Radical prostatectomy: men's experiences and postoperative needs

Abstract

This study sought to explore men's experiences after radical prostatectomy and whether they perceived their preoperative teaching adequately prepared them for postoperative recovery. Tape-recorded telephone and face-to-face interviews were conducted at days 2, 7 and 21, and 3 and 12 months postdischarge. Although verbal and written instruction about postoperative expectations and care are provided routinely before radical prostatectomy, patients express concern about a lack of preparation in managing urinary incontinence and erectile dysfunction. This qualitative descriptive study explored in-depth men's experiences during the year following their surgery. Multiple, tape-recorded, semistructured telephone interviews were conducted with 17 participants and a single, in-depth, face-to-face interview was conducted 12 months postoperatively with a subset of five men selected for their reflective and descriptive abilities. Although participants received comprehensive written and verbal information preoperatively, it was not sufficient to foster their management of all postoperative sequelae. Telephone follow-up, used as a data collection strategy, was helpful in fostering adjustment after surgery and relieved anxiety caused by side effects of surgery and unanswered questions. Pre- and postoperative teaching needs to make allowances for the impact of stress on the recall and processing of information. Written information in itself is not adequate to answer necessary questions and provide reassurance. Follow-up telephone support is recommended as a way of fostering adjustment after surgery. This study shows that: (i) Written information in itself is not adequate to answer necessary questions and provide reassurance, (ii) Nurses need to be prepared, both educationally and psychologically, to observe non-verbal cues and to address questions and concerns that are rarely voiced in ways that indicate their significance to the person and (iii) Men may not speak about sexuality issues in ways that accurately reflect the extent of their worry and/or distress about erectile dysfunction.