That men should have an altered sense of masculine identity following penile cancer surgery is not unexpected. However, the ways in which altered masculinity manifested itself were both subtle and insidious. The results have implications for clinical practice and demonstrated the need for further research.
Purpose: Penile cancer is a rare but highly treatable condition. Whilst over 80% survive for over five years, treatment can have a significant impact on quality of life. There has been little research conducted to date on men's experiences of treatment for penile cancer; The Patients Experiences of Penile Cancer study (PEPC) aimed to redress this shortfall by exploring men's experiences of surgical treatment for penile cancer.Method: Data were collected using two methods; an initial narrative oral history followed by a semistructured interview. Maximum variation sampling was used to acquire the widest possible range of experiences. Twenty-seven interviews were conducted with men with an average age of 63 years at diagnosis (range = 41 -82). The data were analysed using constant comparison analysis.
Results:The physical impact of surgery was inter-connected with broader events in the lives of the men experiencing treatment. These experiences cover urinary function, sexual function and sexual relationships, healing and recovery, masculinity, mental well-being, coping and support.
Conclusions:A key area for the development of care is to devise and evaluate procedures for ensuring that men are well-informed about the extent and potential consequences of their treatment. Men's experiences of penile cancer surgery will be informed by a complex web interlaced with their broader life making it difficult for health professionals to judge how surgery will impact on a men presenting to them. Further research is required to ascertain the most appropriate strategies for rehabilitation of men experiencing penile cancer surgery.
Continuous, high volume, venous-venous haemofiltration was used as renal support in 28 critically ill patients with acute renal failure. Fifteen patients survived and were subsequently discharged from the ITU. Although haemofiltration was highly effective in reducing the blood urea and serum creatinine, only survivors demonstrated a significant increase in arterial pH (medians before and at two days 7.28 and 7.49 respectively, p less than 0.005) with a reduction in severity of their illness (median APACHE II scores before and at two days 23 and 16, p less than 0.005). Patients who died remained severely ill and acidotic (median APACHE II scores before and at two days 26 and 28; median arterial pH values 7.32 and 7.31 respectively) and by day two of treatment, marked differences between the patient groups in APACHE II scores, mean arterial pressure, arterial pH and urine flow rate had developed. Haemofiltration with the correction of acute uraemia alone does not necessarily lead to a reduction in the severity of illness which in the critically ill more frequently reflects other organ dysfunction.
Aim: To explore how men with penile cancer construct humour in relation to their diagnosis and treatment.Background: Functionalist, relief and incongruity theories attempt to account for humour but there is a dearth of empirical evidence in nursing care. This is particularly so in relation to a condition like penile cancer where some nurses think that humour in their interactions with patients would be inappropriate.Design: The study employed a participative, mixed-qualitative-methods design.Method: Focus groups and patient-conducted interviews were both used during a one-day
Objective To investigate the effect of a nutrition education intervention and four hours of related teaching on the nutrition concepts of a sample of 9 year-old children. Design Prepost test design. Children's food classification concepts were assessed before and after the intervention and nutrition teaching. Setting Year 4 class of a suburban primary school in South Wales. Method The children completed a food classification task before and after visiting a health promotion exhibition and receiving lessons emphasising food/health related concepts.Results Comparison of the results before and after the intervention suggested that there was no significant change in the participant's conceptual understanding of food.Conclusion Children's food classification concepts remain resistant to change despite enhanced exposure to nutrition information.
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