Sexual values as the key to maintaining satisfying sex after prostate cancer treatment: the physical pleasure-relational intimacy model of sexual motivation.

Sexual dysfunction is the most significant long lasting effect of prostate cancer (PrCa) treatment. Despite the many medical treatments for erectile dysfunction, many couples report that they are dissatisfied with their sexual relationship and eventually cease sexual relations altogether. We sought to understand what distinguishes successful couples from those who are not successful in adjusting to changes in sexual function subsequent to PrCa treatment. Ten couples who maintained satisfying sexual intimacy after PrCa treatment and seven couples that did not were interviewed conjointly and individually. Interviews were transcribed and analyzed using grounded theory methodology. The theory that resulted suggests that individuals are motivated to engage in sex primarily because of physical pleasure and relational intimacy. The couples who valued sex primarily for relational intimacy were more likely to successfully adjust to changes in sexual function than those who primarily valued sex for physical pleasure. The attributes of acceptance, flexibility, and persistence helped sustain couples through the process of adjustment. Based on these findings, a new theory, the Physical Pleasure-Relational Intimacy Model of Sexual Motivation (PRISM) is presented. The results elucidate the main motives for engaging in sexual activity-physical pleasure and/or relational intimacy-as a determining factor in the successful maintenance of satisfying sexual intimacy after PrCa treatment. The PRISM model predicts that couples who place a greater value on sex for relational intimacy will better adjust to the sexual challenges after PrCa treatment than couples who place a lower value on sex for relational intimacy. Implications of the model for counselling are discussed. This model remains to be tested in future research.

Sexual intimacy in heterosexual couples after prostate cancer treatment: What we know and what we still need to learn.

Receiving a diagnosis of and treatment for prostate cancer often results in significant physical side-effects and associated psychosocial stressors that can interfere with the experience of sexual intimacy for couples. Despite the fact that prostate cancer affects mainly older men, the maintenance of sexual intimacy is an important issue to consider, as the majority of older adults continue to value, engage in, and enjoy sexual activity throughout their lives. While the current research identifies the challenges that many men face, little is known about the strategies that couples use to successfully maintain sexual intimacy after prostate cancer treatment. In this review article, the existing literature on sexual intimacy after prostate cancer is reviewed, a critical analysis of current limitations in our knowledge and understanding is provided, and directions for further research are suggested.

Ethical issues in the study of bereavement: the opinions of bereaved adults.

Few studies examine ethical issues in bereavement research and none survey the opinions of bereaved individuals who have not previously participated in bereavement research. This study examined the theoretical opinions of bereaved adults about ethical issues such as attitudes toward bereavement research, timing and methods of recruitment, and competency to consent. Participants felt positively about bereavement research, although opinions about timing and method of recruitment were varied. The results also suggest that bereaved individuals should be considered competent to consent to bereavement research participation. Conclusions may guide bereavement researchers and research ethics boards in the design and review of bereavement studies.