Open Access Highly Accessed Research article

The struggle towards ‘the New Normal’: a qualitative insight into psychosexual adjustment to prostate cancer

Narelle Hanly1, Shab Mireskandari2* and Ilona Juraskova2

Author Affiliations

1 Faculty of Health Sciences, The University of Sydney, Sydney, NSW, Australia

2 Centre for Medical Psychology & Evidence-based Decision-making (CeMPED), School of Psychology, The University of Sydney, Level 6, Chris O’Brien Lifehouse (C39Z), Sydney, NSW 2006, Australia

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BMC Urology 2014, 14:56  doi:10.1186/1471-2490-14-56

Published: 30 July 2014

Abstract

Background

Despite the growing body of literature which highlights the potential for significant and enduring side-effects of prostate cancer treatment, there is limited research exploring the experience of living with the treatment-induced side-effects such as sexual dysfunction, and their repercussions for men and their partners. The aim of this qualitative study was to explore factors influencing psychosexual adjustment, self-perception, and unmet information and support needs of prostate cancer patients and their partners.

Methods

Twenty-one men, recruited via a prostate cancer support group newsletter, participated in face-to-face semi-structured interviews, which were subjected to thematic analysis.

Results

The qualitative analysis revealed three inter-connected main themes which contributed to men’s psychosexual adjustment: i) Psychosexual impact, ii) Communication and support, and iii) Integration process. Men reported distressing sexual and urinary difficulties, tainted self-perception and altered intimate relationships. Receiving adequate information and support, and having good communication with their doctors and partners facilitated better adjustment to prostate cancer treatment. Coming to terms with the significant impact of treatment had involved making lifestyle changes, coping with emotional struggles and striving to accept and integrate their post-treatment “new normal” self and sexual life.

Conclusions

The importance of adequate communication with health professionals and partners, especially regarding treatment effects on sexual function and rehabilitation options, was highlighted as a key factor facilitating the adjustment process. Prostate cancer patients would benefit from improved access to timely and tailored information and decision-making resources, ongoing multidisciplinary care, and support groups, as well as appropriate referrals for sexual and psychological counselling.

Keywords:
Prostate cancer; Sexual function; Self-perception; Qualitative research