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Charlick M, Tiruye T, Ettridge K, O'Callaghan M, Sara S, Jay A, Beckmann K. Prostate Cancer Related Sexual Dysfunction and Barriers to Help Seeking: A Scoping Review. Psychooncology 2024; 33:e9303. [PMID: 39138118 DOI: 10.1002/pon.9303] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2024] [Revised: 07/23/2024] [Accepted: 08/05/2024] [Indexed: 08/15/2024]
Abstract
OBJECTIVE Despite available support, sexuality needs are the most frequently reported unmet need among men with prostate cancer, which may be due to low help-seeking rates. Using the Ecological Systems Framework as a theoretical foundation, we conducted a scoping review of the available literature to understand what factors impact help-seeking behaviour for sexual issues after prostate cancer treatment among men who had received treatment. METHODS Following PRISMA guidelines, a systematic search on Medline, PsychInfo, Embase, Emcare, and Scopus was conducted to identify studies of adult prostate cancer patients post-treatment, which reported barriers and/or facilitators to help-seeking for sexual health issues. Quality appraisals were conducted using Joanna Briggs Institute appraisal tools, and results were qualitatively synthesised. RESULTS Of the 3870 unique results, only 30 studies met inclusion criteria. In general, studies were considered moderate to good quality, though only six used standardised measures to assess help-seeking behaviour. Barriers and facilitators for sexual help-seeking were identified across all five levels of the Ecological Systems Framework, including age, treatment type, and previous help seeking experience (individual level), healthcare professional communication and partner support (microsystem), financial cost and accessibility of support (meso/exosystem), and finally embarrassment, masculinity, cultural norms, and sexuality minority (macrosystem). CONCLUSIONS Addressing commonly reported barriers (and inversely, enhancing facilitators) to help-seeking for sexual issues is essential to ensure patients are appropriately supported. Based on our results, we recommend healthcare professionals include sexual wellbeing discussions as standard care for all prostate cancer patients, regardless of treatment received, age, sexual orientation, and partnership status/involvement.
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Affiliation(s)
- Megan Charlick
- Cancer Epidemiology and Population Health, University of South Australia, Adelaide, Australia
| | - Tenaw Tiruye
- Cancer Epidemiology and Population Health, University of South Australia, Adelaide, Australia
| | - Kerry Ettridge
- Health Policy Centre, South Australian Health and Medical Research Institute, Adelaide, Australia
| | - Michael O'Callaghan
- South Australian Prostate Cancer Clinical Outcomes Collaborative, Flinders Medical Centre, Adelaide, Australia
- College of Medicine and Public Health, Flinders University, Adelaide, Australia
- Discipline of Medicine, University of Adelaide, Adelaide, Australia
| | - Sally Sara
- Nursing Programs, Prostate Cancer Foundation of Australia, St Leonards, Australia
| | - Alexander Jay
- Urology Department, Flinders Medical Centre, Adelaide, Australia
| | - Kerri Beckmann
- Cancer Epidemiology and Population Health, University of South Australia, Adelaide, Australia
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Gupta N, Zebib L, Wittmann D, Nelson CJ, Salter CA, Mulhall JP, Byrne N, Nolasco TS, Schofield E, Loeb S. Unmet Sexual Health Resource Needs and Preferences for Interventions to Address These Needs Among Female Partners of Patients With Prostate Cancer. Urology 2024; 184:19-25. [PMID: 38160766 DOI: 10.1016/j.urology.2023.12.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Revised: 12/04/2023] [Accepted: 12/06/2023] [Indexed: 01/03/2024]
Abstract
OBJECTIVE To characterize unmet sexual health resource needs and preferences for interventions to address unmet needs among female partners of patients with prostate cancer (PCa), given the significant negative impact of PCa on the sexual health of partners. METHODS We conducted an exploratory sequential mixed methods study of female partners recruited from multiple U.S. clinical locations, websites, and support groups for caregivers. We first conducted semistructured in-depth interviews. Qualitative results informed development of a cross-sectional survey, which was administered to a larger sample of partners. RESULTS Overall, 12 and 200 female partners participated in the qualitative and quantitative portions of the study. Major emergent themes from interviews were the benefits and drawbacks of technology-based interventions, the importance of sexual health resources throughout the PCa journey, and a desire for sexual health support groups that include partners. In the survey, the most common sexual health topics that partners wanted more information about were male libido problems (30.0%), erectile dysfunction (26.5%), and female libido and arousal problems (24.5%). Additionally, 41.5% wanted more information about sexual health websites, 35.0% about partners-only support groups, 29.5% about support groups for couples, and 23.5% about sexual medicine specialists. CONCLUSIONS To our knowledge, this is the largest study to date on female partners' unmet sexual health resource needs and preferences for sexual health interventions. Partners prefer technology-based interventions, desire sexual health-focused support groups, and want more information about a variety of sexual issues and specialists who treat them.
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Affiliation(s)
- Natasha Gupta
- Department of Urology and Population Health, New York University and Manhattan Veterans Affairs, New York, NY.
| | - Laura Zebib
- Department of Urology, University of Michigan, Ann Arbor, MI
| | | | - Christian J Nelson
- Department of Psychiatry, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Carolyn A Salter
- Department of Urology, Madigan Army Medical Center, Joint Base Lewis-McChord, WA
| | - John P Mulhall
- Department of Urology, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Nataliya Byrne
- Department of Urology and Population Health, New York University and Manhattan Veterans Affairs, New York, NY
| | - Tatiana Sanchez Nolasco
- Department of Urology and Population Health, New York University and Manhattan Veterans Affairs, New York, NY
| | - Elizabeth Schofield
- Department of Psychiatry, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Stacy Loeb
- Department of Urology and Population Health, New York University and Manhattan Veterans Affairs, New York, NY
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Chen YL, Huang KJ, Scoglio AAJ, Borgogna NC, Potenza MN, Blycker GR, Kraus SW. A Network Comparison of Sexual Dysfunction, Psychological Factors, and Body Dissociation between Individuals with and without Sexual Trauma Histories. J Trauma Dissociation 2024; 25:62-82. [PMID: 37415426 DOI: 10.1080/15299732.2023.2231915] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/20/2022] [Accepted: 05/09/2023] [Indexed: 07/08/2023]
Abstract
Sexual dysfunction is associated with psychological symptoms, including depression and anxiety. Sexual dysfunctions are often attributed to dissociation symptoms in individuals who reported sexual trauma histories. This study utilized a network approach to analyze relationships between sexual and psychological symptoms and examine whether the identified network structures differed between individuals who reported a history of sexual trauma and those who did not. Sexual dysfunction, history of sexual trauma, internalizing symptoms, dissociation symptoms, sex-related shame, and negative body image were assessed in 1,937 United States college students (women = 69.5%). Nearly half (46.8%) of the participants reported a sexual trauma history in their lifetime. Using regularized partial correlation networks, the relationships between sexual and psychological symptoms were analyzed and compared between groups with and without trauma histories. Internalizing symptoms were positively correlated with sexual dysfunction regardless of the presence of sexual trauma history. Anxiety had a stronger influence in the trauma network than in the no-trauma network. Feeling separated from the body during sexual activity was a central symptom and was related to difficulties relaxing and enjoying sex only in the trauma network. Sex-related shame appeared to play a more important role in men compared to women. To improve clinical practice of assessing and treating sexual dysfunction, researchers and clinicians should consider core symptoms that connect different aspects of sexual and psychological functioning while being aware of the unique role of dissociation in the context of traumatic stress.
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Affiliation(s)
- Yen-Ling Chen
- Department of Psychology, University of Nevada, Las Vegas, Nevada, USA
| | - Kuan-Ju Huang
- Graduate School of Human and Environmental Studies, Kyoto University, Kyoto, Japan
| | - Arielle A J Scoglio
- Epidemiology Department, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
- Department of Natural and Applied Sciences, Bentley University, Waltham, Massachusetts, USA
| | - Nicholas C Borgogna
- Department of Psychological Sciences, Texas Tech University, Lubbock, Texas, USA
| | - Marc N Potenza
- Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut, USA
- Child Study Center, Yale University School of Medicine, New Haven, Connecticut, USA
- Connecticut Mental Health Center, New Haven, Connecticut, USA
- Connecticut Council on Problem Gambling, Wethersfield, Connecticut, USA
- Department of Neuroscience, Yale University, New Haven, Connecticut, USA
- Wu Tsai Institute, Yale University, New Haven, Connecticut, USA
| | - Gretchen R Blycker
- Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut, USA
- College of Nursing, University of Rhode Island, Kingston, Rhode Island, USA
| | - Shane W Kraus
- Department of Psychology, University of Nevada, Las Vegas, Nevada, USA
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Rozenberg S, Nappi RE, Schaudig K, Jannini EA, Giraldi AGE. Couplepause: deconstructing sick menopause and andropause during midlife. J Sex Med 2023; 20:1270-1273. [PMID: 37932239 DOI: 10.1093/jsxmed/qdad113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Revised: 08/04/2023] [Accepted: 08/09/2023] [Indexed: 11/08/2023]
Affiliation(s)
- Serge Rozenberg
- Department of Obstetrics and Gynecology, CHU St Pierre, Université libre de Bruxelles and Vrije Universiteit Brussel, Brussel, Belgium
| | - Rossella E Nappi
- Department of Clinical, Surgical, Diagnostic, and Pediatric Sciences, University of Pavia, Pavia, Italy
- Research Center for Reproductive Medicine, Gynecological Endocrinology and Menopause, IRCCS San Matteo Foundation, Pavia, Italy
| | - Katrin Schaudig
- Hormone Hamburg Gynecological Endocrinology, German Menopause Society, Hamburg, Germany
| | | | - Annamaria G E Giraldi
- Department of Clinical Medicine, Copenhagen University Hospital, Copenhagen, 1353, Denmark
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Shemesh B, Opie J, Tsiamis E, Ayton D, Satasivam P, Wilton P, Gough K, Lewis K, O'Brien C, Shub M, Pomery A, Mac Manus C, Millar J, Evans S. Codesigning a patient support portal with health professionals and men with prostate cancer: An action research study. Health Expect 2022; 25:1319-1331. [PMID: 35411697 PMCID: PMC9327875 DOI: 10.1111/hex.13444] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Revised: 12/02/2021] [Accepted: 01/18/2022] [Indexed: 11/29/2022] Open
Abstract
INTRODUCTION The supportive care needs of men with prostate cancer (PCa) have been well documented, but little is known about how an online portal may address these. This study sought to determine priority issues facing men with PCa, barriers and enablers to accessing care and whether health professionals (HPs) and men would support the inclusion of a patient-reported outcome (PRO) comparator tool. METHODS We conducted four online focus groups with HPs recruited from healthcare services in Victoria, followed by seven online codesign workshops with men with PCa, recruited through the Victorian Prostate Cancer Outcomes Registry, Prostate Cancer Foundation Australia and the Cancer Council Victoria. Men were eligible to participate if they had lived experience of PCa and access to the internet. We analysed focus groups thematically. Workshops were analysed using descriptive-content analysis. RESULTS HPs (n = 39) highlighted that men had shifting priorities over time, but noted the importance of providing information to men in lay terms to assist in treatment decision-making and side-effect management. HPs identified key enablers to men accessing support services such as practice nurses, partners and having men share their stories with each other. HPs raised financial, cultural, geographic and emotional barriers to accessing supportive care. Inclusion of a PRO comparator tool received mixed support from HPs, with 41% (n = 16) supportive, 49% (n = 19) unsure and 10% (n = 4) not supportive. Men involved in workshops (n = 28) identified informational needs to assist in treatment decision-making and side-effect management as the top priority throughout care. Men described support groups and practice nurses as key enablers. Short consultation times and complex information were described as barriers. Unlike HPs, all men supported the inclusion of a PRO comparator tool in a portal. CONCLUSIONS Our findings suggest that a patient support portal should provide information in lay terms that address the shifting priorities of men with PCa. Men with PCa would welcome the development of a portal to centralize support information and a PRO comparator tool to prompt health-seeking behaviour. Future research will implement these findings in the development of a portal, and pilot and evaluate the portal within a population-based sample. PATIENT OR PUBLIC CONTRIBUTION This project adopted a codesign approach including both men with PCa and HPs involved in PCa care. Men with PCa also formed part of the study's steering committee and consumer advisory groups. HPs were consulted in a serious of online focus groups. Subsequently, men with PCa and their support persons participated in workshops. Men with PCa were also involved in the preparation of this manuscript.
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Affiliation(s)
- Benjamin Shemesh
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Jacinta Opie
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Ellie Tsiamis
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Darshini Ayton
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Prassannah Satasivam
- Department of Surgery, Northern Health, The University of Melbourne, Melbourne, Victoria, Australia
| | - Paula Wilton
- The Victorian Agency for Health Information (VAHI), Melbourne, Victoria, Australia
| | - Karla Gough
- Health Services Research, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
| | - Katrina Lewis
- Patient Experience and Consumer Participation, Alfred Health, Melbourne, Victoria, Australia
| | - Colin O'Brien
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Max Shub
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | | | | | - Jeremy Millar
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.,Radiation Oncology, Alfred Health, Melbourne, Victoria, Australia
| | - Susan Evans
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.,Cancer Council Victoria, Melbourne, Victoria, Australia
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Bowie J, Brunckhorst O, Stewart R, Dasgupta P, Ahmed K. Body image, self-esteem, and sense of masculinity in patients with prostate cancer: a qualitative meta-synthesis. J Cancer Surviv 2022; 16:95-110. [PMID: 33963973 PMCID: PMC8881246 DOI: 10.1007/s11764-021-01007-9] [Citation(s) in RCA: 26] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2020] [Accepted: 02/17/2021] [Indexed: 11/30/2022]
Abstract
PURPOSE Body image, self-esteem, and masculinity are three interconnected constructs in men with prostate cancer, with profound effects on quality of life. This meta-synthesis aimed to evaluate all known qualitative studies published studying the effect of prostate cancer on these constructs. METHODS A systematic review utilising PubMed, Embase, MEDLINE, and PsycINFO databases up to May 2020 was conducted in line with PRISMA and ENTREQ guidelines. All qualitative studies of men's experiences with body image, self-esteem, and masculinity whilst living with prostate cancer were included. A thematic meta-synthesis was conducted to identify emergent descriptive and analytical themes under the main study constructs. RESULTS Of 2188 articles identified, 68 were included. Eight descriptive themes were identified under two analytical themes: 'Becoming a Prostate Cancer Patient' and 'Becoming a Prostate Cancer Survivor'. These described the distress caused by changes to body image, sexual functioning, sense of masculinity, and self-esteem, and the subsequent discourses men engaged with to cope with and manage their disease. A key element was increased flexibility in masculinity definitions, and finding other ways to re-affirm masculinity. CONCLUSIONS Prostate cancer has an important effect on men's health post-diagnosis, and we identified strong relationships between each construct evaluated. The role of hegemonic masculinity is important when considering men's coping mechanisms and is also a key factor when addressing these constructs in counselling post-treatment. IMPLICATIONS FOR CANCER SURVIVORS This meta-synthesis provides key topics that uniquely affect prostate cancer survivors, enabling these patients to be effectively counselled, and have their concerns recognised by clinicians.
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Affiliation(s)
- Jessica Bowie
- MRC Centre for Transplantation, Guy's Hospital Campus, King's College London, King's Health Partners, London, UK
| | - Oliver Brunckhorst
- MRC Centre for Transplantation, Guy's Hospital Campus, King's College London, King's Health Partners, London, UK
| | - Robert Stewart
- King's College London Institute of Psychiatry, Psychology and Neuroscience, London, UK
- South London and Maudsley NHS Foundation Trust, London, UK
| | - Prokar Dasgupta
- MRC Centre for Transplantation, Guy's Hospital Campus, King's College London, King's Health Partners, London, UK
| | - Kamran Ahmed
- MRC Centre for Transplantation, Guy's Hospital Campus, King's College London, King's Health Partners, London, UK.
- Department of Urology, King's College Hospital, London, UK.
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Prashar J, Schartau P, Murray E. Supportive care needs of men with prostate cancer: A systematic review update. Eur J Cancer Care (Engl) 2022; 31:e13541. [PMID: 35038783 PMCID: PMC9285340 DOI: 10.1111/ecc.13541] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Revised: 11/05/2021] [Accepted: 12/02/2021] [Indexed: 01/16/2023]
Abstract
BACKGROUND Prostate cancer is highly prevalent and impacts profoundly on patients' quality of life, leading to a range of supportive care needs. METHODS An updated systematic review and thematic synthesis of qualitative data using the Preferred Reporting Items for Systematic Reviews (PRISMA) reporting guidelines, to explore prostate cancer patients' experience of, and need for, supportive care. Five databases (Medline, Embase, PsycInfo, Emcare and ASSIA) were searched; extracted data were synthesised using Corbin and Strauss's 'Three Lines of Work' framework. RESULTS Searches identified 2091 citations, of which 105 were included. Overarching themes emerged under the headings of illness, everyday life and biographical work. Illness work needs include consistency and continuity of information, tailored to ethnicity, age and sexual orientation. Biographical work focused on a desire to preserve identity in the context of damaging sexual side effects. Everyday life needs centred around exercise and diet support and supportive relationships with partners and peers. Work-related issues were highlighted specifically by younger patients, whereas gay and bisexual men emphasised a lack of specialised support. CONCLUSION While demonstrating some overarching needs common to most patients with prostate cancer, this review offers novel insight into the unique experiences and needs of men of different demographic backgrounds, which will enable clinicians to deliver individually tailored supportive care.
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Affiliation(s)
- Jai Prashar
- Research Department of Primary Care and Population Health, Royal Free Hospital, University College London, London, UK
| | - Patricia Schartau
- Research Department of Primary Care and Population Health, Royal Free Hospital, University College London, London, UK
| | - Elizabeth Murray
- Research Department of Primary Care and Population Health, Royal Free Hospital, University College London, London, UK
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Barriers and Facilitators to Supportive Care Implementation in Advanced Disease Prostate Cancer Survivors: A Theory-Informed Scoping Review. Cancer Nurs 2022; 45:E782-E800. [PMID: 35025769 DOI: 10.1097/ncc.0000000000001051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Individualized supportive care is recommended to manage the debilitating effects of advanced prostate cancer and its treatments. Yet, the implementation of supportive care in practice remains inconsistent. OBJECTIVE The aim of this study was to synthesize the barriers and facilitators to implementing supportive care interventions after identifying supportive care interventions for advanced prostate cancer survivors. METHODS PubMed, SCOPUS, CINAHL Complete, ProQuest, and PsycINFO were searched for relevant studies published between 2011 and 2020. Studies were included if they reported on a supportive care intervention and included a description of implementation barriers and/or facilitators. The Theoretical Domains Framework was used to characterize implementation barriers and facilitators. RESULTS Of the 620 articles identified, 13 met all prespecified inclusion criteria. Primary barriers were related to the domains of environmental context and resources (eg, limited resources), knowledge (eg, insufficient knowledge on efficacy of supportive care), and beliefs about capabilities (eg, lack of confidence in materials). Facilitators fell under environmental context and resources (partnerships with local services), reinforcement (eg, partners inclusion), and skills (eg, delivery by professionals). CONCLUSIONS This scoping review highlights barriers and facilitators that affect supportive care implementation. Future research that focuses on overcoming barriers and maximizing facilitators is needed to improve, modify, or supplement existing supportive care implementation practices. IMPLICATIONS FOR PRACTICE As the number of advanced prostate cancer survivors continues to increase, supportive care must become the standard of care. Future interventions must incorporate increased knowledge and funding, alternative delivery models, and consistent use of specialty nurses.
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Testosterone replacement therapy in the era of telemedicine. Int J Impot Res 2022; 34:663-668. [PMID: 34799712 PMCID: PMC8604198 DOI: 10.1038/s41443-021-00498-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Revised: 10/26/2021] [Accepted: 11/05/2021] [Indexed: 11/18/2022]
Abstract
The events of the 2019 SARS-CoV2 virus pandemic have all but ensured that telemedicine will remain an important aspect of patient care delivery. As health technologies evolve, so must physician practices. Currently, there is limited data on the management of testosterone replacement therapy (TRT) in the era of telemedicine. This review aims to explore the potential benefits and pitfalls of TRT management via telemedicine. We also propose a theoretical framework for TRT management via telemedicine. Telemedicine provides patients and physicians with a new mechanism for American Urological Association guideline-concordant TRT management that can increase patient access to care and provide a safe space for men who may otherwise not have been comfortable with in-person evaluation. However, there are significant limitations to the use of telemedicine for the management of TRT, including the inability to perform a physical exam, inability to administer specific medications, technological barriers, data security, and medical-legal considerations, and both patients and providers should engage in shared decision making before pursuing this approach. Understanding and acknowledging the potential pitfalls of telemedicine for TRT management will enable both patients and providers to achieve optimal outcomes and satisfaction.
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Beliefs and Experiences of Individuals Following a Zero-Carb Diet. Behav Sci (Basel) 2021; 11:bs11120161. [PMID: 34940096 PMCID: PMC8699012 DOI: 10.3390/bs11120161] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2021] [Revised: 11/09/2021] [Accepted: 11/19/2021] [Indexed: 01/31/2023] Open
Abstract
The adoption of carbohydrate-restrictive diets to improve health is increasing in popularity, but there is a dearth of research on individuals who choose to severely restrict or entirely exclude carbohydrates. The present study investigated the beliefs and experiences of individuals following a diet that severely limits, or entirely excludes, dietary carbohydrates, colloquially known as a ‘zero-carb’ diet, for at least 6 months. Zero-carb dieters (n = 170) recruited via a social networking site completed an online qualitative survey prompting them to discuss their motives, rationale, and experiences of following a low-carb diet. Transcripts of participants’ responses were analyzed using inductive thematic analysis. Results revealed that participants’ decision to follow a zero-carb diet was driven by health concerns and benefits. Participants expressed a strong social identity and belongingness to online zero-carb communities. Participants reported strong intentions to follow the diet indefinitely. Shortcomings of the diet centered on experienced stigma; lack of support from healthcare providers and significant others; limited access to, and high cost of, foods; and limited scientific data on the diet. Further research into the benefits and shortcomings of zero-carb diets across settings and populations is warranted, and guidelines for healthcare professionals on how to support individuals following a zero-carb diet are needed.
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Popovac M, Roomaney R. Measuring online health-seeking behaviour: Construction and initial validation of a new scale. Br J Health Psychol 2021; 27:756-776. [PMID: 34747092 DOI: 10.1111/bjhp.12571] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2020] [Revised: 09/30/2021] [Accepted: 09/22/2021] [Indexed: 11/27/2022]
Abstract
OBJECTIVES Online health-seeking behaviour (OHSB) such as information- and support-seeking encompasses a range of motivations and outcomes, but few studies consider the nuances of OHSB. The current study aimed to (1) develop and provide an initial validation of an OHSB measure, and (2) explore the role of demographic variables in OHSB among adult Internet users. DESIGN The study was a quantitative, cross-sectional online survey. METHODS The study consistent of two data collection waves, including 451 general Internet users (aged 18-73) and 204 online health groups users (aged 19-78) who completed online questionnaires. RESULT Exploratory Factor Analysis and Item Analysis in the two samples resulted in a final 37-item measure. The scale comprises three distinct factors: Support seeking (α = .97); information seeking (α = .89); and the Internet as a supplement or alternative to offline medical care (α = .88). Multiple regression analyses indicated that younger age, a higher number of people living in the household, and presence of a chronic condition significantly predicted all three aspects of OHSB. Poorer perceived health also predicted support-seeking online, while being male, employed and a general Internet user (vs. online health group member) also predicted using the Internet as a supplement or alternative to offline medical care. CONCLUSION The study presents a useful scale for future research to explore more complex psychosocial, contextual and health-related variables as potential contributors to health-seeking in the online domain.
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Affiliation(s)
- Maša Popovac
- School of Psychology, University of Buckingham, UK
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Ezenwankwo EF, Oladoyimbo CA, Dogo HM, Idowu AA, Alabi AO, Oyelekan A, Ajayi AO, Ogo CN, Mbadiwe O, Nwadilibe IB, Rivers B, Kaninjing E. Factors Influencing Help-Seeking Behavior in Men with Symptoms of Prostate Cancer: A Qualitative Study Using an Ecological Perspective. Cancer Invest 2021; 39:529-538. [PMID: 34014791 DOI: 10.1080/07357907.2021.1933009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
This qualitative study explored factors that could potentially influence help-seeking in men with symptoms of prostate cancer in Nigeria. A face-to-face interview was conducted with 27 men, between 54 and 84 years, diagnosed with prostate cancer ≤ 2 years prior to the interview. Data were analyzed using thematic framework approach. Several factors were identified and further captured as intrapersonal, interpersonal, and institutional/community level factors using an ecological perspective. These factors interact to impact negatively on the help-seeking behavior of men with symptoms of prostate cancer. These findings support the formulation of public health strategies to improve men's help-seeking behavior in Nigeria.
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Affiliation(s)
| | | | - Hassan Mohammed Dogo
- Department of Surgery, Urology Division, University of Maiduguri, Maiduguri, Nigeria
| | - Ademola Amos Idowu
- Department of Chemical Pathology, Ekiti State University College of Medicine, Ado-Ekiti, Nigeria
| | - Adewumi Olabimpe Alabi
- Department of Radiotherapy and Oncology, Lagos University Teaching Hospital, Idi-araba, Lagos, Nigeria
| | - Abimbola Oyelekan
- Department of Surgery, Olabisi Onabanjo University Teaching Hospital, Sagamu, Nigeria
| | | | | | - Okezie Mbadiwe
- Department of Surgery, College of Medicine, University of Nigeria, Enugu, Nigeria
| | | | - Brian Rivers
- Department of Community Health and Preventive Medicine, Morehouse School of Medicine, Atlanta, GA, USA
| | - Ernie Kaninjing
- School of Health and Human Performance, Georgia College and State University, Milledgeville, GA, USA
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Lyu X, Liu Y, Yu H, Mi M, Shang L, Zhong Y, Xie D. Development and validation of a risk perception scale of medical help-seeking behavior in Chinese adults. ANNALS OF TRANSLATIONAL MEDICINE 2020; 8:1352. [PMID: 33313097 PMCID: PMC7723601 DOI: 10.21037/atm-20-1656] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/17/2020] [Accepted: 09/18/2020] [Indexed: 12/13/2022]
Abstract
BACKGROUND When people require medical treatment, many risk factors including adverse medical events, economic burdens, and social-psychological consequences may contribute to their hesitation to seek medical help. Therefore, a reliable and valid instrument that can comprehensively assess the risk perception of medical help-seeking behavior among ordinary Chinese adults should be developed. METHODS The basic dimensions of the scale were determined based on literature review and in-depth interviews with patients. Then, an item pool with 32 items and six dimensions was developed. After the item reduction process based on item and factor analyses, a three-factor, 16-item scale was established. From March 2019, this scale was distributed among 639 healthy adults, outpatients, or inpatients in 20 provinces and municipalities in the mainland of China by convenience sampling. Then, the reliability and validity of the scale were examined. RESULTS The scale consists of three dimensions (treatment risks, burden risks, and stigma risks) and 16 items. The root-mean-square error of approximation, comparative fit index, and Tucker-Lewis index of this model were 0.069, 0.925, and 0.910, respectively. The internal consistency reliability of the scale was 0.893, and the test-retest reliability was 0.784. The criterion-related validity was 0.720 (P<0.01). CONCLUSIONS The risk perception scale of medical help-seeking behavior is a reliable and valid instrument to measure Chinese adults' perception for potential risks in the process of medical treatment.
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Affiliation(s)
- Xiaokang Lyu
- Computational Social Science Laboratory, Nankai University, Tianjin, China
- Department of Social Psychology, Zhou Enlai School of Government, Nankai University, Tianjin, China
| | - Ying Liu
- Department of Social Psychology, Zhou Enlai School of Government, Nankai University, Tianjin, China
| | - Huaran Yu
- Department of Social Psychology, Zhou Enlai School of Government, Nankai University, Tianjin, China
| | - Mingdi Mi
- Department of Social Psychology, Zhou Enlai School of Government, Nankai University, Tianjin, China
| | - Lijun Shang
- Computational Social Science Laboratory, Nankai University, Tianjin, China
| | - Yifan Zhong
- Department of Thoracic Surgery, Shanghai Pulmonary Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Dong Xie
- Department of Thoracic Surgery, Shanghai Pulmonary Hospital, School of Medicine, Tongji University, Shanghai, China
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Effects of exercise interventions on social and cognitive functioning of men with prostate cancer: a meta-analysis. Support Care Cancer 2020; 28:2043-2057. [DOI: 10.1007/s00520-019-05278-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2019] [Accepted: 12/23/2019] [Indexed: 12/24/2022]
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15
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Araújo JS, Conceição VMD, Zago MMF. Transitory masculinities in the context of being sick with prostate cancer. Rev Lat Am Enfermagem 2019; 27:e3224. [PMID: 31826165 PMCID: PMC6896817 DOI: 10.1590/1518-8345.3248.3224] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2019] [Accepted: 09/07/2019] [Indexed: 01/06/2023] Open
Abstract
Objective: to interpret the meanings attributed by men with prostate cancer to the experience regarding their bodies and masculinities during illness. Method: ethnographic research with 17 men, guided by the narrative method and theoretical framework of medical anthropology and masculinities. The information was collected through recorded interviews, direct observation and field diary records, which were analyzed by inductive thematic analysis. Results: men undergo body and identity transformations when they get sick with prostate cancer, transiting through multiple masculinities, resigning their actions, and occupying subordinate positions in relation to other healthy bodies, which are marginalized in their social relationships and allied with regard to establishing their affective relationships. Conclusion: this evidence enhances and deepens the knowledge disclosed in the literature and contributes to the strengthening of nursing care actions when dealing with the sick.
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Affiliation(s)
- Jeferson Santos Araújo
- Universidade Federal do Sul e Sudeste do Pará, Faculdade de Saúde Coletiva, Marabá, PA, Brazil
| | | | - Marcia Maria Fontão Zago
- Universidade de São Paulo, Escola de Enfermagem de Ribeirão Preto, PAHO/WHO Collaborating Centre for Nursing Research Development, Ribeirão Preto, SP, Brazil
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16
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Rubach A, Balasubramaniam K, Elnegaard S, Larsen SE, Jarbøl DE. Barriers to health care seeking with bothersome lower urinary tract symptoms among men-a nationwide study. Fam Pract 2019; 36:743-750. [PMID: 31038698 DOI: 10.1093/fampra/cmz019] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND The majority of men who report urological symptoms of extreme concern or influence on daily activities do not contact their general practitioner (GP). No previous study on barriers to health care seeking with lower urinary tract symptoms in men has been carried out in a population-based setting. OBJECTIVES (i) To examine associations between different types of lower urinary tract symptoms and barriers to contact a GP in men with urological symptoms reported to be of concern or influencing daily activity (termed 'bothersome'); (ii) to examine associations between age and barriers to health care seeking in men with bothersome lower urinary tract symptoms. STUDY DESIGN A population-based cross-sectional study design. METHODS A total of 48 910 men aged 20 or older were randomly selected from the general Danish population. Data was collected in 2012. Logistic regression was used to calculate odds ratios for reporting different barriers to health care seeking with bothersome lower urinary tract symptoms according to age and urological symptom. RESULTS A total of 23 240 men participated. Among men aged 20-39 years who reported bothersome lower urinary tract symptoms, the proportion who did not contact their GP ranged from 73.4% (incontinence) to 84.5% (nocturia). Men younger than 60 years of age had significantly higher odds for reporting any barriers to health care seeking compared to older men. The odds for reporting each of the barriers differed significantly according to the different urological symptoms. CONCLUSION Younger men more often report barriers to health care seeking, but the barriers differ between the different urological symptoms.
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Affiliation(s)
- Ann Rubach
- Research Unit of General Practice, Department of Public Health, University of Southern Denmark, Odense C, Denmark
| | - Kirubakaran Balasubramaniam
- Research Unit of General Practice, Department of Public Health, University of Southern Denmark, Odense C, Denmark
| | - Sandra Elnegaard
- Research Unit of General Practice, Department of Public Health, University of Southern Denmark, Odense C, Denmark
| | - Stine E Larsen
- Research Unit of General Practice, Department of Public Health, University of Southern Denmark, Odense C, Denmark
| | - Dorte E Jarbøl
- Research Unit of General Practice, Department of Public Health, University of Southern Denmark, Odense C, Denmark
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Lemanska A, Poole K, Griffin BA, Manders R, Saxton JM, Turner L, Wainwright J, Faithfull S. Community pharmacy lifestyle intervention to increase physical activity and improve cardiovascular health of men with prostate cancer: a phase II feasibility study. BMJ Open 2019; 9:e025114. [PMID: 31186245 PMCID: PMC6585832 DOI: 10.1136/bmjopen-2018-025114] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
OBJECTIVES To assess the feasibility and acceptability of a community pharmacy lifestyle intervention to improve physical activity and cardiovascular health of men with prostate cancer. To refine the intervention. DESIGN Phase II feasibility study of a complex intervention. SETTING Nine community pharmacies in the UK. INTERVENTION Community pharmacy teams were trained to deliver a health assessment including fitness, strength and anthropometric measures. A computer algorithm generated a personalised lifestyle prescription for a home-based programme accompanied by supporting resources. The health assessment was repeated 12 weeks later and support phone calls were provided at weeks 1 and 6. PARTICIPANTS 116 men who completed treatment for prostate cancer. OUTCOME MEASURES The feasibility and acceptability of the intervention and the delivery model were assessed by evaluating study processes (rate of participant recruitment, consent, retention and adverse events), by analysing delivery data and semi-structured interviews with participants and by focus groups with pharmacy teams. Physical activity (measured with accelerometry at baseline, 3 and 6 months) and patient reported outcomes (activation, dietary intake and quality of life) were evaluated. Change in physical activity was used to inform the sample size calculations for a future trial. RESULTS Out of 403 invited men, 172 (43%) responded and 116 (29%) participated. Of these, 99 (85%) completed the intervention and 88 (76%) completed the 6-month follow-up (attrition 24%). Certain components of the intervention were feasible and acceptable (eg, community pharmacy delivery), while others were more challenging (eg, fitness assessment) and will be refined for future studies. By 3 months, moderate to vigorous physical activity increased on average by 34 min (95% CI 6 to 62, p=0.018), but this was not sustained over 6 months. CONCLUSIONS The community pharmacy intervention was feasible and acceptable. Results are encouraging and warrant a definitive trial to assess the effectiveness of the refined intervention.
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Affiliation(s)
- Agnieszka Lemanska
- School of Health Sciences, Faculty of Health and Medical Sciences, University of Surrey, Guildford, UK
| | - Karen Poole
- School of Health Sciences, Faculty of Health and Medical Sciences, University of Surrey, Guildford, UK
| | - Bruce A Griffin
- Department of Nutritional Sciences, Faculty of Health and Medical Sciences, University of Surrey, Guildford, UK
| | - Ralph Manders
- School of Biosciences and Medicine, Faculty of Health and Medical Sciences, University of Surrey, Guildford, UK
| | - John M Saxton
- Department of Sport, Exercise and Rehabilitation, Northumbria University, Newcastle upon Tyne, UK
| | | | - Joe Wainwright
- Surrey Human Performance Institute, University of Surrey, Guildford, UK
| | - Sara Faithfull
- School of Health Sciences, Faculty of Health and Medical Sciences, University of Surrey, Guildford, UK
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van Ee I, Hagedoorn M, Smits C, Kamper A, Honkoop H, Slaets J. This is an older men's world: A qualitative study of men's experiences with prostate cancer. Eur J Oncol Nurs 2018; 37:56-64. [DOI: 10.1016/j.ejon.2018.11.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2018] [Revised: 09/26/2018] [Accepted: 11/02/2018] [Indexed: 12/20/2022]
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Noble‐Jones R, Thomas MJ, Bose P. The Lymphoedema Genitourinary Cancer Questionnaire in urology follow‐up clinics. INTERNATIONAL JOURNAL OF UROLOGICAL NURSING 2018. [DOI: 10.1111/ijun.12174] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
| | - Melanie J. Thomas
- National Lead for Lymphoedema WalesAbertawe Bro Morgannwg University Health Board (ABMUHB) Port Talbot UK
| | - Pradeep Bose
- Swansea NHS TrustAbertawe Bro Morgannwg University Health Board (ABMUHB) Port Talbot UK
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