" It might not have occurred to my husband that this woman, his wife who is taking care of him has some emotional needs as well ": the unheard voices of partners of Black African and Black Caribbean men with prostate cancer.

PURPOSE: Evidence suggests that partners of men with prostate cancer (CaP) experience greater psychosocial distress compared with men themselves. However, the experiences of partners of high-risk (1 in 4) Black African (BA) and Black Caribbean (BC) men with CaP remain poorly understood as existing research has predominantly focused on Caucasian populations. This study aimed to address this gap by exploring partners' experience and support needs as influenced both by the specific impacts of CaP, treatment side effects and socio-cultural context. METHODS: Using a constructivist grounded theory approach, eight face-to-face, two Skype and one telephone interviews were conducted with eligible partners (n = 11). The interviews were analysed using constant comparison following key stages of open, focused and theoretical coding. RESULTS: Three broad categories emerged which described participants' experiences: 'partner in the passenger seat', 'care-giving on an isolating journey', and 'coping as a partner'. Findings showed that BA and BC cultural marital context influenced how partners experienced and traversed the CaP journey. Peripheral involvement in decision-making, communication restrictions, limited access to support and lack of recognition for their experiences and needs further contributed to partners' psychological and emotional distress. CONCLUSIONS: Cultural beliefs, behaviours and values should be taken into account when developing psychosocial support for partners and their men with CaP. Specifically providing information focused on partners and including them in the CaP care pathway could help ensure that partners' needs are recognised and improve marital communications. This could potentially help partners and their men to identify acceptable ways of supporting each other throughout the CaP experience.

Fathers' experiences of living with cancer: a phenomenological study.

There is a paucity of knowledge about fathers' experiences of cancer. This study explored the experiences of fathers diagnosed and living with cancer while also having parental responsibility for children. A hermeneutic phenomenological approach guided the study. Data were generated through 22 in-depth interviews with 10 fathers throughout Northern Ireland. The findings evidenced that fathers' identities are challenged and frequently re-shaped by the cancer experience, in many cases leading to an improved lifestyle behaviour. Heightened engagement with their children can provide a protective effect from the illness. On the other hand a lack of involvement led to frustration and low mood. The findings also demonstrated that father/child relationships were adversely affected by the social complexities that exist in the variances and diversity of fathers parenting roles and status. This knowledge contributes to our understanding of the complex relationships of fathers in non-traditional roles. It extends our understanding of how, when stereotyped gendered roles are ascribed to fathers it can impact on a fathers' ability to fulfil the traditional breadwinner's role. This is knowledge that will inform health care professionals and enable them to provide gendered-sensitive care that takes account of the masculine psychological responses that can shape the cancer experience.

Development and evaluation of a holistic surgical head and neck cancer post-treatment follow-up clinic using touchscreen technology-Feasibility study.

The efficacy of traditional follow-up care is being challenged, as cancer survivors' supportive and psychological needs are often neither identified, nor addressed. This study's aim was to develop a holistic surgical follow-up clinic for oral and oropharyngeal cancer patients were participants completed a disease-specific health-related quality of life tool (UWQOLv4) and item prompt list (Patient Concern Inventory) on a touchscreen computer. Information generated was used to focus the consultation on patient's identified needs and concerns. By means of a prospective non-randomised, pre-test post-test design, this follow-up clinic was evaluated using the patient enablement instrument (PEI) and patient content checklist (PCC). Feasibility was explored from the patient perspective (satisfaction survey) and clinician perspective (qualitative interview). Forty-four consecutive patients were recruited. Findings demonstrating five of the eight topics (overall QOL, emotions, head and neck symptoms, side-effects of treatment, chronic non-specific) on PCC were discussed more frequently, but changes were not statistically significant. The PEI highlighted a trend towards perceived improvement in four of the six items. Using touchscreen computers to aid communication during routine follow-up was reported as both feasible and beneficial by patients and clinicians. Providing a patient-focused follow-up consultation can facilitate the identification of unmet needs, permitting timely and appropriate intervention being initiated.

Life after prostate cancer: A systematic literature review and thematic synthesis of the post-treatment experiences of Black African and Black Caribbean men.

Evidence shows that there are significant ethnic variations in prostate cancer prevalence and outcomes. Specifically, Black African and Black Caribbean men may encounter different post-treatment experiences than Caucasian men due to their disproportionately higher risk of being diagnosed with advanced prostate cancer. But to date, no review of these experiences has been undertaken. This review synthesised findings from existing literature on the post-treatment experiences of Black African and Black Caribbean men with prostate cancer and identified pertinent issues which may be useful to inform practice and future research. Seven databases were systematically searched using developed search terms. Four qualitative studies were identified and critically appraised. Findings are summarised under four main themes: symptom experience, healthcare experience, marital and social relationships and coping strategies. Cultural definitions of masculinity influenced the meanings men gave to their post-treatment experiences. While men's experiences of healthcare varied, the provision of professional support to address their post-treatment distress was lacking. Men derived most support from wives, peers and church communities. A culturally sensitive approach which recognises diversity among Black African and Black Caribbean populations and treats individuals within their religious and socio-cultural contexts could potentially improve men's post-treatment experiences. Areas for further research were also identified.

The establishment of a 3D breast photography service in medical illustration.

This paper aims to describe the development of a 3D breast photography service managed by the Medical Illustration Department, in the Belfast Health and Social Care Trust, Northern Ireland. Dedicated 3D breast photography equipment was installed in Medical Illustration for 18 months. Women were referred for a variety of indications including pre- and post-surgical assessment. A dedicated 3D breast photography protocol was developed locally and this requires further refinement to allow reproducibility in other centres. There are image/data artefacts associated with this technology and special techniques are required to reduce these. Specialist software is necessary for clinicians and scientists to use 3D breast photography data in surgical planning and measurement of surgical outcome.

Family life when a parent is diagnosed with cancer: impact of a psychosocial intervention for young children.

When a parent is diagnosed with cancer it can have a profound impact on the family, especially the children. This paper reports on the experience of parental cancer for parents' and their children and the impact of a psychosocial intervention for young children whose parent has cancer. Using a qualitative design, data were generated from separate focus groups with children (n = 7) and parents (n = 6). One-to-one interviews were conducted with professionals delivering the intervention (n = 2). Findings indicated that parents are often the gatekeeper to how, when and the context in which children learn about parental cancer. Many parents expressed a lack of confidence and skills as they considered communicating with their children about cancer. Parents stated the need for professional input mainly due to changes in their children's behaviour. Children had a number of fantasies and misconceptions surrounding cancer. This psychological intervention normalized their experience of parental cancer. It also improved children's understanding of cancer and equipped them with coping strategies. Professionals perceived the intervention led to improved family communication and promoted discussion of emotions. Open communication is pivotal for children whose parents have cancer but parents need supported and resourced to promote family coping when diagnosed with cancer.

Fatherhood and cancer: a commentary on the literature.

When a parent is diagnosed with cancer it may create a multitude of concerns and worries, which can be enormously challenging. Despite the increase in research pertaining to parental cancer, there is a paucity of knowledge addressing the impact of cancer on fathers. Fathers' roles are evolving, becoming increasingly diverse and multidimensional. This paper aims to uncover some issues that may be relevant for fathers with cancer. A cancer diagnosis may not solely impact on a man's identity but also on the lives of his children given the contemporary shift from patriarch to more diverse roles. Men and women may share commonalities when diagnosed with cancer but they also experience differences emphasising the need for gender-sensitive care. This paper highlights the significant role and function that fathers have in their children's lives. It is important that healthcare professionals are aware and pay attention to how gendered responses shape fathers' masculinity and consequently the cancer experience and parenting role. Furthermore this paper highlights the need to gather additional evidence on fathers' experiences when diagnosed and living with cancer. This knowledge can then be used to inform healthcare policy to target fathers, which will benefit both fathers and their children.

Attitudes to cancer of medical and surgical nurses in a district general hospital.

The personal beliefs and attitudes of nurses can have serious implications for their practice. Yet there are a lack of studies on nurses' attitudes to cancer in the UK in general, and in Northern Ireland specifically. The need for such studies is further emphasized by the importance of nurses' role in the Cancer Units of district general hospitals, as proposed by the Calman-Hine Report (Department of Health 1995). The aim of this study was to assess the attitudes to cancer of medical and surgical nurses who care for cancer patients in one district general hospital in Northern Ireland. A questionnaire comprising the Cancer Attitude Scale (Corner 1993) was administered to 106 qualified nurses. The response rate was 68.9% (n=73). Responses to items on the Cancer Attitude Scale show that while generally these nurses held positive attitudes, a high proportion also held negative views about cancer. Of particular concern were their attitudes to the value of active treatments. The implications of these findings are discussed.

Validation of a passive stereophotogrammetry system for imaging of the breast: a geometric analysis.

The overall aim of this study was to assess the accuracy, reproducibility and stability of a high resolution passive stereophotogrammetry system to image a female mannequin torso, to validate measurements made on the textured virtual surface compared with those obtained using manual techniques and to develop an approach to make objective measurements of the female breast. 3D surface imaging was carried out on a textured female torso and measurements made in accordance with the system of mammometrics. Linear errors in measurements were less than 0.5mm, system calibration produced errors of less than 1.0mm over 94% over the surface and intra-rater reliability measured by ICC=0.999. The mean difference between manual and digital curved surface distances was 1.36 mm with maximum and minimum differences of 3.15 mm and 0.02 mm, respectively. The stereophotogrammetry system has been demonstrated to perform accurately and reliably with specific reference to breast assessment.

Medical and surgical nurses' perceptions of their level of competence and educational needs in caring for patients with cancer.

Recent proposals recommend that cancer patients are cared for, as much as possible, in specialist cancer units and centres. However, a large number of these patients will still be admitted to medical and surgical wards of general hospitals at one time or other. Yet little is known about the knowledge and skills of nurses dealing with this group of patients. A survey design was used to assess the self-reported level of competence, in a number of activities relating to their work with cancer patients, among medical and surgical nurses (n = 106) in a district general hospital in Northern Ireland. It also aimed to identify their self-reported educational needs in caring for this group of patients. Results showed that these nurses cared for people with a range of cancers. While they reported an above-moderate level of competence, they also rated their level of competence higher in physical than in psychosocial care. Among their self-perceived educational needs were more knowledge, and skills in psychosocial care, communication, dealing with side-effects of treatment and pain management.

Research utilization and attitudes towards research among learning disability nurses in Northern Ireland.

Research utilization and attitudes towards research among learning disability nurses in Northern Ireland The current emphasis on evidence-based practice has focused attention once again on the research activities of health professionals in general and their research utilization in particular. While there has been a limited number of studies on research utilization in the United Kingdom, these have tended to concentrate on general nurses and midwives. Little is known about the research activities, research utilization and the attitudes to research of learning disability nurses. This paper reports on data from a survey of a convenience sample of 87 nurses from three learning disability hospitals in Northern Ireland. The results show that while these nurses generally held positive attitudes to research, a substantial minority (18.3%) believed that 'research is not relevant to the day to day work in nursing'. Only a quarter of the sample reported using research 'frequently/all the time' in their practice. The extent of research utilization among these disability nurses must be considerably improved if evidence-based practice is to become a reality in their field of nursing.

Research utilization among medical and surgical nurses: a comparison of their self reports and perceptions of barriers and facilitators.

BACKGROUND: Although the number of studies on research utilization is steadily growing, there are only a few specialty-specific studies. AIMS: This study focuses on medical and surgical nurses. It compares their reported use of research utilization and their perceptions of barriers and obstacles. METHODS: A convenient sample of 210 medical nurses and 269 surgical nurses, from 10 general hospitals in 14 Trusts in Northern Ireland (NI), was surveyed. RESULTS: The results showed that the reported extent of research utilization was high, with less than 10% in each group reporting never/seldom using research. The reported difference between the medical and surgical nurses was very small, with medical nurses reporting a slightly higher rate of utilization. However, this was not statistically significant at 5% level. CONCLUSIONS: The Barriers Scale (Funk et al. 1991a) used in this study to assess their perceptions of barriers and facilitators revealed a similar picture for both groups. The top two barriers were "Management will not allow implementation" and "The nurse does not feel she/he has enough authority to change patient care procedures". These findings, as well as the need to take research utilization studies further, are discussed.

Women's perceptions of their experiences with breast cancer: are their needs being addressed?

Breast cancer is the major cause of female deaths in Western Europe. In the United Kingdom, one woman in 14 is liable to develop this disease. An increasing emphasis on recognizing survival from cancer and remission periods of up to 20 years for breast cancer has important implications for health-care professionals. Care and support should effectively meet patients' needs to enable them to cope with the impact of a breast cancer diagnosis. This paper provides an overview of selected literature on women's experiences of breast cancer. It places particular emphasis on their perceptions of the information they received about the disease and its treatment, and their perceptions of the support available to them. The overview illustrates the problem of inadequacies in the information and support currently available to women with breast cancer. The necessity for a more comprehensive and sensitive assessment of these women's needs is emphasized and suggestions are made for the direction of future research in this area.