A qualitative exploration of prostate cancer survivors experiencing psychological distress: Loss of self, function, connection, and control

Purpose: To explore the experiences of men with prostate cancer identified as having psychological distress and to identify factors influencing distress. Participants and setting: 28 men with prostate cancer diagnosed 18-42 months earlier, identified as having psychological distress on survey measures. Methodologic approach: Semi-structured telephone interviews were conducted. Thematic analysis using a Framework approach was used. Findings: Men with psychological distress had strong perceptions of ‘loss’ towards a) self (identity, sexuality/masculinity, self-confidence), b) function (physical, activities), c) connection (relational, social, community) and d) control (future, emotional). Psychological vulnerability appeared heightened in particular groups of men. Maladaptive strategies of emotional concealment, help-seeking avoidance and withdrawal appeared to contribute to distress. Implications for nursing: Distress in men with prostate cancer is multifaceted. Men with distress should be identified and offered support. Nursing and/or peer-led interventions are required. Knowledge Translation: 1. A significant minority of men with prostate cancer report distress 18-42 months following diagnosis. Screening tools for psychological difficulties may help identify men in need of further support. 2. The author’s conceptual model highlights pre-existing and treatment related factors, as well as maladaptive coping strategies influencing distress. Greater support with restoring self-identity and confidence is needed. 3. Nurse-led patient education and information on managing psychological and physical concerns, as well as sign-posting to peer support, community or online support groups is required