Resilience and quality of life of francophone patients living with prostate cancer: an analysis of the situation in Northern Ontario, Canada

Prostate cancer is the most prevalent cancer among Canadian men with current statistics estimating that one in eight men will develop this disease during his lifetime and for one in 28, it will be fatal (Canadian Cancer Society, 2014). Using social constructivism as its theoretical underpinning, the purpose of the present study was to develop a theoretical framework illustrating how Francophone men from Northeastern Ontario constructed their prostate cancer experiences. More specifically, this study sought to highlight the impact of this disease and the uncertainty it generates on Francophone patients’ resilience and overall quality of life by uncovering the strategies they utilized to construct and reconstruct their lives upon receipt of their initial diagnosis, to their selected treatment and subsequently, to their current post-treatment realities. The central question that guided this inquiry was: What are the strategies that Northeastern Ontario Francophone men utilize when faced with a diagnosis and subsequent treatment(s) for prostate cancer? This study was guided by a qualitative social constructivist grounded theory design. To collect data, 22 face-to-face, in-depth interviews were conducted with men from eight different communities throughout Northeastern Ontario. All interviews were digitally audio-recorded using two separate digital audio recorders and were transcribed verbatim in the language of the interview. Data were analyzed using the key principles of grounded theory, mainly, constant comparison, data saturation, as well as initial, focused, and theoretical coding. Results from this study highlighted the influence of language and culture on the illness experiences of Francophone prostate cancer patients from Northeastern Ontario. In addition, linguistic preferences and geographic locations were shown to be key considerations that weighed heavily within participants’ treatment decision-making processes. The role of the wife and the role of the primary family physician were also identified as important supports within the context of men’s overall assessment of their cancer experience and the impact of the disease on men’s post-treatment quality of life. Using a variety of formal and informal strategies, participants were able to mitigate some of the negative consequences of the disease and demonstrate resiliency in the face of a challenging and uncertain disease. iii Overview of Thesis Chapters This thesis follows a monograph style. The introduction presents the research proposal, the theoretical approach, the conceptual framework, the research question and the hypotheses that guided this study. Chapter 1 presents a critical review of the research literature regarding the development of prostate cancer; the physical, sexual and psychological impact of prostate cancer and the impact of this disease on a person’s quality of life. It also provides a summary of the current literature on resilience as well as an overview of the geographical and cultural contexts affecting Francophone prostate cancer patients from Northeastern Ontario. Chapter 2 outlines the theoretical framework and conceptual model guiding this study. Chapter 3 explains the research methodology used. Chapter 4 and Chapter 5 report on the findings of the study while Chapter 6 discusses their theoretical implications. The final chapter of this thesis draws conclusions and discusses the relevance of this study, its limitations, and provides recommendations for future research.