Open Journal of Nursing, 2011, 1, 15-25
doi:10.4236/ojn.2011.12003 Published Online September 2011 (http://www.SciRP.org/journal/ojn/ OJN ).
Published Online September 2011 in SciRes. http://www.scirp.org/journal/OJN
Men with prostate cancer and the accessibility to information
—a literature review
Charlotte Dorisdatter Bjørnes1,2,3, Christian Nøhr2, Charlotte Delmar1, Birgitte Schantz Laursen1
1Department of Development and Planning, Aalborg University, Aalborg, DK;
2Clinical Nursing Research Unit, Aalborg Hospital, Aarhus University Hospital, DK;
3Department of Urology, Aalborg Hospital, Aarhus University Hospital, DK.
Received 4 July 2011; revised 19 August 2011; accepted 4 September 2011.
ABSTRACT
Objective: To explore possible consequences of short
stays in hospitals, as these short contacts reduce the
patients’ time for information and support. Method:
A literature survey was carried out to get an insight
in possible consequences by summarizing the state of
knowledge on how men with prostate cancer under-
going prostatectomy surgery experience their con-
tacts with the healthcare professionals. Results: A
consequence is that often men with prostate cancer,
treated with prostatectomy surgery, do not receive
the individualized support, information, and dialogue
they need, which leads to feelings of uncertainty, in-
security, and loss of control. The men use the Internet
in their search for information and support, which
makes them able to stay in control and be active, re-
sponsible partners in their own course of treatment.
Conclusion: For men to feel secure and certain the
accessibility of the healthcare professionals and the
healthcare professionals’ ability to individualize in-
formation and support are important aspects. Prac-
tice Implications: It is relevant to provide male can-
cer patients with tools that can underpin their con-
tact to the healthcare professionals. Utilizing Web 2.0
technologies, Internet based tools can support ex-
change-ability, towards dialogue-based contacts, be-
tween men with prostate cancer and healthcare pro-
fessionals.
Keywords: Health Communication; Access to Informa-
tion; Short Stay Patients; Prostate cancer; Prostatectomy;
Uncertainty; Active Patients; Health informatics; Online
Social Support
1. INTRODUCTION
This paper documents the significance of patients’ receiv-
ing individualized information through dialogue-based
contacts with healthcare professionals. This is exemplified
by summarizing the state of knowledge on how men with
prostate cancer, undergoing prostatectomy surgery, experi-
ence their conta cts wit h the healthca re profes sionals .
Secondary the paper points to the re levance in designing
new health informatics tools that can support these dia-
logue-based contacts by utilizing Web 2.0 technologies.
Web 2.0 websites differ from the static web pages estab-
lished on Web 1.0 technolog ies where the user s are limited
to passive viewing. Web 2.0 technologies establish dy-
namic websites, as for example the users can interact and
collaborate with each other in a dialogue.
2. BACKGROUND
Today’s he althcar e syst ems are ch aracter ised by shor t stays
in hospital with planned d ischarge within on e, two, or three
days even after large operations. This decreases the time
and opportunity for contact between the patients and the
healthcare professionals. As contacts are situations or con-
ditions where persons are able to exchange information,
attitudes, feelings and so on [1], these short contacts reduce
the patients’ time for information and support.
Patient satisfaction surveys show that the patients are
satisfied with short hospital stays [2-4]. However, qu ali-
tative studies have demonstrated that patients lack contact
with healthcare professionals, and therefore often lack
information and support [5-6]. This contradiction is ex-
plored in depth by focusing on the defined group of pa-
tients: Men with prostate cancer treated with prostatec-
tomy surgery.
The number of men diagnosed with prostate cancer
has increased with over 51 percent from 2000 to 2009. In
2009 prostate cancer ranked as the most frequent cancer
among men [7]. A growing number of these men are
treated with surgery; radical prostatectomy. Previously,
these men were hospitalized up to 19 - 20 days in rela-
tion to the surg ery [8]. Currently th e stays in hospital, in
relation to the surgery, are less than five days, which still

C. D. Bjørnes et al. / Open Journal of Nursing 1 (2011) 1-11 16
decreases to planned discharge the day after surgery.
3. METHOD
Systematic review is selected as the data-gathering method
for the study.
3.1 Aim
The aim of this literature survey is to su mmarize the s tat e
of knowledge on how men with prostate cancer experi-
ence their contacts with the healthcare professionals and
what these men need and do to feel secure and certain.
The specific research questions were:
1) How do men with prostate cancer, treated with
prostatectomy surgery, experience their contacts with the
healthcare professionals in clinical practice based on
short stays?
2) What do patients need to feel secure and certain?
3) What is the role of the Internet?
3.2 Literature Search
The PubMed and CINAHL databases were searched.
The inclusion criteria were English-language research
articles. The study population was men with prostate
cancer treated with prostatectomy surgery. When articles
were of particular relevance related articles were ex-
plored by lower the demand in relation to the population.
Therefore some articles relate to studies on men with
prostate cancer in general, though still including men
with prostate cancer treated with prostatectomy surgery.
The exclusion criteria were publication age older than
1997, due to the focus on short stays in hospital, in to-
day’s healthcare system.
The PICO schema (Figure 1) reports the search his-
tory. The first and second research questions generated
the search terms in the primary part of the literature
search (primary search). Early findings [9-14] indicated
that the Internet played a significant role, as this media
was often mentioned in relation to information and sup-
port. To understand the role of the Internet the first two
research questions were followed by the third research
question: What is the role of the Internet? The third re-
search question generated the secondary part of the lit-
erature search (secondary search). The Figure 1 also
includes the exclusions of articles, when reading the
abstracts: Due to the frequency of side effects as incon-
tinence and sexual dysfunction after prostatectomy, the-
se topics are wide-ranging in the literatu re. Articles, with
these terms as major concept, were excluded if the ab-
stracts did not include content of data related to the top-
ics in current study. Reading abstracts from the secon-
dary search excluded: Duplicates from the primary
search, however, still including repeaters in relation to
authors or findings generated in different areas of the
same project. Excluded were also articles focusing on
health informatics as decision support systems, as the
population in current study already were in a course of
treatment. Articles related to intervention studies were
excluded, as these represented health informatics sys-
tems that the patients were invited or asked to use.
Figure 1. PICO schemas report the search terms.
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C. D. Bjørnes et al. / Open Journal of Nursing 1 (2011) 1-11 17
Searching PubMed and CINAHL February 2011 ac
cording to the search terms in the primary search, the re-
sults were 78 in PubMed and three in CINAHL (Figure
2). Due to the small number in the CINAHL databases,
the area was search through, as illustrated in the Sup-
plementation. These supplementing searches expanded
the number in the CINAHL to 56 including duplicates.
Then the abstracts were read through. The numbers of
relevant and research-based articles in the two databases
were 29: 16 articles has specific focus on men with pro-
state cancer treated with prostatectomy surgery, whe-
reas 13 articles also include other groups of men with
prostate cancer. When categorizing the 29 articles accor-
ding to the methods: 13 articles document survey studies
and one article combines survey and interview. The rest;
15 articles report use of various forms of interview stud-
ies.
In the secondary search the focus was still on the same
group of patients though expanded to men with prostate
cancer in general. PubMed identified 141 titles. Search-
ing CINAHL identified 56 titles whereas some were du-
plicates. The abstracts were read, leaving 18 research-
based articles, which contribute to understanding the role
of the Internet in relation to the specified focus on in-
formation and communication according to the research
questions. Six papers document findings from text an-
alysis based on diverse philosophies. These studies ana-
lyse text that were generated on websites, which host
different forms of online social support. Seven papers
report survey studies and five describe findings gener-
ated by interview studies. Findings generated from a
total of 47 articles are provided in relation to each of the
three research questions.
4. RESULTS
4.1. How Do the Men with Prostate Cancer
Experience Their Contact with the
Healthcare Professionals?
The patient satisfaction surveys document that the men
with prostate cancer in general are satisfied with short
hospital stays in relation to their surgery [8,15,16].
However, interview based studies contributes to a di-
verse picture to that [9,10,12-14,17 -29]. Milne et al. de-
scribe how the men had mixed perceptions about the
benefit of short stays. This is underpinned by patients
who explain how they were grateful that they had been
allowed to stay in the hospital for two or three additional
days. Sinfield et al. [28] conclude that although there
were no widespread dissatisfaction, patients reported-
problems throughout their course of care. One of the
problems was that information needs were often not id-
entified or met. The lack in information is documented
in several studies [12,18,20,23,24,27 ]. Phillips et al. [24]
emphasize how the patients felt that they could have
been better prepared by the healthcare professionals,
even in cases in which no complications occurred. Moo-
re and Estey [23] writes that the information deficits aff-
ected the patients’ quality of life and healthy postopera-
tive rehabilitation.
The short contacts reduce the patients’ time for infor-
mation and support. Though, it does not seem to be the
amount of time, more likely how to get in contact and
the quality of these contacts. In other words, contacts
presuppose both accessibility and exchange-ability. As
depicted in the following, accessibility means availabil-
ity; it must be easy for the patients to g et in contact with
the healthcare professionals. And exchange-ability means;
the ability to exch ange information, as an essential b asis
for individualizing information.
Harden et al. [20] explain how the perception that all
the healthcare professionals are extremely busy, for ex-
ample at the hospital, deters many patients from asking
the healthcare professionals, because they feel uncom-
fortable and self-conscious doing it. Hedestig et al. [21]
describe how men with prostate cancer, btween their
check-ups, often had difficulties containg the health care
professionals or getting answers out of them, even
though the men had questions they wanted to ask. This
Figure 2. Number of research articles.
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C. D. Bjørnes et al. / Open Journal of Nursing 1 (2011) 1-11 18
illustrates why healthcare professionals must be easily
accessible during the patients’ course of treatment and
care. The importance of accessibility is further describe
by Harden et al. [20]. In their study, the men explain,
how they function well most of the time, however, there
were still ten percent of the time that was difficult. The
men describe how their difficult issues easily became
serious concerns and got out of proportion, when no one
was listening to them. The men state that it would have
been beneficial for them to have the opportunity to voice
their concerns by having a person to call and ask a spe-
cific question [20]. The study by Milne et al. [13] illus-
trates how the accessibility is important. Milne et al.
conclude that being home without readily and available
support and advice from healthcare professionals caused
anxiety and uncertainty. This is further underpinned by
their own study, providing that the participants in the
study experienced the researcher as an invaluable re-
source. The researcher collected the data by telephone
and E-mails both pre and postoperative. The study itself
became an information and support-intervention, which
the participants benefit from, as it h elped them to talk to
the researcher and have the opening to telephone or E-
mail the researcher [13]. It is essential that the patients
experience the healthcare professionals as easily accessi-
ble both at the hospital and when the patients are home.
The importance of the ex change-ability is fo r example
shown in the study by Iyigun et al. [27], as the men ex-
plained how the information should be individualized:
The healthcare professionals must keep the patients’
cultural level and psychological state in mind when pro-
viding the information. Harden et al. [20] describe how
the participants in their study told that the need for in-
formation was great, but they all needed different infor-
mation or needed it in a different way than others. The
men wanted someone to listen to their specific ne eds an d
fears and to help them find answers or just review in-
formation. When a healthcare professional aimed to in-
dividualize the information the men felt supported [20].
Again, it does not seem to be the amount of time, more
likely the quality of the information and support, mean-
ing the healthcare professionals ability to exchange ex-
periences, and so on, to generate individualized informa-
tion upon that. The men need the healthcare profession-
als to build the information and support on their indi-
vidual questions, experiences, and resources. The men
require a contact where the healthcare professionals en-
ter into a dialogue with them, as the dialogues are pre-
requisite in individualising the information and support.
A survey study by Smith et al. [30] document how a
little more than half of the men express some levels of
unmet psychological needs. Uncertainty about the future
was for example an important area of unmet need. The
dialogues are prerequisite if the healthcare professionals
shall be able to discover such uncertainty and meet the
needs of the particular patient. Thus, the healthcare pro-
fessionals’ accessibility and ability to individualize in-
formation and support, based on exchange-ability, are
important aspects for men with prostate cancer treated
with prostatectomy surgery.
In summary, this section illustrates that even though
the short contacts reduce the patients’ time for informa-
tion and support it does not seem to be the amount of
time that is most important. Instead it is how to get in
contact with the healthcare professionals and the quality
of the contacts, meaning the contacts need to be dia-
logue-based.
4.2. What Do Patients Need to Feel Secure and
Certain?
The consequences, when men with prostate cancer lack
dialogue with, and therefore information and support
from, healthcare professionals, are explored by searching
across the papers [9,12-14,20,21,23,24,27,28]. The find-
ings are illustrated in Figure 3. As depicted, lacking
information can start a negative process in which feel-
ings of uncertainty and insecurity can affect the men’s
ability to cope. When lacking information there is a risk
that the men experience disempowerment, which is
feelings of powerlessness or helplessness that reduces
the amount of control that someone, has over a situation
[1]. In contradiction, obtaining contact, enter dialogues,
and receiving individualized information and support are
related to experiences and feelings, which support the
positive process (Figure 3). Empowerment is the proc-
ess of giving somebody power in a particular situation;
to give someone more control over their own life or the
situation they are in [1].
In the paper by Iyigun et al. [27] the negative process
is illustrated, as lack of knowledge causes insecurity.
The study documents how the men felt anxious going
home because they were afraid of complications. It is
emphasized how the anxiety about going home is due to
lack of adequate information from the healthcare profes-
sionals. This is underpinned by the few men, who ob-
tained information from the healthcare professionals, as
they were more comfortable afterwards [27]. Sinfield et
al. [28] explain that information interventions improve
the patients’ knowledge and understanding. Individual-
ized, clearly information and communication influence
the patients’ ability to make decisions and participate.
Butler et al. [10] identify how male cancer patients’
coping was influenced by receiving individualized in-
formation. Thus Maliski et al. [12] conclude that health-
care professionals can hasten thepatients’ ability to re-
gain a sense of mastery by providing information and
being available.
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C. D. Bjørnes et al. / Open Journal of Nursing 1 (2011) 1-11 19
Figure 3. The negative and positive process of coping.
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C. D. Bjørnes et al. / Open Journal of Nursing 1 (2011) 1-11 20
OJN
In summary, this section gives a picture of the impor-
tance of receiving information and support in a course of
treatment and care. By providing information and sup-
port healthcare professionals may be able to empower
the patients. The empowered patient is also the active
patient.
The healthcare professionals’ accessibility and ability
to individualize information and support are important
aspects for men with prostate cancer treated with pro-
statectomy surgery, to feel secure and certain. By pro-
viding information and support healthcare professionals
supports the pati e nt s’ process of copi n g.
4.3. What Is the Role of the Internet?
The findings illustrate how men with prostate cancer use
the Internet to cope with the lacking information and
support. They use the online media to get information
about the diagnosis prostate cancer, treatment options,
and other topics related to a course of treatment [31-40].
Another purpose is to achieve social support ; online social
support [41-46]. Huber et al. [42] describe online social
support as social interactions and Dickerson et al. [32]
explain it as online friendship.
The study by Dickerson et al. [32] illustrate how the
important elements of social support exist in the Internet
based groups. In the online social support groups, the
patients share their stories, which contribute to recogni-
tion and reflections, which again generate other perspec-
tives and new knowledge. A patient, in their study, tells
how using the Internet and recognising other people with
identical problems were reassuring and helped him much.
Another patient showed how sharing experiences with
other patients generated insight and developed selfma-
nagement skills. Huber et al. [42] emphasize that the
Internet based social interactions can be important for the
individual in coping with and during his own course of
treatment.
In general Iyigun et al. [27] explain how some men
learn to cope themselves, when they are not receiving
information or when facing problems, and therefore for
example use the Internet. Van de Poll-Franse et al. [38]
describe how patients by themselves searched for infor-
mation on the Internet about the cancer, treatment, and
the consequences of treatment in general. Their study
illustrates how the patients use the Internet in every step
of their course of treatment, though varying in relation to
topics and amount of time. Most of the patients, who
used the Internet to find information, felt themselves be-
tter informed. Buntrock et al. [40] characterize the Inter-
net users as information seekers and point to how these
patients become active participants in their course of tr-
eatment and care. Milne et al. [13] explain how men with
prostate cancer use the Internet to be in front. The men
experience a sense of confidence and control for example
by consulting a variety of websites on the Internet prior
to meetings with th e healthcare profession als. Broom [47]
explains how the Internet allows the patients to “do
something”. The patients experience themselves as com-
petent and feel as they do not only rely on the doctor.
The patients become capable to take part in decision-
making, which also increase their sense of control over
their treatment process. As such the Internet usage redu-
ces the patients’ uncertainties and supports the patients’
involvement in making decision along their course of
treatment [47]. Dickerson et al. [32] found that the pa-
tients themselves felt more comfortable and knowledge-
able by utilizing the Internet as a too l during their course
of treatment. The Internet is a tool that generated under-
standings, for example about one’s own situation. Dic-
kerson et al. describe that men with cancer incorporate
Internet use into their cancer journey and become prob-
lem solvers. The men use the Internet to enhance their
sense of control. The men seek to be proactive, prepared,
and responsible, and thereby trying to change the pro-
vider-patient relationships towards collaboration and op-
en communication. The men use the Internet information
for verification and to clarify, compare, and validate the
information obtained during their course of treatment and
care. Dickerson et al. [32] point to how the men became
experts at finding resources online to confirm their deci-
sions, realizing the need to make choices, and to monitor
their progress or possible reoccurrence.
The men use the Internet to stay in control and engage
in their own course of treatment as active and responsible
partners.
5. DISCUSSION
The aim of this literature survey was to summarize the
state of knowledge on how men with prostate cancer,
treated with prostatectomy surgery, experience their con-
tact with the healthcare professionals. A relative small
number of studies were found. None had a defined focus
on these men and their experience of contacts with heal-
thcare professionals. However, this article reviews the
literature for men’s experience on themes relevant in the
contact between men and healthcare professionals: In-
formation; support; and dialogues.
The literature survey identified that the patients often
do not receive the individualized support, information,
and dialogue that they need. As a result of the lack of
contact, the men struggle with feelings of insecurity and
uncertaint y, often fol l o wed by loss of contr ol.
Even so the men had mixed feelings about the short
stays at hospital. The contradiction based on different
research methods, as illustrated in the introduction, is
comparable with these findings. Though the interview

C. D. Bjørnes et al. / Open Journal of Nursing 1 (2011) 1-11 21
based studies that were reviewed specify the difficulties.
This elaboration gives an understanding of the com-
plexity of and cor relations in human m eaning. The s hort st ays
in hospital limits and defines the time for contact between the
patients and the healthcare professionals, as the contacts are
both dated and categorized. However the patients’ need for
contact cannot be define d in the sam e matter.
The accessibility of the healthcare professionals and
the healthcare professionals’ ability to individualize in-
formation and support are important aspects for men
with prostate cancer treated with prostatectomy surgery.
The opportunity for male patients to get in contact with
healthcare professionals, an d th e quality of these con tacts,
is related to male patients’ chance to feel secure and to
stay in control. The men require a contact where the heal-
thcare professionals enter into a dialogue with them, as the
dialogues are prerequisite for individualising the informa-
tion and support.
A literature survey by Shaha et al. [48] document that
people with cancer in general often experience uncer-
tainty due to lack of information. Shaha et al. [48] illus-
trate how uncertainty is present in different, and often in
all, phases of a cancer trajectory, although with varying
intensity and based on diverse issues. Shaha et al. em-
phasize the importance of information, support, and in-
dividual approaches to care to minimize the negative
aspects of uncertainty, especially in the light of the in-
creasing ambulatory approaches to cancer care in general.
A general conclusion, in the literature, is that there is
still a need to develop new ways and too ls to provide the
patients with information and support. Based on an in-
tervention study using survey evaluation Berglund et al.
[49] support this significant conclusion and describes
that this is a crucial task for the healthcare sector. Heal-
thcare professionals seem to recognize the importance of
providing individual information and support, but need
to determine the best manner in which to provide it and
foremost important to incorporate it into practice [12,
18,20,23]. Sharpley et al. [50] stress that the ideal format
for patient information still needs to be id entified, which
require further research. For instance how to include the
provision of information, assist with navigating through
large amounts of information, dispelling misinformma-
tion, encouraging acquisition of self-care skills, and pro-
viding individual information and support to decrease
insecurity.
Especially, when having men as patients it can be
relevant to develop new health informatics tools. The
findings illustrate that men with prostate cancer use the
Internet to get information and support. The men use the
Internet to stay in control and engage in their own course
of treatment as active and responsible partners. Though
every single patient is an individual, there are indications
of differences men versus women as patients. Dickerson
et al. [32] describe how men focus on problem solving,
determine effects, treatments, and symptom management
in a functional way. Male cancer patients actively org an iz e
information, monitor for reoccurrence, prepare, facilitate,
and validate ahead of their contacts with healthcare pro-
fessionals. Previous studies, with focus particularly on
men as patients, state that male patients want to in stay
control and remain autonomy. Men like to act. Therefore
information, advice, and tools that support actions, are
important in their course of treatment [50-57]. Hence, it
is relevant to provide male cancer patien ts with tools th at
can underpin their contact to and dialogues with the heal-
thcare professionals.
The short stays in hospital limits and defines the time for
contact between the patients and the healthcare profession-
als, as the contacts are both dated and categorized. However
the patients’ need for contact cannot be defined in the same
matter. The men require a contact where the healthcare pro-
fessionals enter into a dialogue with them, as the dialogues
are prerequisite for individualising the information and
support. The relatively new Internet technologies Web 2.0
establish dynamic websites, which allow the users to do
more than just retrieve information, as on Web 1.0 sites [1 ].
Thereby Web 2.0 websites differ from the static web pages
established on Web 1.0 technolog ies where the users are li-
mited to passiv e viewi ng. A We b 2.0 we bsite allo ws user s to
interact and collaborate with each other in a dialogue. Users
can provide and control the data on a Web 2.0 site. The
contents are u ser-genera ted and th e us er s are intera c tiv e and
able to communicate with each other. The asynchronous
environments, which the Web 2.0 technologies prov ide, are
a significan t way to expand the time for contacts besides the
restricted formal face-to-face contacts at hospital. Utilizing
this expansion in flexible time healthcare professionals have
the opportunity to comply with the contradiction between
the patients’ needs for contact and the intensifying of pa-
tients’ short stays at hospital. The course of care can go be-
yond the formal face-to-face contacts between the patients
and the healthcare professionals, so that the patients have
the opportunity to feel informed and supported, and the-
reby empowered, even at home. As such the online asyn-
chronous health informatics tools can be one of the com-
ponents to accommodate these organisational changes.
In general, it is suggested that healthcare professionals
do have a responsibility in creating Internet based reli-
able information and online social support groups for the
patients. This is consistent with the findings, when fo-
cusing on men with prostate cancer. Broom [47] exp-
lains how the empowering of the patients changed the
roles between the patients and the healthcare profession-
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C. D. Bjørnes et al. / Open Journal of Nursing 1 (2011) 1-11 22
als, as the Internet allows the patients to act. The pa-
tients’ activities are grounded on the information on the
Internet, whether it is reliable or not. As illustrated Dic-
kerson et al. [32] describe that the men use the online
information to validate the information from the health-
care professionals. However, the patients are also aware
of the importance of checking the qu ality of the informa-
tion available on the Internet. Therefore most of the men
consider the information cautiously. Van de Poll-Franse
et al. [38] emphasize the importance of healthcare pro-
fessionals taking active part in the future use and devel-
opment of Internet based tools. Pautler et al. [34] specify
the importance in healthcare professionals participating
in the development of information websites, as these may
influence the patients’ decisions regarding treatment.
Hence, the healthcare professionals may acknowledge
the role of Internet in their contact with each patient. Fur-
t he rm o re , the healthcare professionals may use their organi-
sations websites to provide comprehensive and reliable in-
formation.
Healthcare professionals’ active involvement in devel-
oping Internet based tools is consistent with the patients’
request, as Van de Poll-Franse et al. [38] document. The
patients prefer to get reliable information from websites
made, or recommend, by thei r healthcare professionals, for
example the oncologist and the hospital. Hence, using the
Internet actively, the healthcare professionals would have
a tool to underpin their contact wit h the patient s.
Many patients describe their wishes about future use
of the Internet, for example access to medical files and
test results [38]. Two survey based studies report men’s
interest in [58] and satisfaction with [59] access to their
own medical record. Cathala et al. supplemented the me-
dical files by inviting the patients to fill out quality of life
questionnaires to document treatment outcome. A contact
page allows the patient and physician to exchange infor-
mation by text. In both studies [58,59] the men appraised
the access to the Internet medical record positively and
the researchers emphasize the relevance in further de-
veloping. Based on the surveys it is indicated that the
contact to the doctor becomes closer and the patients are
more capable to engage in shared medical decision mak-
ing with their doctor. However, the questionnaire-based
findings did not reveal whether the access to medical
records or the exchanging of information actually seem-
ed to be more individualized or managed to meet the pa-
tients’ individual needs in support, information, and dia-
logue [58,59]. Therefore, it seems relevant that both
healthcare professionals and patients not only are involved
when evaluating new health informatics tools, but also
are engaged in future design and development of health
informatics systems.
Limitations
The defined population and research questions generated
a relative limited number of articles. Furthermore, sev-
eral papers were excluded, because their focus was mainl y
incontinence. Some of these papers could have been
relevant in relation to the concrete population. However
the overall focuses were contacts, dialogues, information,
and support, in the light of short stay surgery, and not
long term complications after surgery.
The area of health informatics tools expands quickly.
This can for example be illustrated by the increasing
number of decision support systems to men with prostate
cancer. According to the exclusion criteria, studies related to
that topic were not a part of the current study. These arti-
cles could have contributed to the third research question:
What is the role of the Internet? However the answer to
the third research question shall be seen in relation to the
first and second research questions.
The research questions are generated from a problem
experienced in nursing care. Looking at the search terms
it is clear that the study is born in nursing. Expanding the
search terms to other professions for example doctors
and to the health informatics field wou ld potentially give
various perspectives. Though, the patients needs, will be
identical.
6. CONCLUSIONS
The literature survey identify that men with prostate
cancer treated with prostatectomy surgery often do not
receive the individualized support, information, and dia-
logue they need. Because of that the men struggle with
feelings of uncertainty, insecurity, and loss of control.
However, contacts based on short stays at the hospital
seem to be acceptable for men with prostate cancer, treated
with prostatectomy surgery. The importance, in relation
to the patients’ contact with healthcare professionals, is
not the length and amount of time. Instead accessibility
and exchange-ability are significant aspects. For men to
feel secure and certain, the healthcare professionals must
be easy to get in contact with during the whole course of
treatment and care. Concurrently, the healthcare profes-
sionals’ ability to exchange information, and thereby to
individualize information and support based on dialogues
with the particularly man, is essential. Providing infor-
mation and support healthcare professionals may be able
to empower the patients, and the empowered patient is
also the active patient.
The findings demonstrate that men with prostate cancer
use the Internet in their search for information and sup-
port. The Internet he lps the men to stay in control and to
engage in their own course of treatment as active and
responsible partners.
7. PRACICE IMPLICATIONS
The results may be a starting point for the development
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C. D. Bjørnes et al. / Open Journal of Nursing 1 (2011) 1-11 23
of new health informatics tools by combining Web 1.0
technologies with Web 2.0 technologies. Seeing that it is
relevant to provide male cancer patients with tools that
can underpin their contacts to and dialogues with the
healthcare professionals and in combination, the Internet
is already a common used media. It seems relevant that
both healthcare professionals and patients are engaged in
future development of health informatics systems, as a
collaborative development and use of Internet based tools
could underpin the exchange-ability, towards dialogue-
based contacts between men with prostate cancer and
healthcare professionals.
8. ACKNOWLEDGEMENTS
The authors wish to acknowledge funding from: The Novo Nordisk
Foundation, DOF Det Obelske Familiefond, Danish Nursing Research
Society, Harboefonden. The funding source had no involvement in the
study. There is no conflict of interest for the authors associated with
this study. The manuscript is revised by: Lene Sømod Flou, BA in
English Languages, Staff Member with University Degree, Aalborg
University.
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