A Critique of a Qualitative Research Article:
Andropause Syndrome in Men Treated for Metastatic Prostate Cancer
By
Grand Canyon University
NRS-433V

Purpose of the Study Many people understand that women go through Menopause; it is not uncommon to hear a lady friend or a stranger say “there goes another hot flash” and then fan herself with whatever happens to be within reach. What many might be unfamiliar with is Andropause, or the equivalent of male Menopause. Andropause Syndrome in Men Treated for Metastatic Prostate Cancer: A Qualitative Study of the Impact of Symptoms (Grunfeld, Halliday, Martin, Drudge-Coates, 2011) , is a research article that talks about 21 men and their experience while undergoing androgen deprivation therapy (ADT) for treatment of metastatic prostate cancer. It is noted during this research that the participants experienced many different and debilitating symptoms. By exploring the feelings and symptoms of the men, it is the hope of the researchers that a positive impact can be made by professionals if they are more assertive in talking with patient’s about the effects of ADT treatment. When done, this can enable the patient to seek help with the side-effects whether it be medicinal, mechanical, or psychological (Grunfield, Halliday, Martin, Drudge-Coates, 2011).
Literature Review Background. In this research article, 41 references were used with the majority of them being from other journal articles. This study takes place in the United Kingdom and Andropause is found to have risen significantly there, likely due to the advancement of medicine making it possible to detect it where it was thought to be something else in the past.(Rachet et al, 2009). The article goes on to talk about ADT being the current treatment of preference, as well as the other options discussed. It also discusses the symptoms, such as hot flashes lasting 2 to 10 minutes, gynecomastia, and depression (Grunfield, Halliday, Martin, & Drudge-Coates, 2011). Beyond this, however, nothing is said about previous studies; if one wants to know about previous studies the references would need to be gleaned. Areas of Nursing Practice. This research study does not appear to talk about nursing practices. While it talks about professionals helping those with Andropause to express their feelings and find ways to achieve help through different means, there is no direct mention of nursing applications. They talk a great deal about studies done on Andropause and treatment, but nursing practices could have been brought into the study as a way to also help those with Andropause. Nurses are at times the front-line, the eyes that see what medical doctors are often unable. This is an important aspect that was overlooked.
Study Design It seems for the purposes of this study a phenomenological research method was used. The researchers state in the article that other studies have not utilized cognitive and behavioral aspects on men with Andropause and that their qualitative method will be used to “explore subjective experiences and allow an insight into individuals’ interpretations and beliefs” (Grunfeld, Halliday, Martin & Drudge-Coates, 2011). Considering the strength in which these statements were made, it seems safe to believe the researchers are very invested in knowing how the men feel and are not wanting to have explicit control over the research. The researchers are very knowledgeable about Andropause and its effects, but do not seem to allow that to influence their study. They were successful, however, in achieving the goal of their study, which was to “explore the experience and impact of Andropause symptoms, particularly hot flashes among men undergoing ADT for prostate cancer,” (Grunfeld, Halliday, Martin& Drudge-Coates, 2011.
Methods
The researchers initially chose interviews to gather data from the participants of the study. Those were loosely set up after talking with a psychologist, a nurse specialist in a urology clinic, and a urologist himself; in conjunction with these, established research was also consulted (Grunfeld, Halliday, Martin & Drudge-Coates, 2011). In some manner, these can possibly be considered using data, though not necessarily historic. During the interviews, questions were open-ended and researchers were interested in how Andropause interrupted the daily lives of the interviewees (Grunfeld, Halliday, Martin, Drudge-Coates, 2011). As well, they were careful to pay attention to the other symptoms that the participants might mention.
Sampling
Three criteria were utilized when narrowing the sample: metastatic prostate cancer patients receiving ADT treatment for at least 3 months, ability to speak English well, and cognitively and physically well enough to participate (Grunfeld, Halliday, Martin & Drudge-Coates, 2011). Through a London teaching hospital 48 patients were chosen for the study and sent information on the study and an informed consent form. For various reasons, 48 men were narrowed down to 21 to be interviewed for the study. With those 21 men is does not appear as if sampling was done until redundancy of data was reached. This would then be an oversight on the researchers part.
Data Collection Particularly, the researchers made it clear that they were interested in hot flashes/night sweats of the men treated with ADT and having metastatic prostate cancer. They also received information on other symptoms such as gynecomastia, decline in cognitive function, reduced sexual function and relationship issues. The authors of the article were careful to make it understood throughout what they were focusing on, however. Through careful study though, it was not clear if the researchers understood their biases or assumptions. They immediately appear to assume that they will find every man experiencing hot flashes from ADT treatment regardless of any outside variables.
Data Analysis Inductive methods were utilized once data analysis was completed. All raw formats, both written and recorded, were quickly put into a more brief format while connections were made between the data gathered and the study objective (Thomas, 2003). Free codes were then used to group the data into themes and it was very obvious as the researches narrowed down the information with various processes that, at least with this small sample, their hypothesis proved to be true and trustworthy (Grunfeld, Halliday, Martin, & Drudge-Coates, 2011).
Conclusion
In a research study concerned with the effects of androgen deprivation therapy and its effect on men, causing Andropause, which is similar to a male version of menopause, four researchers set out to interview 21 men. These were open-ended questions either in person or over the telephone, thus making this a qualitative study. Though sample population was small, the researchers were able to accomplish what they set out to do. All 21 men had experienced hot flashes from the ADT treatment. This sort of information seems more pertinent to a medical doctor, than a nurse, in that perhaps these men can be worked with to control some of the symptoms experienced, not just the hot flashes. Still, nurses are on the front-line, there with the patients when doctors are unable to be and can sometimes witness these symptoms and report them or encourage the patient to report them. There is also nurse to doctor communication and it can be noted that patients can often feel more comfortable opening up to their nurses about these symptoms than their doctors. So, to some degree, this study does have an effect on nursing knowledge as it gives the nursing professional another opportunity to help a patient who is possibly in need.

References
Grunfeld, E.A. PhD, Halliday A. MBBS, Martin P. MSc, & Drudge-Coates L. MSc. (2011).
Andropause Syndrome in Men Treated for Metastatic Prostate Cancer: A Qualitative
Study of the Impact of Symptoms. Cancer Nursing. 00(0). DOI:
10.1097/NCC.0b013e318211fa92.
Ratchet, B. et al. (2009). Population-based cancer survival trends in England and Wales up to
\ 2007: an assessment of the NHS cancer plan for England. Lancet Oncology. 10. 351-369.
Thomas, D.R. (2003). A General Inductive Approach for Qualitative Data Analysis. Retrieved from: http://www.fmhs.auckland.ac.nz/soph/centres/hrmas/_docs/Inductive2003.pdf.