Uniting the body and mind in prostate cancer: A qualitative exploration of the psychosexual impact of prostate cancer treatment and related clinical communication needs

Abstract

The thesis sought to gain an in-depth understanding of the psychosexual impact of prostate cancer treatment and associated clinical communication needs. It is comprised of three standalone papers. Papers one and two are prepared for submission to the journal Social Science and Medicine and in accordance with the journal guidelines. Paper one is a systematic review and meta-synthesis of qualitative findings related to men's perspectives of the impact of localised prostate cancer treatment on sexual intimacy. A systematic search of four key databases was conducted. Twelve studies met the inclusion criteria for the review. Findings are organised within four inter-related themes: i) Loss and grief: Destroyed intimacy; ii) Going through the motions: Artificial intimacy; iii) Fear of failure: Avoiding intimacy; iv) Breaking barriers: Alternative intimacy. The themes form a conceptual model describing how men can experience sexual intimacy in the context of localised prostate cancer. The implications of this model for health care professionals and researchers are discussed. The meta-synthesis established that psychosexual wellbeing is a salient concern of men who have undergone prostate cancer treatment providing a strong rationale for empirical study into men's clinical communication needs in this area. Hence, paper two is a qualitative study illuminating men's clinical communication needs in relation to the psychosexual aspects of prostate cancer treatment. Twenty one men were interviewed and transcripts were analysed using thematic analysis. Three themes were identified which describe the psychosexual clinical communication challenges men encountered: i) "Sex is kind of the last thing on my mind": It can be too soon to talk about sex; ii) The importance of "recognising nuance": Clinician's assumptions can lead to not treating as an individual; iii) "It's just so mechanical": The psychology of sex is missing. Theoretical and substantive implications of the findings are discussed. Paper three provides a critical review of papers one and two and offers reflexive commentary on the qualitative research process. This paper offers personal and professional reflections, a critique of epistemological and methodological issues raised by the two studies and an extended discussion of the implications of the findings in relation to both research and clinical practice.

Date of Award	31 Dec 2015
Original language	English
Awarding Institution	The University of Manchester
Supervisor	Sarah Peters (Supervisor) & Susan Speer (Supervisor)