Men’s strategies for preserving emotional well-being in advanced prostate cancer: an interpretative phenomenological analysis

Objective This study explores men with advanced prostate cancers’ own practices for promoting and maintaining emotional well-being using Interpretative Phenomenological Analysis. Design Five men with advanced prostate cancer participated in face-to-face, semi-structured, in-depth interviews. Results Within rich narratives of lost and regained well-being, two super-ordinate themes emerged – ‘living with an imminent and uncertain death’ and ‘holding on to life.’ Well-being was threatened by reduced sense of the future, isolation and uncertainty. Yet, the men pursued well-being by managing their emotions, striving for the future whilst enjoying life in the present, taking care of their families and renegotiating purpose. Running through participant’s accounts was a preference for taking action and problem-solving. Sense of purpose, social connectedness and life-engagement were revealed as concepts central to improving well-being, indicating areas which practitioners could explore with men to help them re-establish personal goals and life-purpose. Conclusions The findings also add weight to the evidence base for the potential value of psychological interventions such as cognitive behaviour therapy and mindfulness in men with prostate cancer

Recommending yoga for health: A survey of perceptions among healthcare practitioners in the UK.

Yoga has the potential to support patients across various health conditions. It is slowly being integrated into healthcare worldwide. While healthcare practitioners (HCPs) are critical to integration, there are currently no studies investigating their perceptions of yoga for health, their openness to recommending yoga to patients, and barriers to doing so. This novel UK study aims to address this. An online survey was conducted among practising UK HCPs. Recruitment was through multi-modal convenience sampling. The COM-B model was used as a framework. Regression analysis examined predictors of HCPs' likelihood to recommend yoga. Open-end responses were analysed through thematic analysis. 198 HCPs were included in the analysis, including general practitioners (GPs, 18.8%), psychologists (18.3%), and nurses/health visitors (14.7%). A high proportion (68.8%) practised yoga at least monthly. The likelihood of recommending yoga to patients was high (M = 4.03, SD = 0.94; 5-point scale). Older age, not being a GP, and greater capability and motivation significantly predicted a greater likelihood of recommending yoga, explaining 41.4% of the variance (p < 0.001). Barriers to recommending yoga were mostly related to the lack of opportunity. HCPs in this study had high levels of personal engagement with yoga and were open to recommending yoga to patients, but still faced several barriers. Workplace support, particularly for GPs, and information about how patients can access appropriate and affordable yoga instruction would facilitate referral. Further research with a representative sample is warranted to understand perceptions of HCPs less engaged with yoga. [Abstract copyright: Copyright © 2023 The Authors. Published by Elsevier Ltd.. All rights reserved.

Representations of illness: patient satisfaction, adherence and coping

Chapter I evaluates the self-regulatory model and other theoretical frameworks which have informed the six empirical studies described in this thesis. Chapter 2 reviews the literature on patients' satisfaction with care, adherence to treatment recommendations and coping with chronic illness. It highlights omissions in the literature which are addressed by the current research. Chapter 3 provides a systematic description of people's representations of 37 different illnesses and examines the basis on which these illnesses are categorized. It was found that beliefs about symptoms, typical sufferer, and treatment were particularly important in discriminating between different illnesses. Using data from interviews with patients visiting their GP (pre- and post-consultation), chapter 4 explores the relationship between patients' representations of their illness, and satisfaction and intentions to follow treatment recommendations. It was found that doctor-patient discrepancies about diagnosis and treatment were the sole predictors of satisfaction, but were not related to intentions. In a follow-up study, chapter 5 investigates the predictors of satisfaction and adherence two weeks after the consultation. Several factors were found to predict satisfaction at time 2, but doctorpatient discrepancies were no longer related to ratings of satisfaction. Belief in the benefits of treatment was the principal predictor of adherence. The primary aim of the two studies described in chapter 6 was to produce a shorter version of the 60-item COPE suitable for assessing coping in patients. The 32-item measure demonstrated construct validity with the longer version and acceptable internal reliability. Chapter 7 explores the relationship between the different stages of the self-regulatory model in diabetic and hypertensive patients. It was found that beliefs about the costs and benefits of treatment were the principal predictors of dietary and exercise adherence. As predicted, strong relationships were found between patients' illness representations, coping strategies and appraisal of functioning. The final chapter surnmarises the findings of the research and concludes that the self-regulatory model is a useful too] for understanding people's responses to illness and adaptation to chronic illness. SuggestionsN verem ade regarding ways in which the self-regulatory model might be extended to incorporate other conceptually compatible models. Theoretical, methodological and practical implications are discussed

New Ways of Being a Man: "Positive" Hegemonic Masculinity in Meditation-based Communities of Practice

Connell’s concept of hegemonic masculinity is often reduced to a singular construct, consisting of “toxic” traits viewed as detrimental to well-being. However, the concept allows for variation in hegemony, including the possibility of forms more conducive to well-being. Through in-depth interviews with thirty male meditators in the United Kingdom, we explored the social dimensions of meditation practice to examine its potential implications for well-being. Most participants became involved with “communities of practice” centered on meditation that promoted new local hegemonies, and these included ideals experienced as conducive to well-being, like abstinence. However, social processes associated with hegemony, like hierarchy and marginalization, were not overturned. Moreover, participants faced challenges enacting new practices in relation to the broader system of hegemonic masculinity—outside these communities—reporting censure. Our findings are cautionary for professionals seeking to encourage well-being behaviors: that is, there is potential for adaptation in men, yet complex social processes influence this change

Making sense of illness: the experiences of users of complementary medicine

The present study investigated the experiences of users of complementary and alternative medicine (CAM) using a qualitative approach. In-depth interviews were conducted with 11 frequent users and analysed using interpretative phenomenological analysis (IPA). Results indicated that the patient-practitioner relationship and explanatory frameworks provided by CAM were perceived as important components of the therapeutic process, irrespective of treatment efficacy. CAM served a variety of functions beyond the explicit relief of symptoms by increasing energy and relaxation, facilitating coping and enhancing self/other awareness. It is therefore important that these wider effects are taken into account when evaluating complementary medicine in order to accurately reflect patients' experiences

Cultivating equanimity through mindfulness meditation: A mixed methods enquiry into the development of decentring capabilities in men

Mindfulness meditation is thought to help practitioners become more tolerant of dysphoric emotions by enabling them to cultivate decentring skills. Such skills may be especially useful for male meditators, as men are thought to have particular difficulties regulating their emotions, partly due to masculinity norms related to emotional toughness. However, few studies of mindfulness have focussed specifically on men to explore the intersection between wellbeing and masculinity. Uniquely, we sought to examine the development of decentring capabilities in a non-clinical sample of male meditators using a longitudinal mixed-methods design. Thirty meditators were recruited in London, UK. Participants completed an emotional Stroop task – at two points, a year apart – to assess changes in emotional reactivity linked to meditation. Participants also undertook qualitative interviews at both time points, analysed using a modified constant comparison approach. Together, the two datasets converged to suggest that men did develop decentring skills through meditation, leading to greater equanimity in the presence of negative qualia. In addition to offering insights into the mechanisms underpinning the impact of mindfulness on wellbeing, the study provides a gendered dimension to the analysis of wellbeing strategies like meditation, a dimension which has hitherto been conspicuously absent from recent literature in fields such as positive psychology