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Aim The aim of this paper is to report the process evaluation of facilitators’ delivery of a psychosocial intervention (called CONNECT), in a randomised controlled trial, to men with prostate cancer and their partners. Background There is a lack of information on the process of implementing psychosocial interventions in controlled trials and, in particular, on the role and performance of facilitators who deliver them. Yet this information is crucial in assessing whether these interventions are effective or not and why. Methods Semi-structured qualitative interviews and diaries were used to collect data (January - October 2012) from four facilitators and a co-facilitator. Data were analysed using the Miles et al. framework. Results Five themes were discernible. These were ‘difficulties to keep to the structure of the intervention’, ‘selective coverage of topics’, ‘partner participation’, ‘overall impression of the group and telephone sessions’ and ‘perceived benefits to participants’. Issues such as not keeping to the aim of the intervention, deviating from the content and/or reluctance in discussing sensitive issues such as sexual health may mean that the psychosocial effects of the intervention may not have been fully realised. Conclusions These findings will be useful for further development and evaluation of the intervention. A tentative conceptual framework of factors, related to facilitators, influencing the fidelity of interventions in the context of controlled trials, is offered. This model, which requires further development and testing, will be useful for researchers worldwide who are involved in developing interventions and training facilitators. This article is protected by copyright. All rights reserved.

mccaughan e., parahoo k. & prue g. (2011). Comparing cancer experiences among people with colorectal cancer: a qualitative study. Journal of Advanced Nursing67(12), 2686–2695. Abstract Aim. This paper reports on how people with colorectal cancer compare experiences, what comparison meant to them and the context in which it took place. Background. People with cancer need information to make sense of their disease and treatment, and comparing with others in similar situations provides such opportunities. While social comparison studies date back more than half a century, there is a lack of qualitative approaches to explore how people with cancer compare with others and the context in which they do so. Method. In-depth interviews were carried out in the period 2006–2007 with a convenience sample of 24 men and 14 women with a first diagnosis of colorectal cancer. Findings. Most participants could not avoid the almost constant exposure to other people with cancer or hear of their stories, especially when they accessed health services. Comparison was part of their interaction with the ‘community’ of people with cancer, which included giving and receiving information and support. Many valued this ‘experiential’ information, while some tried to avoid contact with others with cancer as they felt that it would depress them. This study also showed that many of the participants had personal experience of caring for close relatives with cancer and this helped them to make sense of their own condition. Conclusion. The challenge for health professionals is to help people with cancer to interpret the information and beliefs they already have from such previous experience or they obtain when comparing with others with cancer.

Aim. This paper is a report of a study exploring and comparing the experience of men and women with colorectal cancer at diagnosis and during surgery.Background. Men have higher incidence and mortality rates for nearly all cancers and frequently use health behaviours that reflect their masculinity. There has been minimal investigation into the influence of gender on the experience of a ‘shared’ cancer.Methods. From November 2006 to November 2008, a qualitative study was conducted involving 38 individuals (24 men, 14 women) with colorectal cancer. Data were generated using semi-structured interviews at four time points over an 18-month period. This paper reports the participants’ experience at diagnosis and during surgery (time point 1) with the purpose of examining the impact of gender on this experience.Findings. In general, men appeared more accepting of their diagnosis. The majority of females seemed more emotional and more affected by the physical side effects. However, there was variation in both gender groups, with some men and women portraying both ‘masculine’ and ‘feminine’ traits. There was also individual variation in relation to context.Conclusions. It appears that many men may have been experiencing side effects and/or psychological distress that they were reluctant to discuss, particularly as some men portrayed typical ‘masculine’ traits in public, but felt able to open up in private. Nurses should not make assumptions based on the traditional view of masculinity, and should determine how each man wants to deal with their diagnosis and not presume that all men need to ‘open up’ about their illness.

Aim This paper reports a study on how men cope with the side-effects of radiotherapy and neo-adjuvant androgen deprivation for prostate cancer up to 1 year after treatment. Background With early detection and improved treatments, prostate cancer survivors are living longer with the disease and the side-effects of treatment. How they cope affects their long-term physical and mental health. Design A prospective, longitudinal, exploratory design using both qualitative and quantitative methods was used in this study. Method Between September 2006–September 2007 149 men who were about to undergo radical radiotherapy ± androgen deprivation for localized prostate cancer in Northern Ireland were recruited to the study. They completed the Brief Cope scale at four time-points. Results Acceptance, positive reframing, emotional support, planning and, just getting on with it, were the most common ways of coping. Fewer men used coping strategies less at 6 months and 1 year after radiotherapy in comparison to pre-treatment and 4–6 weeks after radiotherapy. Interviews with these men demonstrated that men adapted to a new norm, with the support of their wives/partners and did not readily seek professional help. A minority of men used alcohol, behavioural disengagement and self blame as ways of coping. Conclusion Men used a variety of ways of coping to help them deal with radiotherapy and neo-adjuvant androgen deprivation for up to 12 months after radiotherapy. Interventions need to be developed to take account of the specific needs of partners of men with prostate cancer and single men who have prostate cancer.

This paper reports on how people with colorectal cancer compare experiences, what comparison meant to them and the context in which it took place.People with cancer need information to make sense of their disease and treatment, and comparing with others in similar situations provides such opportunities. While social comparison studies date back more than half a century, there is a lack of qualitative approaches to explore how people with cancer compare with others and the context in which they do so.In-depth interviews were carried out in the period 2006-2007 with a convenience sample of 24 men and 14 women with a first diagnosis of colorectal cancer.Most participants could not avoid the almost constant exposure to other people with cancer or hear of their stories, especially when they accessed health services. Comparison was part of their interaction with the 'community' of people with cancer, which included giving and receiving information and support. Many valued this 'experiential' information, while some tried to avoid contact with others with cancer as they felt that it would depress them. This study also showed that many of the participants had personal experience of caring for close relatives with cancer and this helped them to make sense of their own condition.The challenge for health professionals is to help people with cancer to interpret the information and beliefs they already have from such previous experience or they obtain when comparing with others with cancer.

This paper is a report of a study exploring and comparing the experience of men and women with colorectal cancer at diagnosis and during surgery.Men have higher incidence and mortality rates for nearly all cancers and frequently use health behaviours that reflect their masculinity. There has been minimal investigation into the influence of gender on the experience of a 'shared' cancer.From November 2006 to November 2008, a qualitative study was conducted involving 38 individuals (24 men, 14 women) with colorectal cancer. Data were generated using semi-structured interviews at four time points over an 18-month period. This paper reports the participants' experience at diagnosis and during surgery (time point 1) with the purpose of examining the impact of gender on this experience.In general, men appeared more accepting of their diagnosis. The majority of females seemed more emotional and more affected by the physical side effects. However, there was variation in both gender groups, with some men and women portraying both 'masculine' and 'feminine' traits. There was also individual variation in relation to context.It appears that many men may have been experiencing side effects and/or psychological distress that they were reluctant to discuss, particularly as some men portrayed typical 'masculine' traits in public, but felt able to open up in private. Nurses should not make assumptions based on the traditional view of masculinity, and should determine how each man wants to deal with their diagnosis and not presume that all men need to 'open up' about their illness.