title: Dismantling the present and future threats of testicular cancer: a grounded theory of positive and negative adjustment trajectories.
abstract: OBJECTIVE
  Testicular cancer commonly affects men in the prime of their lives. While survival rates are excellent, little previous research has examined men's experiences of adjustment to survivorship. We aimed to explore this issue in younger testicular cancer survivors.
  
  
  METHODS
  In-depth qualitative interviews were conducted with testicular cancer survivors over two time points approximately 6 months apart in the year following treatment completion. Interviews were analysed using a grounded theory approach.
  
  
  RESULTS
  The sample included 18 testicular cancer survivors between 22 and 44 years (mean age 34). A grounded theory was developed, which explained the process of positive adjustment over the first year following the treatment completion in terms of men's ability to dismantle the present and future threats of cancer, involving the key transitions of gaining a sense of perspective and striving to get on with life and restore normality. These were facilitated by six key processes. The processes that explained a negative adjustment trajectory are also presented.
  
  
  CONCLUSIONS
  These findings contribute to the understanding of the psychosocial impact of testicular cancer on younger men's lives and have implications for the provision of support to testicular cancer survivors. Further investigation into the feasibility of one-on-one peer support interventions is warranted, as well as informal support that respects men's desire for independence.
  
  
  CONCLUSIONS
  Understanding the processes involved in adjustment highlights ways in which health professionals can offer support to those struggling to adjust through challenging illness beliefs, encouraging emotional disclosure and facilitating peer mentoring.
authors.affiliation: Cancer Care Research Group, Department of Applied Health and Professional Development, Faculty of Health and Life Sciences, Oxford Brookes University, Marston, Oxford, OX3 0FL, UK. l.matheson@brookes.ac.uk.
authors.forename: Lauren
authors.initials: L
authors.lastname: Matheson
authors.affiliation: Cancer Care Research Group, Department of Applied Health and Professional Development, Faculty of Health and Life Sciences, Oxford Brookes University, Marston, Oxford, OX3 0FL, UK.
authors.forename: Mary
authors.initials: M
authors.lastname: Boulton
authors.affiliation: Cancer Care Research Group, Department of Applied Health and Professional Development, Faculty of Health and Life Sciences, Oxford Brookes University, Marston, Oxford, OX3 0FL, UK.
authors.forename: Verna
authors.initials: V
authors.lastname: Lavender
authors.affiliation: University of Oxford Department of Oncology, Oxford Cancer and Haematology Centre, Oxford University Hospitals Trust, Headington, Oxford, OX3 7LJ, UK.
authors.forename: Andrew
authors.initials: A
authors.lastname: Protheroe
authors.affiliation: Bristol Testicular Cancer Service, Bristol Haematology and Oncology Centre, University Hospitals Bristol, Horfield Road, Bristol, BS2 8ED, UK.
authors.forename: Sue
authors.initials: S
authors.lastname: Brand
authors.affiliation: Cancer Care Research Group, Department of Applied Health and Professional Development, Faculty of Health and Life Sciences, Oxford Brookes University, Marston, Oxford, OX3 0FL, UK.
authors.forename: Marta
authors.initials: M
authors.lastname: Wanat
authors.affiliation: Cancer Care Research Group, Department of Applied Health and Professional Development, Faculty of Health and Life Sciences, Oxford Brookes University, Marston, Oxford, OX3 0FL, UK.
authors.forename: Eila
authors.initials: E
authors.lastname: Watson
mesh_terms: D000223:Adaptation, Psychological / Q000502:physiology*; D000328:Adult; D004644:Emotions / Q000502:physiology; D066296:Grounded Theory; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009042:Motivation / Q000502:physiology; D010379:Peer Group; D017741:Survivors / Q000523:psychology / Q000706:statistics & numerical data*; D013736:Testicular Neoplasms / Q000401:mortality* / Q000523:psychology* / Q000534:rehabilitation; D055815:Young Adult
keywords: Adjustment; Cancer survivorship; Grounded theory; Qualitative; Testicular cancer