences in PCa outcomes in regional and metropolitan areas. Potential age and gender differences in GPs in relation to prostate care warrant further examination. Although GPs were able to offer only limited insights into the poorer outcomes in regional areas, they identified ways in which they could be assisted to provide best-practice care. Multidisciplinary care, resources for patients, and consistent guidelines for the detection and treatment of PCa should contribute to better care in all areas.

The purpose of this study was to explore the experiences and perspectives of men who have had prostate cancer to better understand the effect of prostate cancer and associated stigmas on men in the Canadian province Newfoundland and Labrador (NL). Eleven men from NL who have had prostate cancer participated in semistructured interviews exploring their perspectives and experiences of prostate cancer and stigma. A social-ecological framework was used to understand experiences from different domains. Interviews were analyzed using Lichtman's three Cs approach. Analysis focused on establishing themes of the participants' lived experience of prostate cancer and related stigma. Participants described how emasculating a prostate cancer diagnosis can feel. They identified ways prostate cancer negatively affected their behaviors and sense of self, described coping with the diagnosis and different strategies, and talked about broader system change required to address prostate cancer stigma. Participants expressed a need for additional support from healthcare providers (HCPs). HCPs, such as oncology nurses, may be able to reduce stigmatization by providing patient navigation, improving information delivery, or providing psychosocial counseling to individuals experiencing feelings of internal or external stigmatization related to prostate cancer.