Everyday problems in men with prostate cancer. Aspects of micturition, indwelling urinary catheter treathment and sexual life

University dissertation from Lund University, Department of Nursing, P.O.Box 198, SE-221 00 LUND, Sweden

Abstract: The aim was to investigate the presence of everyday problems in men with prostate cancer, their relation to health-related quality of life, HRQOL, and sense of coherence, SOC, and to compare with men with benign prostatic hyperplasia, BPH, and a sample from the general population. The aim also was to investigate what nursing care needs there were in men with prostate cancer and how these were met during an in-patient period. Semi-structured interviews exploring everyday problems in men with prostate cancer (n=11) created the basis for further investigation. This was followed by an interview investigation (n=25) focusing the specific problems. The specific problems were also focus for the development of a study-specific questionnaire administered by mail-out mail-in procedure to men with prostate cancer (n=155), BPH (n=131), and the general population (n=129) and focused on micturition problems and sexual life problems, as well as provision and satisfaction with information. For assessment of indwelling urinary catheter treatment those with such experience were selected (prostate cancer n=71, BPH n=37). HRQOL (EORTC QLQ C-30) and SOC were additionally assessed. Living with prostate cancer meant alterations in life continuum, patients’ dealing with the altered life continuum and leaning on the next-of-kin for help and support, and that life was rearranged in relation to physical and existential fatigue, life in itself, life quality, and significant others. Living with micturition problems, indwelling urinary catheter treatment and sexual life meant a changed life continuum and changed life quality. Patients interpreted as passive (n=8) receivers were explicitly and implicitly stating unmet nursing care needs, or explicitly stating satisfaction and implicitly contradicting their statements. Active receivers (n=3) were explicitly stating unmet needs but seemed to get nursing care that met their needs, while passive receivers did not. HRQOL was reported at the same level though significantly lower (p=<0.002) in men with prostate cancer or BPH than in the general population. Those having a cancer diagnosis did not report more problems than those with BPH. Most troublesome urinary problems were leakage (m 2.74), feelings of discomfort (m 2.01) and disrupted urinary function and frequency (m 1.87). Sexual problems were related to pleasure and attraction (m 2.84), erectile function and sexual satisfaction (m 2.74), and sexual performance (m 2.83). Indwelling urinary catheter treatment was connected with discomfort in wearing a catheter (m 1.65), practical and psychosocial difficulties in handling and wearing (m 1.60), and discomfort at instalment (m 1.48). The information given on disease and treatment was stated to be satisfactory, however, reported to be too little. The results give some insights into what it means to live with prostate cancer or BPH. Special problems with micturition, catheter treatment and sexual life were identified, as well as the need for emotional support and professional availability indicating areas for nursing care measures.

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