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Last updated: May 26, 2019

How Men Diagnosed and Living with Advance Prostate Cancers’ Use TheirOwn Practises to Promote and Maintain their Emotional Well-Being: A ThematicAnalysis  AbstractObjectiveMenwho are diagnosed and living with prostate cancer, their responses develop awide range of emotions. This report explores the ways in which men withadvanced prostate cancers’ individual approach to maintain and promote theiremotional well-being.MethodAsample of 3 males who have advanced prostate cancer was recruited from theProstate Cancer UK’s (registered charity) through a volunteer sampling.

Theyfurther participated in a semi-structured interview schedule in their homes.Participants were asked to talk through their treatment and diagnosis; impacton their well-being, and the ways in which they strategize to ensure emotionalwell-being. Thematic Analysis was used to code and develop two themes withinthe data collected associated with the research question. ResultsTheresults produced two themes emerging in the transcript – ‘living with advancedprostate cancer (APC)’ and ‘striving to make the most out of life’.

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Theemotional well-being of participants left uncertainty separating from life andtheir loved ones. Participants ensured to maintain and promote their well-beingthrough emotions, reconnecting with families/community, which gave them a senseof control. All of this has shown positive emotional well-being, whichindicates areas for health professionals could possibility explore to aid menre-establish their life-purpose.ConclusionThefindings which have emerged from all three transcripts present value towardspsychological interventions such as mindfulness with men who have advancedprostate cancer as a way to think positively from their situation. IntroductionAdvancedprostate cancer (APC) is a cancer which spreads further from the prostate toother parts of the individuals’ body.

APC is able to cause symptoms withphysical morbidities such as problems with urination, bone pain and fatiguecaused by the disease spreading across the body (Heidenreich et al., 2014). There are varioustreatments available for help such as chemotherapy, androgen deprivationtherapy (ADT) other comforting treatments to help manage these symptoms. In particular,patients who are diagnosed and living with APC experiences a decrease inhealth-related quality of life, and consequently feel worse in terms ofpsychological distress and being able to adjust to the stage of the disease (Resnick & Penson, 2012).

Results have shown 41% of patients with APC reported not feeling the people understoodwhat they are going through, greater percentage showed patients to feel emotionaldistress and uncertainty the with diagnosis of APC (62%), fearful (33%), sad(32%) and felt isolated (20%; Aning et al., 2012). However, limited research in the area ofpsychological well-being amongst men with APC tends to focus more towardstreatments such as ADT and the side effects such as mood swings or depression. Therefore,psychosocial interventions have shown improvement coping with stress managementskills and decrease levels of perceived stress to be beneficial across a rangeof health-related quality of living outcomes amongst prostate cancer survivors;this includes physical, family/social, emotional well-being and functional domain(Benedict et al.

, 2015). However,research is currently undergoing in Health Psychology to re-focus on engagingmen with well-being, than simply highlighting their deficits. This can eitherbe through consideration or seeking help for depression with a diagnosis (Ridgeet al., 2011).This report aims to explore 3interviews for analysis on the experience of males with prostate cancer.Specifically, a qualitative study was conducted in order to explore men withadvanced prostate cancers’ own practises with promoting and maintaining anemotional well-being. Thematic Analysis (TA) was chosen an appropriate methodto identify, analyse and report any recurring themes associated with thespecific research question.

 MethodologyParticipantsParticipants were based in the UK andwere recruited through a volunteer sample from the Prostate Cancer UK’s(registered charity). Inclusion criteria required English speaking men withAPC, and using strategies in order to maintain and promote their emotionalwell-being. All participants were Caucasian and were management levelprofessionals; either retired or taken early retirement due to diagnosis. Ageand demographic information of participants is provided down below:Table1. Demographicinformation on participants with advanced prostate cancer (APC). Participant Age Time Since Diagnosis (years) Treatments Received Physical Function Robert 52 3 Androgen Deprivation Therapy (ADT) and Radiotherapy Active and mobile Jack 72 10 ADT Physical function reduced and unable to exercise Clive 53 4 ADT, Second-Line ADT and Chemotherapy Active and mobile  MaterialsEthical approval was first to beobtained from the University of Westminster research ethics committee. Anadvert was used to place on the bulletin of the registered charity as mentionedin order to recruit volunteers from Prostate Cancer UK. Researchers would then contactvolunteers to confirm basic information and details as mentioned.

Briefedinformation sheet and consent form were to be provided before the interviewswere to commence, followed by a debriefing form to know the true purpose of thestudy and further contact details for support.DesignThis study used a qualitative designusing a semi-structured interview and Thematic Analysis (TA). This method is ableto familiarize the data, generate initial codes, search for themes among codes,review these themes, define and name the themes, and lastly producing the finalreport. This analysis is able to provide flexibility, be useful by qualitativelearners and be resource efficient (Braun & Clarke, 2006).ProcedureEthical approval was first obtainedfrom the University of Westminster by the research ethics committee. An advertwas placed in the Prostate Cancer UK’s (registered charity) bulletin to receivevolunteers.

Participants were to be English speaking men, diagnosed withadvanced prostate cancer and self-identified to using strategies to maintain andpromote their emotional well-being. Men who came forward were contacted viatelephone or email by the researcher and were asked to confirm age otherdemographics (Table 1). All participants were then briefed and given consentforms as anonymity was preserved by pseudo names and rights to withdraw anytime during the research. All participants were interviewed in their homes, todiscuss their treatment and diagnosis, personal meanings of well-being andemotions, the impact prostate cancer had on them, and strategies they used to preserveemotionally well.

The interview durations was between 1h 27 min – 2 h (M time –1h 45 min). All interviews were to be recorded and then transcribed word forword. Once transcribed, a thematic analysis was used to code and theme (seeappendix A) and then placed into a table (see appendix B). Lastly, participantswere then debriefed about the study. ResultsThis report focuses on a thematicanalysis, two key themes occurred from all three interviews which was ‘livingwith advance prostate cancer’ and ‘making the most of life’. There wassignificance within all three transcripts with uncertainty for the future andliving with the advanced prostate cancer.Theme 1: Living with Advanced Prostate CancerThe impact of living with advancedprostate cancer had an affect across all three men’s emotional well-being.

Forexample, in Robert’s transcript, it was highlighted his uncertainty coping withthe diagnosis which had left him in disbelief.”Butstraight away there was a ‘that’s not me,’ vegetarian, healthy, no history ofcancer in the family, no it will just be the motorbike thing, that’s what it’llbe” – RobertBeing diagnosed with cancer has ledall three men to question their identity and actions on the circumstances. Onthe other hand, living with APC has displayed a range of emotions in responseto their situation. All three men were able to express their feelings towardsthe support given to them from people outside their family. An example of thiswas shown in Jack’s transcript.”Soand…I enjoy it, I enjoy being with the people. I mean when we get together inthe patient carer group (laughs), we gets down to business, but there’s alwayslaughter.

Some of them are ex-patients, some of them are carers, some of themare actually dying. I mean we’ve lost quite a number of people from the groupthat subsequently died. Butit’s very, very therapeutic for me”.– JackJack has come to value the supportaround him from individuals who are in the same position through volunteering.For all three men, emotional expression became therapeutic, which may havedeveloped a psychological distance from death and reinforcing their sense ofmasculinity. However, Clive had a different experience.”Now, whether the healthcare professionals tailor how they deal with individuals based on theirjudgement of individuals…I don’t know, I’ve only got my own experience.

But myexperience is, erm, you’re offered a specialist nurse who you can go toanytime, but outside of that – no real, no real support from an emotional or aphysically well-being point of view. Quite, quite weak” – Clive Clive expresses a decrease with further emotional andphysical support for his well-being outside of healthcare professionals. Thismay consequently cause more psychological distress unable to cope with thestage of disease. Theme 2: Striving to Make the Most out of LifeParticipants have presented to striveand make the most out of their life in a goal-orientated way to maintain andpromote emotional well-being.

For example, Jack emphasises his volunteer roleand how this has changed him.”And…becausethe cancer support centre was so good to me in turning me around, I’ve becomemore and more engrossed in volunteering, because the people who’ve helped me, Iwant to put something back” – JackClive has shown a sense of social connectionand belonging by helping others which helps promote emotional well-being, andless of feeling separated from life or feeling alone living with APC byadopting this new role in life which has given him a purpose. Participants havealso mentioned making the most out being with family members. This example wasshown by Clive.”So,when I said I tried to be normal, when I reached a certain place, I thought,well now is the time for me. So….you know to give myself to my wife and thekids more than I had been…” – CliveThis creates a sense of duty regainedagain, and masculine attitude to be able to look after the family.

On the otherhand, participants have also emphasised a sense of physical ability whichcreated more awareness to be mindful as well as sensory pleasure for theindividual. An example of this was shown in Roberts’s transcript.”Itook my bike up there, took my life in my hands and cycled through central xxactually, which was marvellous actually, it was absolutely marvellous and Iloved my time there, it was really good fun”. – RobertHere, Robert also reinforces physicalability to carry out existing hobbies such as riding his bicycle which helpspromote and maintain emotional well-being. This helps to move away from livingwith APC which build uncertainty with life and death. DiscussionOverall, the study adopted knowledgeon how the impact of living with advanced prostate cancer affected theiremotional well-being and uncertainty with their future selves. In relation toprevious research, the current findings have provided an insight on how advancedcancer gives them sense of uncertainty on hearing the diagnosis, which hascreated a sense of fear that cancer has truly taken over their lives (Aning etal.

, 2012). However to maintain a health emotional well-being, participantshave expressed the support from others outside of their family to have a changein perspective and take control in their life. The support from those understanding their condition creates a sense ofcommunity and belonging. On the other hand, some participants have felt thelack of support from others outside to promote and maintain an emotionalwell-being. This supported previous finding which have shown those living withAPC experience a decline in health-related quality of life, which may affectpsychological distress due to the severity of their stage in diagnosis (Resnick & Penson, 2012).Previous research has noted to ensure emotional well-being in well promoted,the importance of stress coping management skills have shown to be beneficialwithin health-related quality of living outcomes with APC (Benedict et al.,2015).  This has known to be a necessaryapproach which presents optimism and positivity, key aspects for maintainingand promoting emotional well-being.

The study presented limitations byonly interviewing three men who were all living in the United Kingdom. All theparticipants where Caucasian, married and management level professions, thislacks generalizability as there has been no consideration of men of differentcolour, ethnicity or educational level diagnosed with advanced prostate cancer.The sample has also shown to be bias in the study considering how all theparticipants were selected through a volunteer sampling. Therefore, it was nosurprise for participants to have an interest in volunteering and give back tothe community. Future research to use interventions such as mindfulnessapproaches which was shown to potentially enhance attempts to change participants’perspectives to appreciate life more whilst offering them coping mechanism toovercome struggles they may face in the future. This has already showneffectiveness in patients groups with advanced prostate cancer (Chambers etal., 2012). ReflectionOverall, analysingeach transcript I’ve come to realize that men can sometimes retain theiremotional distress, or not feel it is ideal to reveal them in order to upholdthis masculine identity amongst family members.

Therefore, I felt it would beuseful for researchers to target areas in which are weak in individuals andraise any concern which they may feel to ensure better coping strategies usedto deal with these threats. Lastly, I personally feel more could be done toensure the emotional well-being of men who are diagnosed with a terminalillness, which would lead to a greater improvement in their quality of life. 

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