COUPLES' SEXUAL RECOVERY AFTER SURGERY FOR PROSTATE CANCER: THE DEVELOPMENT OF A CONCEPTUAL MODEL.ByDaniela Wittmann The goal of this multiple-manuscript dissertation is to addresses a gap in the literature on couples' sexual recovery after surgery for prostate cancer in order to arrive at a testable conceptual model of couples' sexual recovery. The three manuscripts are independent in their research questions and methodologies, but are related in their exploratory nature and in their effort to examine different aspects of couples' sexual recovery. In Chapter I, the theoretical framework of the research is described and a preliminary model of couples' sexual recovery is proposed. It is a biopsychosocial model of sexuality, with grief as a process through which couples work on recovery. In Chapter II, a qualitative study describes couples' anticipation of the sexual recovery and their actual experience after surgery. The study findings support the theoretical framework in which couples experience the affect of the side-effects of prostate cancer surgery on the biopsychosocial aspects of sexuality and cope more or less successfully with the sexual losses through grief and mourning, which starts at diagnosis. Female partners' interest in sex, regardless of menopausal status of their sexual function, makes a contribution to the recovery. Chapter III presents the second study, also qualitative, and describes patients' and partners' view of the role of the partner in the sexual recovery. Men and partners have many common perceptions of the role, including the importance of the partner's interest in sex regardless of menopause. However, the men generally are not aware of partners' sexual needs and needs of support; partners are not certain about help-seeking. The third study, described in Chapter IV, is a quantitative study that uses validated measures to trace the change in patients' and partners' sexual function, sexual satisfaction, and dyadic satisfaction from before surgery to 18 months after surgery, on average. In spite of the patients' improving sexual function, sexual satisfaction of patients as well as partners decreased. Female partners' dyadic satisfaction appears to depend on the partner's sexual satisfaction and the couple's level of income. The author integrates the three studies' findings into extant research literature and, based on the findings of the dissertation research, proposes a conceptual model of couples' sexual recovery after surgery for prostate cancer that can be tested in confirmatory, hypothesis driven research.
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