Men’s experiences of prostate cancer care: qualitative findings from cognitive interviews

Introduction:
Prostate cancer is the most common cancer in men in developed countries. Incidence in Ireland is the highest in Europe. Patients’ experiences of care are an important indicator of quality of care, but remain poorly understood.
Objectives:
The PiCTure 2 study aims to assess the care experiences of men recently diagnosed with prostate cancer in Ireland.
Methods:
A questionnaire was developed from the Prostate Care Questionnaire (PCQ; Baker et al., 2007). To modify as appropriate for Ireland, it was pre-tested using cognitive interviewing. Seventeen interviews were conducted with prostate cancer patients (managed by all major treatment modalities) recruited by Urologists and/or Clinical Nurse Specialists at three hospitals during September 2012-January 2013. Men were invited to 'think-aloud' whilst completing the survey; the interviewer used prompts to understand how respondents interpreted survey questions. Interviews lasted 20-90 minutes. Interview recordings were transcribed and analysed thematically.
Results:
Emergent themes included: breaking the bad news; support (both informational and emotional) from doctors, nurses and spouses/partners; growth in knowledge throughout the diagnosis-treatment trajectory but a reliance on ‘experts’ at the outset and how this impacted on their ability to participate in care and decision-making; and altruism. Key revisions were made to the survey so that it will accurately capture experiences of patients in Ireland.
Conclusions:
As well as informing survey development, cognitive interviews provided rich qualitative data which will add to the interpretation of the survey findings. The PiCTure 2 results will be of value to policy-makers, service providers, health professionals and patient support organisations.