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Table 2 Characteristics of included studies

From: The accessibility and acceptability of self-management support interventions for men with long term conditions: a systematic review and meta-synthesis of qualitative studies

Study (First Author, Year, Country)

Aim

Classification of support activity used in qualitative synthesis

Condition

Data collection (IV, FG, OP, PO) and sample size

Methodological approach

Sample (size, sex, condition details, age, ethnicity, locality/settlement, SES, employment, sexuality, relationship)

Adamsen [41] Denmark

Men's experiences of a tailored intervention involving physical activity and information relay for men with cancer

lifestyle

cancer - any

FG 10 men, PO 17 men, Total 17 men

descriptive/interpretive

range of cancers and varying stages; mean age 56.5 yrs (range 21-71); ethnicity n/r; “broad range” of education, employment, relationship status

Arrington [42] USA

Communication practices of Man to Man prostate cancer support groups

support group (face-to-face)

cancer - prostate

PO n/r (20 groups of men)

discourse analysis

all “senior citizens”; “almost exclusively retired, elderly”; no further details reported

Baird [43] USA

Self-care factors influencing adherence to a cardiac rehabilitation programme

lifestyle

cardiac - coronary artery disease

IV 5 men

phenomenology

majority myocardial infarction (4 myocardial infarction, 1 sudden cardiac arrest; one was Post-Cerebral-Vascular Accident (CVA); two were post-percutaneous-transluminal-coronary angioplasty, and one was post-coronary-artery-bypass-graft surgery); aged 60-70 yrs; 80% Caucasian (4 Caucasian, 1 African American); 100% retired; mix of previous 'blue-collar' and 'white-collar' occupations; 100% married

Barlow [44] UK

Patients' with multiple sclerosis experiences of the Chronic Disease Self-Management Course

lifestyle

multiple sclerosis

IV 3 men 7 women

descriptive/interpretive (part of mixed methods study)

disease duration 4-19 yrs; aged 35-60 yrs

Barlow [45] UK

Patients' with myocardial infarction experiences of the Chronic Disease Self-Management Course and cardiac rehabilitation

lifestyle

cardiac - myocardial infarction

IV 10 men 9 women

descriptive/interpretive (part of mixed methods study)

14 with co-morbidity; median age 68 yrs (range 59-74); 1 employed; majority (16) married/ residing with partner; all had attended at least 5 of the 6 intervention sessions.

Bedell [46] USA

Daily life experiences of gay men with HIV/AIDS living alone in New York City

support group (face-to-face)

HIV/AIDS

IV 8 men

descriptive/interpretive

varying severity (6 diagnosed with AIDS for ≥ 2 yrs, 2 not yet developed); all had prior/current difficulty with daily activities; aged 25-50 yrs; majority white (6 white, 2 African American); all urban; majority “middle-class”; education ranged 1 yr college to doctorate; 4 employed, 3 on public assistance, 1 neither; all gay; all lived alone.

Bell [47] Canada

Composition, processes and patients' views of differently designed and structured cancer support groups

support group (face-to-face)

cancer – 1) women with metastatic cancer; 2) Colorectal cancer patients; 3) Chinese patients with cancer)

IV 3 men and 17 women. PO Metastatic group: 0 men, 25 women; Colorectal group: 14 men, 16 women; Chinese group: 35 men, 61 women (incl. 48 caregivers).

descriptive/interpretive

interview sample: time since diagnosis 3 months-3 yrs, 13 in treatment, 7 post treatment; time in group 1 month-4yrs; median age 50s (range 40s-70s); ethnicity n/r; metastatic observation sample: 0 men, 25 women; 25 in treatment; median age 50s (range 30s-60s); majority white; colorectal observation sample: 14 men, 16 women; 1 pretreatment, 8 in treatment, 12 post treatment; median age 50s (30s-70s); majority white; Chinese observation sample: 35 men; 61 women; 5 pretreatment, 30 in treatment, 15 post treatment; median age 50s (20s-80s); all Chinese.

Bourke [48] UK

Men's experiences of a lifestyle intervention for men with prostate cancer undergoing androgen suppression therapy

lifestyle

cancer - prostate

FG 12 men (3 groups)

descriptive / interpretive

all T3-T4 prostate cancer receiving androgen suppression therapy ≥ 6 months; details n/r but linked trial reports for intervention group of 25: mean treatment 30 months (sd 31); mean age 71.3 yrs (sd 6.4)

Broom [49] Australia

Impact of Internet use on disease experience of prostate cancer and the doctor-patient relationship

Internet (information and/or support)

cancer - prostate

I V33 men

descriptive / interpretive

“range” of prognoses and treatments; “varying ages”

Chambers [50] Australia

Men's experiences of a mindfulness-based cognitive therapy group intervention in men with advanced prostate cancer

psychological

cancer - prostate

IV 12 men

descriptive / interpretive

n/r for interview sample therefore based on 19 men taking part in intervention. Time since diagnosis mean 68.9 months (sd 51.2, range 1-167); majority had hormone treatment; range of surgery and radiotherapy (16 received hormone therapy incl. 9 ongoing; 11 external beam radiation therapy, 3 brachytherapy, 3 radical prostatectomy surgery, 1 orchidectomy); mean age 67.0 yrs (sd 6.5 yrs, range 58-83); 79% completed university, college, or vocational training; 37% employed, 63% retired; 84% married or in a relationship, 16% widowed, divorced, or separated.

Chenard [51] USA

Impact of stigma on self-care behaviours of HIV-positive gay men

support group (face-to-face)

HIV/AIDS

IV 15 men, FG 5 men (1 group), Total 20 men

grounded theory

all HIV+ ≥1 yr, 85% ≥5 yrs; median age 44 yrs (range 26-62; 70% over 30 yrs); all gay.

Corboy [52] Australia

Perceived barriers to using psychosocial support services in men with cancer living in rural Australia

various

cancer - prostate

IV 9 men (82 surveyed and subsample interviewed)

descriptive / interpretive

men with ‘any’ cancer eligible but all participants had prostate cancer; mean age 69 yrs (sd 9.3); all rural (5 accessible, 4 moderately based on ARIA+ classification); all married; 2 employed, 1 sick leave, 6 retired.

Cramer [53] UK

Men's experiences of depression and anxiety groups and the role of health professionals in accessing support

support group (face-to-face)

depression/anxiety

IV 17 men, PO 30 (4 groups, unclear if this includes some women), Total 38 (may include women)

descriptive / interpretive

details n/r; sampling described as aiming to increase ethnic diversity and diversity in type of help sought

Dickerson 2006 [54] USA (linked study to Dickerson [55])

Experiences of patients with cancer using the Internet for information and support to manage self-care, including symptom management

Internet (information and/or support)

cancer - any

IV 20 women (intended as mixed but only managed to recruit women) - linked study

phenomenology

various cancer types (11 breast, 3 gynecologic, 1 gastrointestinal, 3 lymphomas, 2 hematological; 7 new diagnosis, 7 in treatment, 6 survivors (>5 yrs); mean age 52.3 yrs (sd 8.7, range 34-65); mean education 15 yrs (sd 2, range 12-18); mean 14 hours weekly Internet use (sd 12, range 2-40); mean 6 yrs using Internet (range 2-10).

Dickerson [55] USA

Experiences of men with cancer using the Internet

Internet (information and/or support)

cancer - any

IV 15 men (comparison made with 20 women in above study)

phenomenology

majority prostate cancer (14 prostate, 1 leukemia); 1 new diagnosis, 4 in treatment, 10 survivors (>5 yrs); mean age 63 yrs (sd 10, range 47-78); mean education 17 yrs (sd 3, range 12-20); mean 11 hours weekly Internet use (sd 10, range 1-35); mean 7 yrs using Internet (range 1-10); 10 attend 'Us, Too' face-to-face support group

Eldh [56] Sweden

Phenomena of participation and non-participation in nurse-led clinic for chronic heart failure, as observed in visits and experienced by patients and nurses

lifestyle

cardiac - heart failure

IV 3 men, PO 3 men (11 visits), Total 3 men

phenomenology

classed as II/III using New York Heart Association classes of heart failure; aged 53, 77, 79 yrs

Emslie [57] UK

Experiences of men and women with depression in articulating emotional distress and engaging with health professionals

various

depression

IV 16 men 22 women

descriptive/interpretive

majority (34/38) experienced multiple/prolonged depressive episodes; 18/38 hospitalised; 10/38 bipolar depression; wide age range (<30-66+; 3 <30, 14 30-40, 11 41-55, 6 56-65, 4 66+ yrs); majority White British (33/38 - others 1 each of Black, Asian, South European, North European, American).

Evans [58] UK

Acquisition and evaluation of complementary and alternative medicine (CAM) information in men with cancer

information

cancer - any

IV 34 men (total sample is 43 but paper focus is on 34 who did use CAM)

descriptive/interpretive

various cancer types (10 colorectal, 10 prostate, 3 lung, 11 other - thymic, tonsillar, pancreatic, bone, lymphoma, bladder, renal, oesophageal, leukaemia); varying stages (10 localised, 10 remission, 8 metastatic, 6 palliative care); mean age 57 yrs (range 31-83), all white; 'range' of manual, non-manual and professional occupational backgrounds (over half professional); 22 used CAM before diagnosis.

Ferrand [59] France

Motives for regular physical activity in men and women with type 2 diabetes using the French patients' association Move for Health

lifestyle

diabetes - type 2

IV 9 men 14 women

descriptive/interpretive

men: 6 diagnosed ≥5 yrs; 6 medicated including 2 insulin; mean age 67.0 yrs (sd 6.1); 6 post-secondary education; 1 employed, 8 retired; 7 married, 1 widowed, 1 never married; women mean 56.3 yrs (sd 9.5), total range 35-78 yrs; 13 diagnosed ≥5 yrs; 10 medicated including 4 insulin; mean age 56.3 (sd 9.5); 4 post-secondary education; 3 employed, 7 retired, 4 homemaker; 7 married, 1 widowed, 5 separated/divorced, 1 never married.

Galdas [60] Canada

Canadian Punjabi Sikh men's experiences of adopting lifestyle changes following myocardial infarction

lifestyle

cardiac - myocardial infarction

IV 27 men

descriptive/interpretive

majority reported comorbidity (10 diabetes, 8 high blood pressure, 7 high cholesterol, 3 depression); mean age 65.7 yrs (range 41-86); all Canadian Punjabi Sikh; lived in Canada mean 20 yrs (range 2-42); majority retired, 7 employed, 13 receiving pension or disability income; 24 married, 3 widowed; 15 attended cardiac rehabilitation.

Gibbs [61] Australia

Factors influencing utilisation of self-management services in men with arthritis

various

arthritis

IV 17 men

grounded theory (and participatory research)

time since diagnosis 4 months-25 yrs; varied health status (self-reported 3 poor, 8 fair, 6 good); median age 41-60 yrs (2 18-25, 3 26-40, 7 41-60, 3 61-75, 2 75+); majority Anglo/Celtic (12 Anglo/Celtic incl. 1 also Aboriginal; 1 UK/European, 1 Greek, 1 Chilean, 1 Italian, 1 Filipino/Asian); varied education (1 primary school only, 5 completed secondary, 1 passed secondary, 7 vocational, 3 university, 3 n/r); 9 employed, 6 retired, 1 student, 1 unemployed; range of employment roles (health services, research, managerial, information technology, motor mechanics, farming); sexuality not asked but 1 homosexual, 1 bisexual, others referred to female partners although acknowledge may not identify as heterosexual; varied involvement in self-management programmes (0 to 4 different programmes).

Gibbs [23] Australia

Work as a barrier to accessing self-management services in men with a chronic illness (arthritis)

various

arthritis

IV 17 men

grounded theory (and participatory research)

see 2005 paper (pooled)

Gooden [62] Australia

Comparison of ways in which men with prostate cancer and women with breast cancer share issues online

Internet (information and/or support)

cancer - prostate (men) and breast (women)

OP 77 men (591 postings) 69 women (272 postings)

descriptive/interpretive (part of mixed methods)

no sample characteristics due to methods; however quality of writing in postings suggested “reasonably well educated and articulate”

Gray [63] Canada

Comparison of men's experiences of prostate cancer self-help groups and women's experiences of breast cancer self-help groups

support group (face-to-face)

cancer - prostate (men) and breast (women)

I V12 men, IV/FG 27 women

descriptive/interpretive

men: “representation from among long-term survivors and men with advanced disease”; aged 45-80; women: range of time since diagnosis (4 <1 year, 11 < 3yrs, 10 longer term); range of severity including 6 with recurrence; aged 33-73 yrs (15 aged <50); all white reflecting groups; “predominantly middle class and well educated” (3 had less that high school).

Gray [64] Canada (linked study to Gray [63])

Men's experiences of prostate cancer self-help groups

support group (face-to-face)

cancer - prostate

IV 12 men

descriptive/interpretive

see above

Gray [65] Canada (linked study to Gray [63])

Women's experiences of breast cancer self-help groups

support group (face-to-face)

cancer - breast (women)

IV/FG 27 women - linked study

descriptive/interpretive

see above

Harris [66] Canada

Experiences of counselling and peer support services in gay men with HIV/AIDS

various

HIV/AIDS

IV 12 men

phenomenology

mean 9.75 yrs since diagnosis (range 4-15); mean age 43 yrs (range 27-56); range of education (4 some high school credits, 5 completed high school, 3 “completed some” university/college education); 7 employed, 2 retired, 3 not working; varied income (5 <$20,000, 3 $30,000-$49,999, 1>$50,000, 3 n/r); all gay (5 previously married to women); all involved in local community-based agencies; most reported following their antiretroviral medications; 6 men had used peer support 1-2 times per week for 8 yrs on average; 7 men had received counselling 1-2 times per fortnight for 4 yrs on average.

Iredale [67] UK

Perceptions of information needs in men with breast cancer

information

cancer - breast (male)

IV 30 men (subsample of n161 men surveyed in full study)

descriptive only (supplement to quantitative study)

details for interview sample n/r; details for full sample surveyed (n161): mean 35 months since diagnosis (range 2-120); 55% current breast cancer; mean age 67.3 yrs (range 27-88); 64% secondary education or above; 78% married/ residing with partner, 8% single, 6% divorced/separated, 8% widowed.

Kendall [68] USA

Experiences of community support groups in gay men with HIV/AIDS

support group (face-to-face)

HIV/AIDS

IV 29 men

descriptive/interpretive

mean 3 yrs 2 months since HIV diagnosis (range 3 months-9 yrs); range of disease severity (8 asymptomatic; 8 mild, transient symptoms; 8 “full-blown AIDS, not terminal”, 8 “full-blown AIDS in terminal stage”); mean age 37 yrs (range 25-58); majority Caucasian (27 Caucasian, 2 African American); majority highly educated (mean 16 yrs education; only 1 without college education); 53% employed, 46% disability allowance; all gay; 11 in a relationship (length ranging 1 month-14 yrs); 31% strong family support, 46% strong friend support but “in general … did not feel well-supported”; mean 3 HIV-support groups attended (range 1-8).

Kronenwetter [69] USA

Men's experiences of a prostate cancer lifestyle trial for men with early prostate cancer

lifestyle

cancer - prostate

IV 26 men

descriptive/interpretive

mean age 67 yrs (range 50-85); majority Caucasian (>90%); majority college education, university education or “specialised training” (>90%); “over half” retired; 21 (81%) had “partners/spouses”.

Martin [70] UK

Men's experiences of a nurse-led workshop for men with testicular cancer

lifestyle

cancer - testicular

IV 6 men

descriptive/interpretive

mean age 35 yrs (range 29-45)

Mfecane [71] South Africa

Phenomenon of therapeutic citizenship in HIV/AIDS support groups, as observed in visits and experienced by men in rural South Africa

lifestyle

HIV/AIDS

IV 25 men; PO n n/r (14 months, presumably includes some women)

ethnography

interview sample: aged 28-50 yrs; all South African; all rural; all “poor, working-class community”; majority unemployed; approximately half single (6 married, 4 cohabitating, 3 partners living apart, 12 single); all had ≥1 child but minority lived with their children.

Oliffe [72] Canada

Factors influencing sustainability of prostate cancer support groups

support group (face-to-face)

cancer - prostate

PO 333 men (15 groups of men and partners)

ethnography

details of group members n/r

Oliffe [72] Canada

How prostate cancer support groups simultaneously facilitate health promotion and illness demotion

support group (face-to-face)

cancer - prostate

PO 333 men (15 groups of men and partners), IV 52 men, Total 333 men

ethnography

interview sample: mean 6.8 yrs since diagnosis; majority received treatment (49); mean age 70 yrs (range 53-87); 25 Anglo-Canadian, 25 Northern European; majority retired (42); all attended ≥2 meetings in past year (inclusion criteria); mean 5.3 yrs accessed support groups; 16 were long-term members (had been attending for more than 12 months), and 16 were short-term members (had been attending for less than 12 months); 20 held leadership roles (e.g. facilitator, secretary).

Oliffe [73] Canada

How men who attend prostate cancer support groups engage with health literacy and consumerism

support group (face-to-face)

cancer - prostate

PO n n/r (16 groups of men and partners), IV 54 men, Total n n/r

ethnography

interview sample: majority received treatment (50); mean age 71 yrs (range 53-87); all Canadian, “many” Northern European ancestry; majority retired (44); all attended ≥2 meetings in past year (inclusion criteria); 16 were long-term members (had been attending for more than 12 months), and 16 were short-term members (had been attending for less than 12 months), 22 held leadership roles (e.g. facilitator, secretary).

Ramachandra [[74] UK

Acceptability of a brief self-led psychological intervention in patients with cancer

psychological

cancer - metastatic prostate (men) and metastatic breast (women)

IV unclear if 4 men 3 women or 3 men 2 women (46 in total trial - 24 men 22 women; unclear if feedback at 6 weeks or 12 weeks)

descriptive only (supplement to quantitative study)

interview sample details n/r; full trial details: men: mean age 72.4 yrs; women: mean age 60.8 yrs.

Sandstrom [75] USA

Utilisation of peer support groups by gay men with HIV/AIDS

support group (face-to-face)

HIV/AIDS

IV 25 men

grounded theory

all advanced diagnoses; 10 symptomatic HIV (including 3 with severe complications), 15 diagnosed with AIDS; age ranged 20-56 yrs (7 20s, 11 30s, 6 40s, 1 50s); majority white (2 African American); 12 “attended college or completed college degrees”; 20 urban; all gay; 16 had used support groups at some time, including 9 briefly (“usually 1-4 months”) and 7 for ≥1 year.

Seale [76] UK

Compare the language of men and women with cancer in research interviews and online support groups

Internet (information and/or support)

cancer - prostate (men) and breast (women)

IV 52 men 47 women, OP 900 men, 153 women, Total 952 men, 200 women

descriptive / interpretive

interview sample details n/r; online postings sample details n/r; Ziebland 2004 (cited by authors) reports interview sample details for 49 men and 37 women as respective mean age 62 yrs (range 51-83) and 44 yrs (range 19-75)

Seymour-Smith [20] UK

How men and women negotiate their identities as members of cancer self-help groups

support group (face-to-face)

cancer - testicular (men) and breast (women)

IV 4 men 7 women

discourse analysis

men aged 26-31, women aged 33-64 yrs; all White UK; men's sample includes 1 group leader.

Smith 2002 [77] USA

Views of African American men with prostate cancer who do not use the Man to Man support group

support group (face-to-face)

cancer - prostate

FG 4 men

descriptive only (supplement to quantitative study)

all African American; all members of '100 Black Men' organisation.

Sullivan [78] USA

Comparison of communication practices of men with prostate cancer and women with ovarian cancer supporting each other online

Internet (information and/or support)

cancer - prostate (men) and ovarian (women)

OP 176 men (616 postings) 134 women (1256 postings) (not extracted re: HCPs and others)

descriptive/interpretive

sample details not known (due to methods)

Trapp [79] USA

Men's preferences for cancer support groups

support group (face-to-face)

cancer - any

IV 5 men

descriptive/interpretive

various cancer types (2 melanoma, brain cancer, lymphoma, leukemia); various stages (2 metastatic, 1 stage III); 4 had previous cancer diagnosis; aged 30-69 yrs (30, 62, 62, 64, 69); all Caucasian USA; urban; majority highly educated (1 high school, 2 graduate, 2 postgraduate); all had been employed (some retired/unable to work); 2 married, 2 single, 1 widowed

Vanable [80] USA

Views of men with HIV who have sex with men about sexual risk reduction programmes, to develop a tailored intervention

various

HIV/AIDS

IV 21 men, FG 31 men, Total 52 men

descriptive/interpretive

mean 8 yrs since diagnosis; 50% reported undetectable viral load; mean age 41.4 yrs (sd 8.1, range 24-63, “mostly middle-aged”); majority Caucasian (61% Caucasian, 33% African American, 6% other); 48% employed, 48% unemployed; mean monthly income $1023 (sd 699); all men who have sex with men; 33% cohabiting, 19% relationship but living apart, 48% “did not have a primary partner”; mean 4.8 sexual partners in past year (sd 10.9).

Wallace [81] USA

Psychosocial needs of men with prostate cancer

various

cancer - prostate

FG 16 men (2 groups)

descriptive/interpretive

mean 4.3 yrs since diagnosis (range 6 months-12 yrs); mean age 66.8 yrs (range 49-81); majority Caucasian (1 African American, 1 other); range of education (8 high school, 5 college, 3 graduate school); annual income ranged $20,000-$100,000; majority married (15 married, 1 divorced).