Identifying the psychosexual implications of radical radiation treatment in prostate cancer

The purpose of this study was to determine whether there was any evidence of psychosexual morbidity among men who experienced radical radiation treatment for prostate cancer. With relatively little known or available retrospective data on the psychosexual implications of radical radiation treatment in men with prostate cancer, this study posited eight research questions which provided the basis for the research. Fifty men from Southern Ontario, between the ages of 52 to 78 years, were included in the study. They had been previously randomized to a clinical trial comparing radical radiation therapy by external beam radiation, or radical radiation using a combination of a temporary iridium implant plus external beam radiation, for localized or locally advanced prostate cancer. Assessment of sexual functioning, drive, attitudes, body image, and sexual satisfaction was drawn from a multidimensional approach, since psychosexuality was viewed as having an impact on biological, psychological, and sociological domains of functioning. Medical chart reviews, semi-structured interviews, demographical profiles of each participant, and the Derogatis Sexual Functioning Inventory (DSFI) were the methods used to collect data over a four-month period. Both quantitative and qualitative research methods were incorporated in the design and evaluation of the study. Frequencies, contingency analysis, Pearson's coefficient of correlation, t-tests, and ANOVA comprised the quantitative analysis. Data obtained from audio-taped interviews were analyzed qualitatively, and used for offering further insight and for facilitating the quantitative aspect of the analysis. Overall, there was sufficient evidence to suggest psychosexual morbidity among men who were treated with radiation therapy for prostate cancer. As well,there were a number of significant findings available to answer all of the posited research questions. The most significant findings were noted in post-treatment erectile ability and sexual activity. A post-treatment change in erectile ability was reported by eighty percent of men. Sixty percent of men noted a decrease in their ability to achieve an erection by reporting some morning stiffness only, penile rigidity insufficient for penetration, decreased control of erection, and loss of spontaneous erection. Other contributing factors associated with change in erectile status were: pain or altering sensation of orgasm, blood in ejaculate, pain and decreased amount of ejaculate, and penile numbness or pain. Eighty-two percent of men experienced a post-treatment change in sexual function, primarily due to the impact of decreasing erectile status. Only seven men reported that they experienced a decrease in desire mentally, whereas the vast majority did not experience any change in desire. Changes in foreplay, stress with optimal sexual positioning, and reduced spontaneity of sex, were other factors reported with the changes in sexual activity. The findings in this study broaden our understanding of what middle- to later-aged men feel and experience as they venture onward following treatment. This was the first study that evaluated available prospective data on pre-treatment erectile status and sexual activity. As well, this study was the first (with participant compliance rates of 100 percent) to have included an interview format to capture the views of such a large number of men. This study concluded with recommendations and implications for future research and practice as we move in the direction of understanding what is necessary for preserving psychosexual well being and enhancing quality of life in men treated with radiation therapy for prostate cancer.

For whom the cruiser rolls: a retrospective analysis of factors relating to recidivism in a sample of graduates from a court-ordered alcohol education and awareness program

This study investigated, retrospectively, whether recidivism in a sample of court-ordered'graduates of an alcohol education and awareness program could be predicted. This alcohol education program was based on adult education principles and was philosophically akin to the thoughts of Drs. Jack Mezirow, Stephen Brookfield, and Patricia Cranton. Data on the sample of 214 Halton IDEA (Impaired Driver Education and Awareness) graduates were entered into a spread sheet. Descriptive statistics were generated. Each of the 214 program graduates had taken several tests during the course of the IDEA program. These tests measured knowledge, attitude about impaired driving, and degree of alcohol involvement. Test scores were analyzed to determine whether those IDEA graduates who recidivated differed in any measurable way from those who had no further criminal convictions after a period of at least three years. Their criminal records were obtained from the Canadian Police Information Centre (CPIC). Those program graduates who reoffended were compared to the vast majority who did not reoffend. Results of the study indicated that there was no way to determine who would recidivate from the data that were collected. Further studies could use a qualitative model. Follow-up interviews could be used to determine what impact, if any, attendance at the IDEA program had on the life of the graduates.

Retrospective on the Experience of Parental Pressure and Support by Male Participants that Withdrew from Competitive Youth Hockey: A Phenomenological Investigation

The purpose of this study was to gain an in-depth understanding of the lived experiences of parental pressure and support for males who withdrew from competitive youth hockey. A phenomenological approach was used to explore this phenomenon and develop meaning from the participants' experiences. Data for this study was collected by conducting one in-depth interview with each of the seven participants. Fourteen themes emerged as a result of the data analysis. These themes were grouped into three clusters: (1) Description of parental involvement: “I want them to be there and help me”; (2) Perceived impacts of parental involvement: “I felt like he actually cared”; and (3) Impact of parental involvement on commitment: “I kind of miss hockey now”. The descriptions provided by the participants in this study, and the themes that emerged, offer insight into what it is like for young males to experience parental involvement in competitive youth hockey.