Masculinities, humour and care for penile cancer: a qualitative study.

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 'pilot workshop' in March 2011. The data were initially analysed using framework analysis. This paper explores the theme of humour in depth. FINDINGS: Humour helped participants make light of their condition, which meant that they could laugh about the consequences of treatment ('laughing about urination') and build rapport with health professionals ('humour with health professionals'). Nevertheless, the use of humour was less important than the treatment of their cancer ('humour discounted') and there was a fear that they would be subject to ridicule because of their condition ('fear of ridicule'). CONCLUSION: The findings suggest a combination of functionalist, relief and incongruity theories of humour; the emotions these men experience are contained (functionalist) and released (relief) through humorous interaction, and the potential for comedy lies in an incongruity between what is expected socially and the experiences of these men, for example, around expectations that men use urinals in public toilets. Nurses should continue to use humour to build rapport with patients, should they judge this to be appropriate, although they may want to avoid jokes about sexual and urinary functioning until after treatment.

Engaging men with penile cancer in qualitative research: reflections from an interview-based study.

AIM: To explore the challenges of engaging men with penile cancer in qualitative interview research. BACKGROUND: Qualitative interviewing offers an ideal tool for exploring men's experiences of illness, complementing and providing context to gendered health inequalities identified in epidemiological research on men. But conducting interviews with men can be challenging and embarking on a qualitative interview study with males can feel like a daunting task, given the limited amount of practical, gender-sensitive guidance for researchers. Reflecting on a researcher's experience of conducting qualitative research on men with penile cancer, this paper explores the potential challenges of interviewing this group, but also documents how engagement and data collection were achieved. REVIEW METHODS: This is a reflective paper, informed by the experiences of a male researcher (KW) with no nurse training, who conducted 28 interviews with men who had been treated for penile cancer. The researcher's experiences are reported in chronological order, from the methodological challenges of recruitment to those of conducting the interview. IMPLICATIONS FOR PRACTICE/RESEARCH: The paper offers a resource for the novice researcher, highlighting some advantages and disadvantages of conducting qualitative interview research as a nurse researcher, as well as recommendations on how to overcome challenges. CONCLUSION: Engaging men with penile cancer in qualitative interview raises practical, methodological, ethical and emotional challenges for the researcher. However, when these challenges are met, men will talk about their health. Methodological procedures must enable an open and ongoing dialogue with clinical gatekeepers and potential participants to promote engagement. Support from colleagues is essential for any interviewer, no matter how experienced the researcher is.

The impact of surgical treatment for penile cancer -- patients' perspectives.

PURPOSE OF THE RESEARCH: 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. METHODS AND SAMPLE: The study used a narrative history design in which data were collected using one-on-one semi-structured interviews. Maximum variation sampling was used to acquire the widest possible range of experiences. Twenty-seven interviews of around one hour were conducted with men with an average age of 63 years at diagnosis (range = 41-82). The data were analysed using constant comparison analysis. KEY 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. CONCLUSION: 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 lives, 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.