Congress Abstracts 2005

25

THE MEANING OF PROSTATE CANCER TREATMENT-RELATED INCONTINENCE AND IMPOTENCE AMONG LOW-INCOME AFRICAN AMERICAN MEN. Sally Maliski, PhD, RN, and Mark S. Litwin, MD, MPH, University of California, Los Angeles, Los Angeles, CA.

Prostate cancer is the most common noncutaneous cancer among American men. African Americans men have a 66% higher age-adjusted incidence rate than Caucasians. Primary treatments carry a significant risk for incontinence and/or erectile dysfunction. Oncology nurses must be able to address these symptoms during treatment decision-making and post-treatment symptom management. In order to do so, meaning of these symptoms needs to be understood.

Little work exists on the meaning of these symptoms for low-income African American men to guide development of interventions among this population. Therefore, our purpose was to describe incontinence and impotence experienced by low-income African American men treated for prostate cancer to lay the foundation for culturally appropriate interventions related to these symptoms.

This study is grounded in the assumption that cultural beliefs and socioeconomic factors influence the meaning made of cancer-related symptoms. Furthermore, cultural concepts of masculinity are assumed to affect perceptions of ED.

The design employs ethnomethodology combining ethnographic perspective (cultural) with phenomenologic techniques (meaning) to develop an in-depth understanding of symptoms through personal interviews. Interviews are conducted by male, African American interviewers in the man’s home or by telephone using an open-ended guide. Interviews are audiotaped and transcribed verbatim. Follow-up telephone interviews are conducted 3 months later.

The PI reads all transcripts completely. The sentence is the unit of analysis for data management using NVivo. Unit-by-unit coding is done, identifying the major thought in each unit. Themes will be identified from the codes. Emerging codes and themes will be constantly compared to previous ones. Concepts will be identified from the categories, derived from clustering themes across transcripts. These concepts will be dimensionalized to show the range of themes supporting the concepts and the surrounding variations within themes evidenced in codes. Themes and concepts will be examined back through the unit-by-unit coding for expressions of culture-influenced beliefs.

Initial coding is revealing multiple factors affecting masculine identity, acceptance of current ED, and reluctance to use “unnatural” means of achieving erections. Ambivalence is emerging as men discuss having erections as an integral part of manhood while believing that there’s more to life than sex. Having treatment is seen as a choice between having sex or living.