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Haraldsson J, Johnsson L, Tindberg Y, Kristiansson P, Nordgren L. They are my worries, so it's me the doctor should listen to-adolescent males' experiences of consultations with general practitioners. BMC PRIMARY CARE 2024; 25:169. [PMID: 38760699 PMCID: PMC11102250 DOI: 10.1186/s12875-024-02431-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/10/2023] [Accepted: 05/13/2024] [Indexed: 05/19/2024]
Abstract
BACKGROUND Many adolescent males visit a general practitioner regularly, yet many report unmet health needs and negative experiences. This indicates a gap between provided healthcare and the needs of adolescent males. In order to improve adolescent males' possibilities to discuss their health concerns with general practitioners, the study's aim was to explore and describe how adolescent males understand and assign meaning to their experiences of consultations with general practitioners. METHODS This qualitative study was conducted at two healthcare centres in mid-Sweden in 2022. Nine males 15 to 19 years old described their experiences in semi-structured interviews immediately after consulting a general practitioner, regardless of reason for the consultation and whether or not accompanied by a parent. The analysis was guided by thematic analysis according to Braun & Clarke and reflective lifeworld theory's concepts of openness and sensitivity. RESULTS One overarching theme, To be listened to, and three themes were developed: To handle insecurity and uneasiness, To be understood and cared for, and To get parental support on his terms. In a good appointment, the general practitioner cares about him, listens attentively, and takes him seriously. More importantly, the general practitioner's understanding permeates the consultation, so that all aspects of it is adapted to him. The adolescent males doubted their ability to express themselves and to understand what would happen in the consultation, and therefore feared being dismissed without receiving any help. Such difficulties may be due to unfinished neurocognitive development and inexperience. They struggled with embarrassment, partly due to notions of masculinity, and strived to balance their needs of parental support, privacy, and being the one that the doctor listens to. CONCLUSIONS We argue that adolescent males are particularly vulnerable due to on-going neurocognitive and emotional development, inexperience, and notions of masculinity. However, good experiences can be generated through rather simple means. Adolescent males need individual adaptations demonstrating that they are cared for, understood and taken seriously. Furthermore, they need an unhurried pace to facilitate understanding, verbal affirmations to mitigate embarrassment, and help in navigating parental involvement.
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Affiliation(s)
- Johanna Haraldsson
- Department of Public Health and Caring Sciences/Family Medicine and Preventive Medicine, Uppsala University, Box 564, SE-751 22, Uppsala, Sweden.
- Centre for Clinical Research Sörmland / Uppsala University, Mälarsjukhuset, SE-631 88, Eskilstuna, Sweden.
| | - Linus Johnsson
- Centre for Clinical Research Sörmland / Uppsala University, Mälarsjukhuset, SE-631 88, Eskilstuna, Sweden
- Centre for Research Ethics & Bioethics, Uppsala University, Box 564, Uppsala, SE-751 22, Sweden
| | - Ylva Tindberg
- Centre for Clinical Research Sörmland / Uppsala University, Mälarsjukhuset, SE-631 88, Eskilstuna, Sweden
- Department of Women's and Children's Health, Uppsala University, Akademiska sjukhuset, SE-751 85, Uppsala, Sweden
| | - Per Kristiansson
- Department of Public Health and Caring Sciences/Family Medicine and Preventive Medicine, Uppsala University, Box 564, SE-751 22, Uppsala, Sweden
| | - Lena Nordgren
- Department of Public Health and Caring Sciences/Family Medicine and Preventive Medicine, Uppsala University, Box 564, SE-751 22, Uppsala, Sweden
- Centre for Clinical Research Sörmland / Uppsala University, Mälarsjukhuset, SE-631 88, Eskilstuna, Sweden
- Department of Public Health and Caring Sciences/Caring Sciences, Uppsala University, Box 564, SE-751 22, Uppsala, Sweden
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Oliffe JL. Connecting Masculinities to Men's Illness Vulnerabilities and Resilience. QUALITATIVE HEALTH RESEARCH 2023; 33:1322-1332. [PMID: 37902085 PMCID: PMC10666520 DOI: 10.1177/10497323231198967] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/31/2023]
Abstract
Men's illness vulnerabilities and resilience are two predominant and regularly linked constructs in the masculinities and men's health literature. There has been a steady stream of men's strength-based vulnerabilities in the form of illness testimonials amid critiques that such disclosures are mere props for bolstering patriarchal power. The current article presents secondary analyses of case studies with four participants who took part in wide-ranging qualitative health studies to detail diverse connections between masculinities and men's illness vulnerabilities and resilience. Prostate cancer-related vulnerabilities feature in the first case study where Arthur's resilience for reclaiming his erectile function post-prostatectomy mobilizes an objection masculinity contesting his marginality. In the second case study, Chuck's vulnerabilities are conceded as permanent flowing from his severe mental illness, a positionality situating resilience as obligatory for his survival. Here, Chuck embodies a resignate masculinity that accepts but works to manage the harms of his subordinate status. In the aftermath of his young son's suicide, Jack laments that he did not model vulnerabilities. Resilience for understanding his loss influences a reimagined masculinity where Jack contemplates changes to gender norms for his and other men's lives. Lastly, Sami replaces maladaptive actions for dousing vulnerabilities incurred through a partner-initiated separation with resilience for self-growth. Aspiring progress masculinity, Sami deconstructs his emotions and behaviors to positively change how he shows up as a man, father, and partner. The case studies reveal connections between objection, resignate, reimagined, and progress masculinities and men's illness vulnerabilities and resilience to advance empirical, gender theory and methodological insights.
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Affiliation(s)
- John L. Oliffe
- School of Nursing, University of British Columbia, Vancouver, BC, Canada
- Department of Nursing, The University of Melbourne, Parkville, VIC, Australia
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3
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Robson M, Riley S, Gagen E, McKeogh D. Love and lifestyle: how 'relational healthism' structures couples' talk of engagement with lifestyle advice associated with a new diagnosis of coronary heart disease. Psychol Health 2023; 38:1606-1622. [PMID: 35187996 DOI: 10.1080/08870446.2022.2033240] [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: 06/26/2021] [Revised: 12/17/2021] [Accepted: 01/11/2022] [Indexed: 10/19/2022]
Abstract
OBJECTIVES Healthy lifestyle change improves outcomes in coronary heart disease (CHD), but is rarely sustained. To better understand barriers to lifestyle change, we examined couples' talk of engaging with lifestyle advice after one partner receives a diagnosis of CHD. DESIGN A longitudinal qualitative design, in which a poststructuralist discourse analysis was performed on 35 interviews, conducted with 22 heterosexual British people in a long term relationship. The interviews occurred over three months after one partner was referred to a cardiac rehabilitation programme designed to support lifestyle change. RESULTS Couples understood their health as a shared practice underpinned by an ideological framework of healthism, creating a form of 'relational healthism'. Practicing relational healthism was not straightforward because the practices of surveillance, control, and discipline related to healthism often contravened relationship norms of support, acceptance and respect for the other's autonomy. Couples struggled to resolve this tension, dynamically adopting, resisting, and occasionally transforming discourses of health and love in ways that worked for and against engagement in lifestyle change. CONCLUSION In foregrounding the discursive and relational contexts of behavioural change engagement, we show the considerable complexity for couples, including costs related to engagement with lifestyle advice.
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Affiliation(s)
- Martine Robson
- Department of Psychology, Aberystwyth University, Aberystwyth, UK
| | - Sarah Riley
- School of Psychology, Massey University, Palmerston North, New Zealand
| | - Elizabeth Gagen
- Department of Geography, Aberystwyth University, Aberystwyth, UK
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Matheson FI, McLuhan A, Croxford R, Hahmann T, Ferguson M, Mejia-Lancheros C. Health status and health-care utilization among men recently released from a superjail: a matched prospective cohort study. Int J Prison Health 2023; ahead-of-print. [PMID: 37658480 DOI: 10.1108/ijph-01-2023-0004] [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] [Indexed: 09/03/2023]
Abstract
PURPOSE Continuity of care and access to primary care have been identified as important contributors to improved health outcomes and reduced reincarceration among people who are justice-involved. While the disproportionate burden of health concerns among incarcerated populations is well documented, less is known about their health service utilization, limiting the potential for effective improvements to current policy and practice. This study aims to examine health status and health care utilization among men recently released from a superjail in a large metropolitan area to better understand patterns of use, risk factors and facilitators. DESIGN/METHODOLOGY/APPROACH Participants included adult men (n = 106) matched to a general population group (n = 530) in Ontario, Canada, linked to medical records (88.5% linkage) to examine baseline health status and health utilization three-months post-release. The authors compared differences between the groups in baseline health conditions and estimated the risk of emergency department, primary care, inpatient hospitalization and specialist ambulatory care visits. FINDINGS Superjail participants had a significantly higher prevalence of respiratory conditions, mental illness, substance use and injuries. Substance use was a significant risk factor for all types of visits and emergency department visits were over three times higher among superjail participants. ORIGINALITY/VALUE This empirical case is illustrative of an emerging phenomenon in some regions of the world where emergency departments serve as de facto "walk-in clinics" for those with criminal justice involvement. Strategic approaches to health services are required to meet the complex social and health needs and disparities in access to care experienced by men released from custody.
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Affiliation(s)
- Flora I Matheson
- MAP Centre for Urban Health Solutions, St. Michael's Hospital, Unity Health Toronto, Toronto, Canada; ICES, Toronto, Canada and Dalla Lana School of Public Health and Centre for Criminology and Socio-Legal Studies, University of Toronto, Toronto, Canada
| | - Arthur McLuhan
- MAP Centre for Urban Health Solutions, St. Michael's Hospital, Unity Health Toronto, Toronto, Canada
| | | | - Tara Hahmann
- MAP Centre for Urban Health Solutions, St. Michael's Hospital, Unity Health Toronto, Toronto, Canada
| | - Max Ferguson
- MAP Centre for Urban Health Solutions, St. Michael's Hospital, Unity Health Toronto, Toronto, Canada
| | - Cilia Mejia-Lancheros
- MAP Centre for Urban Health Solutions, St. Michael's Hospital, Unity Health Toronto, Toronto, Canada
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Bruno RM, Varbiro S, Pucci G, Nemcsik J, Lønnebakken MT, Kublickiene K, Schluchter H, Park C, Mozos I, Guala A, Hametner B, Seeland U, Boutouyrie P. Vascular function in hypertension: does gender dimension matter? J Hum Hypertens 2023; 37:634-643. [PMID: 37061653 DOI: 10.1038/s41371-023-00826-w] [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: 07/28/2022] [Revised: 02/27/2023] [Accepted: 03/27/2023] [Indexed: 04/17/2023]
Abstract
Blood pressure and vascular ageing trajectories differ between men and women. These differences develop due to sex-related factors, attributable to sex chromosomes or sex hormones, and due to gender-related factors, mainly related to different sociocultural behaviors. The present review summarizes the relevant facts regarding gender-related differences in vascular function in hypertension. Among sex-related factors, endogenous 17ß-estradiol plays a key role in protecting pre-menopausal women from vascular ageing. However, as vascular ageing (preceding and inducing hypertension) has a steeper increase in women than in men starting already from the third decade, it is likely that gender-related factors play a prominent role, especially in the young. Among gender-related factors, psychological stress (including that one related to gender-based violence and discrimination), depression, some psychological traits, but also low socioeconomic status, are more common in women than men, and their impact on vascular ageing is likely to be greater in women. Men, on the contrary, are more exposed to the vascular adverse consequences of alcohol consumption, as well as of social deprivation, while "toxic masculinity" traits may result in lower adherence to lifestyle and preventive strategies. Unhealthy diet habits are more prevalent in men and smoking is equally prevalent in the two sexes, but have a disproportional negative effect on women's vascular health. In conclusion, given the major and complex role of gender-related factors in driving vascular alterations and blood pressure patterns, gender dimension should be systematically integrated into future research on vascular function and hypertension and to tailor cardiovascular prevention strategies.
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Affiliation(s)
- Rosa-Maria Bruno
- Université Paris Cité, Inserm, PARCC, F-75015, Paris, France.
- Pharmacology Unit, Hôpital Européen Georges Pompidou, Paris, France.
| | - Szabolcs Varbiro
- Workgroup for Science Management, Doctoral School, Semmelweis University, Budapest, Hungary
- Department of Obstetrics and Gynecology, Faculty of Medicine, Semmelweis University, Budapest, Hungary
| | - Giacomo Pucci
- Internal Medicine Unit, "Santa Maria" Terni Hospital and Department of Medicine and Surgery-University of Perugia, Perugia, Italy
| | - János Nemcsik
- Department of Family Medicine and Health Service of Zuglo (ZESZ), Semmelweis University, Budapest, Hungary
| | - Mai Tone Lønnebakken
- Department of Clinical Science, University of Bergen, Bergen, Norway
- Department of Heart Disease, Haukeland University Hospital, Bergen, Norway
| | - Karolina Kublickiene
- Institution for Clinical Science, Intervention and Technology, Department of Renal Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Helena Schluchter
- Department of Anesthesiology, Heidelberg University Hospital, Heidelberg, Germany
| | - Chloe Park
- MRC Unit for Lifelong Health and Ageing at UCL, UCL Institute of Cardiovascular Science, University College London, London, UK
| | - Ioana Mozos
- Department of Functional Sciences-Pathophysiology, Center for Translational Research and Systems Medicine, "Victor Babes" University of Medicine and Pharmacy, Timisoara, Romania
| | - Andrea Guala
- Vall d'Hebron Institut de Recerca (VHIR), Barcelona, Spain
- CIBER-CV, Instituto de Salud Carlos III, Madrid, Spain
| | - Bernhard Hametner
- AIT Austrian Institute of Technology, Center for Health & Bioresources, Vienna, Austria
| | - Ute Seeland
- Institute of Social Medicine, Epidemiology and Health Economics, Charité-Universitaetsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Pierre Boutouyrie
- Université Paris Cité, Inserm, PARCC, F-75015, Paris, France
- Pharmacology Unit, Hôpital Européen Georges Pompidou, Paris, France
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Butsang T, McLuhan A, Keown LA, Fung K, Matheson FI. Sex differences in pre-incarceration mental illness, substance use, injury and sexually transmitted infections and health service utilization: a longitudinal linkage study of people serving federal sentences in Ontario. HEALTH & JUSTICE 2023; 11:19. [PMID: 37004620 PMCID: PMC10067244 DOI: 10.1186/s40352-023-00218-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Accepted: 03/09/2023] [Indexed: 06/19/2023]
Abstract
BACKGROUND People who experience incarceration have poorer health than the general population. Yet, we know little about the health and health service utilization of people during the critical period prior to their incarceration, relative to during incarceration and post-release. In this study, we conducted a longitudinal cohort study of 39,498 adults in Ontario, Canada between January 1, 2002, and December 31, 2011 using linked administrative health and correctional data to describe mental illness, substance use, injury, sexually transmitted infections and health service utilization of men and women in federal prisons in the 3 years prior to their incarceration, compared to a matched group. RESULTS We found that, in the 3-year period prior to their incarceration, men (n = 6,134) and women (n = 449) experiencing their first federal sentence had poorer health across all indicators examined (e.g., psychosis, drug/alcohol use, and self-harm) and higher outpatient psychiatric and emergency department visits, compared with the matched group. Women in the pre-incarceration group exhibited a higher prevalence of self-harm and substance use, relative to women in the matched comparison group and higher relative prevalence to that of men in the pre-incarceration group, compared to their matched counterparts. CONCLUSIONS Disparities in health and health service utilization are gendered and exist prior to incarceration. The gendered nature of these findings, specifically the significantly higher prevalence of poor health among women across several indicators, necessitates a focus on the social and systemic factors that contribute to these disparities. Gender-responsive and trauma-informed primary, secondary, and tertiary prevention strategies, alongside transformative approaches to justice should be considered in addressing the health needs of men and women who experience incarceration.
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Affiliation(s)
- Tenzin Butsang
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
- MAP Centre for Urban Health Solutions, St. Michael's Hospital, Toronto, ON, Canada
| | - Arthur McLuhan
- MAP Centre for Urban Health Solutions, St. Michael's Hospital, Toronto, ON, Canada
| | - Leslie A Keown
- Research Branch, Correctional Service of Canada, Ottawa, ON, Canada
| | | | - Flora I Matheson
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada.
- MAP Centre for Urban Health Solutions, St. Michael's Hospital, Toronto, ON, Canada.
- ICES, Toronto, ON, Canada.
- Centre for Criminology and Socio-Legal Studies, University of Toronto, Toronto, ON, Canada.
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Sakaki JR, Gao S, Ha K, Chavarro JE, Chen MH, Sun Q, Hart JE, Chun OK. Childhood beverage intake and risk of hypertension and hyperlipidaemia in young adults. Int J Food Sci Nutr 2022; 73:954-964. [PMID: 35761780 PMCID: PMC9951226 DOI: 10.1080/09637486.2022.2091524] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Revised: 06/10/2022] [Accepted: 06/15/2022] [Indexed: 10/17/2022]
Abstract
An epidemiological analysis assessing beverage consumption and risk factors for cardiovascular disease was conducted. Participants were 9-16 years old at enrolment, completed food frequency questionnaires in 1996-2001 and self-reported outcomes in 2010-2014. Exclusion criteria included missing data on relevant variables and covariates, prevalent disease before 2005, and implausible/extreme weight or energy intake. Intakes of orange juice, apple/other fruit juice, sugar-sweetened beverages and diet soda were related to the risk of incident hypertension or hyperlipidaemia using Cox proportional hazards regression, adjusting for diet, energy intake, age, smoking, physical activity and body mass index. There were 9,043 participants with 618 cases of hypertension and 850 of hyperlipidaemia in 17 years of mean follow-up. Sugar-sweetened beverage intake but not fruit juice nor diet soda was associated with hypertension (hazard ratio (95% confidence interval): 1.16 (1.03, 1.31)) in males. This study can guide beverage consumption as it relates to early predictors of cardiovascular disease.
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Affiliation(s)
- Junichi R. Sakaki
- Department of Nutritional Sciences, University of Connecticut, 27 Manter Rd., Unit 4017, Storrs, CT 06269
| | - Simiao Gao
- Department of Statistics, University of Connecticut, 215 Glenbrook Rd., U-4120, Storrs, CT, 06269
| | - Kyungho Ha
- Department of Food Science and Nutrition, Jeju National University, Jeju, South Korea
| | - Jorge E. Chavarro
- Department of Nutrition and Epidemiology, Harvard T.H. Chan School of Public Health, 677 Huntington Ave., Boston, MA.; Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital, and Harvard Medical School, Boston, MA
| | - Ming-Hui Chen
- Department of Statistics, University of Connecticut, 215 Glenbrook Rd., U-4120, Storrs, CT, 06269
| | - Qi Sun
- Department of Nutrition and Epidemiology, Harvard T.H. Chan School of Public Health, 677 Huntington Ave., Boston, MA.; Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital, and Harvard Medical School, Boston, MA
| | - Jaime E. Hart
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, 401 Park Drive, 3rd Fl West, Boston, MA 02215.; Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital, and Harvard Medical School, Boston, MA
| | - Ock K. Chun
- Department of Nutritional Sciences, University of Connecticut, 27 Manter Rd., Unit 4017, Storrs, CT 06269
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Mills BW, Hill MG, Miles AK, Smith EC, Afrifa-Yamoah E, Reid DN, Rogers SL, Sim MGB. Ability of the Australian general public to identify common emergency medical situations: Results of an online survey of a nationally representative sample. Australas Emerg Care 2022; 25:327-333. [PMID: 35525724 DOI: 10.1016/j.auec.2022.04.002] [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: 02/14/2022] [Revised: 04/20/2022] [Accepted: 04/26/2022] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To investigate the Australian general public's ability to identify common medical emergencies as requiring an emergency response. METHODS An online survey asked participants to identify likely medical treatment pathways they would take for 17 hypothetical medical scenarios (eight emergency and nine non-emergency). The number and type of emergency scenarios participants correctly suggested warranted an emergency medical response was examined. Participants included Australian residents (aged >18 years; n = 5264) who had never worked as an Australian registered medical doctor, nurse or paramedic. RESULTS Most emergencies were predominately correctly classified as requiring emergency responses (e.g. Severe chest pain, 95% correct). However, non-emergency medical responses were often chosen for some emergency scenarios, such as a child suffering from a scalp haematoma (67%), potential meningococcal disease (57%), a box jellyfish sting (40%), a paracetamol overdose (37%), and mild chest pain (26%). Participants identifying as Aboriginal or Torres Strait Islander suggested a non-emergency response to emergency scenarios 40% more often compared with non-indigenous participants. CONCLUSIONS Educational interventions targeting specific medical symptoms may work to alleviate delayed emergency medical intervention. This research highlights a particular need for improving symptom identification and healthcare system confidence amongst Aboriginal and Torres Strait Islander populations.
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Affiliation(s)
- Brennen W Mills
- School of Medical and Health Sciences, Edith Cowan University, Australia.
| | - Michella G Hill
- School of Medical and Health Sciences, Edith Cowan University, Australia
| | - Alecka K Miles
- School of Medical and Health Sciences, Edith Cowan University, Australia
| | - Erin C Smith
- School of Medical and Health Sciences, Edith Cowan University, Australia
| | | | - David N Reid
- School of Medical and Health Sciences, Edith Cowan University, Australia
| | - Shane L Rogers
- School of Arts and Humanities, Edith Cowan University, Australia
| | - Moira G B Sim
- School of Medical and Health Sciences, Edith Cowan University, Australia
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Mursa R, Patterson C, Halcomb E. Men's help-seeking and engagement with general practice: An integrative review. J Adv Nurs 2022; 78:1938-1953. [PMID: 35384022 PMCID: PMC9322545 DOI: 10.1111/jan.15240] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Revised: 01/25/2022] [Accepted: 03/13/2022] [Indexed: 11/30/2022]
Abstract
Aim To critically synthesize the literature that describes men's help‐seeking and engagement with general practice. Design Integrative literature review. Data sources CINAHL plus, Medline and APA PsycInfo were searched for papers published between 1999 and March 2021. Review methods After screening titles and abstracts, full‐text papers were screened against inclusion / exclusion criteria. All included papers were assessed for methodological quality. Findings were extracted, critically examined and synthesized into themes. Results Twenty studies met the inclusion criteria. Thematic analysis revealed four themes related to; (1) structural barriers, (2) internal barriers, (3) men's understanding of the role of general practice, and (4) self‐care and help‐seeking. The findings indicate that men can find general practice unwelcoming and unaccommodating. Men can also experience psychological barriers that impact engagement and help‐seeking. Men predominantly view general practice as a source of acute health care and do not appreciate the role of general practice in preventive health care and advice. Conclusion This review has provided insight into the issues around the barriers to health care engagement, men's understanding of the role of general practice and their associated help‐seeking. Seeking to further understand these issues could assist in the development of strategies to promote engagement of men with general practice health care. Impact This review highlights research about men's engagement with general practice and the missed opportunities in receiving preventive health care and education. Enhancing men's engagement with general practice has the potential to reduce the impact of their health on quality of life and improve health outcomes.
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Affiliation(s)
- Ruth Mursa
- School of Nursing, Faculty of Science, Medicine & Health, Illawarra Health & Medical Research Institute, University of Wollongong, Wollongong, New South Wales, Australia
| | - Christopher Patterson
- School of Nursing, Faculty of Science, Medicine & Health, Illawarra Health & Medical Research Institute, University of Wollongong, Wollongong, New South Wales, Australia
| | - Elizabeth Halcomb
- School of Nursing, Faculty of Science, Medicine & Health, Illawarra Health & Medical Research Institute, University of Wollongong, Wollongong, New South Wales, Australia
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10
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Davis B, Honomichl R, Sullivan AB. Effects of Conformity to Masculine Norms and Coping on Health Behaviors in Men With Multiple Sclerosis. Int J MS Care 2022; 24:162-168. [DOI: 10.7224/1537-2073.2020-116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Abstract
Background:
The role of conformity to masculine gender norms in health behaviors in men with multiple sclerosis (MS) has not received attention. This cross-sectional study explores these issues and their relationship to coping and health behaviors.
Methods:
Eighty-one men with MS completed the Conformity to Masculine Norms Inventory-46 and the Ways of Coping Questionnaire and provided demographic and clinical variables. These results were used to predict subscale scores of the Health Behavior Inventory-20 in multivariable regression models.
Results:
Models for the Preventive Self-care and Avoiding Anger and Stress subscales were successfully fit. For the former, respondents endorsing lower levels of masculine conformity related to Emotional Control and higher levels of Heterosexual Self-presentation predicted greater self-care, as did higher use of Positive Reappraisal as a coping strategy. For men reporting low levels of Positive Reappraisal as a coping strategy, increasing Heterosexual Self-presentation was associated with higher levels of self-care. For those with high levels of coping with Positive Reappraisals, increased Heterosexual Self-presentation was associated with modest declines in self-care. For the Avoiding Anger and Stress subscale score, men endorsing Violence or Heterosexual Self-presentation as important aspects of masculinity also reported less efforts in controlling stress and anger.
Conclusions:
Masculinity adherence to traditional gender norms was a significant predictor of how men engaged in health behaviors and, in the case of Preventive Self-care, was found to interact with Positive Reappraisal as a coping strategy. Such information is novel and important to providers serving male patients with MS and can improve provider awareness/conceptualization of male patient needs.
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Affiliation(s)
- Bryan Davis
- From the Mellen Center for Multiple Sclerosis (BD, ABS), Cleveland Clinic, Cleveland, OH, USA
| | - Ryan Honomichl
- Department of Quantitative Health Sciences (RH), Cleveland Clinic, Cleveland, OH, USA
| | - Amy B. Sullivan
- From the Mellen Center for Multiple Sclerosis (BD, ABS), Cleveland Clinic, Cleveland, OH, USA
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11
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Vickery A. Men's Help-Seeking for Distress: Navigating Varied Pathways and Practices. FRONTIERS IN SOCIOLOGY 2021; 6:724843. [PMID: 34901258 PMCID: PMC8661038 DOI: 10.3389/fsoc.2021.724843] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Accepted: 10/29/2021] [Indexed: 06/14/2023]
Abstract
There is a widely accepted dominant narrative surrounding men's mental health help-seeking, that men are less likely to pursue formal mental health support on account of hegemonic masculine ideals that limit emotional expression and vulnerability. Across the literature, little attention has been given to the varied ways in which men can and will seek out help when experiencing mental health troubles. This paper reports findings from a qualitative study of men's experiences of distress, specifically focused on their help-seeking and everyday coping and management of distress. Between 2016 and 2017, 38 individual interviews were carried out in South Wales, United Kingdom, with men of a range of ages (21-74 years of age) and social backgrounds. Analysis identifies nuanced help-seeking practices and pathways, emphasizing ways in which men can and will engage with mental health support. Some men struggled with articulating personal issues in mental health terms, and some portrayed ambivalence to help-seeking, yet at the same time reconstructed help-seeking to positively align with masculine values. The paper further highlights the significant influence of familial and friendship networks in the help-seeking process as well as the value of therapy for men experiencing mental health difficulties, challenging the idea that masculinity inhibits the disclosure of emotional problems. Awareness of the diversity of ways in which men can actively engage with their mental health is needed so that mental health support interventions and practitioners can best reach out to men experiencing distress and provide gender-sensitive support suitable to a range of different men.
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Saini P, Chopra J, Hanlon CA, Boland JE. A Case Series Study of Help-Seeking among Younger and Older Men in Suicidal Crisis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18147319. [PMID: 34299773 PMCID: PMC8307966 DOI: 10.3390/ijerph18147319] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Revised: 06/28/2021] [Accepted: 07/02/2021] [Indexed: 11/20/2022]
Abstract
Due to the continuing high suicide rates among young men, there is a need to understand help-seeking behaviour and engagement with tailored suicide prevention interventions. The aim of this study was to compare help-seeking among younger and older men who attended a therapeutic centre for men in a suicidal crisis. In this case series study, data were collected from 546 men who were referred into a community-based therapeutic service in North West England. Of the 546 men, 337 (52%) received therapy; 161 (48%) were aged between 18 and 30 years (mean age 24 years, SD = 3.4). Analyses included baseline differences, symptom trajectories for the CORE-34 Clinical Outcome Measure (CORE-OM), and engagement with the therapy. For the CORE-OM, there was a clinically significant reduction in mean scores between assessment and discharge (p < 0.001) for both younger and older men. At initial assessment, younger men were less affected by entrapment (46% vs. 62%; p = 0.02), defeat (33% vs. 52%; p = 0.01), not engaging in new goals (38% vs. 47%; p = 0.02), and positive attitudes towards suicide (14% vs. 18%; p = 0.001) than older men. At discharge assessment, older men were significantly more likely to have an absence of positive future thinking (15% vs. 8%; p = 0.03), have less social support (45% vs. 33%; p = 0.02), and feelings of entrapment (17% vs. 14%; p = 0.02) than younger men. Future research needs to assess the long-term effects of help-seeking using a brief psychological intervention for young men in order to understand whether the effects of the therapy are sustainable over a period of time following discharge from the service.
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Affiliation(s)
- Pooja Saini
- School of Psychology, Faculty of Health, Liverpool John Moores University, Liverpool L3 3AF, UK; (J.C.); (C.A.H.)
- Correspondence: ; Tel.: +44-151-231-8121
| | - Jennifer Chopra
- School of Psychology, Faculty of Health, Liverpool John Moores University, Liverpool L3 3AF, UK; (J.C.); (C.A.H.)
| | - Claire A. Hanlon
- School of Psychology, Faculty of Health, Liverpool John Moores University, Liverpool L3 3AF, UK; (J.C.); (C.A.H.)
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Morgan PC, Stanfield MH, Durtschi JA. "There may be a problem, but I'm not going because…": examining classes of men and their rationales for not seeking mental health treatment. JOURNAL OF MENTAL HEALTH (ABINGDON, ENGLAND) 2021; 31:180-187. [PMID: 33989504 DOI: 10.1080/09638237.2021.1922639] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
BACKGROUND Men are less likely than women to seek out mental health treatment, despite men also having mental health struggles. AIM We examined typologies of men's reasons for not seeking treatment even though they perceived a need for treatment. METHOD We conducted a latent class analysis using a U.S. national sample of 836 men who specifically indicated a need for mental health services, but did not seek treatment from the National Study on Drug Use and Health. RESULTS We identified three distinct types of men and their unique rationales for not seeking treatment: positive attitudes class, perceived high behavioral control class, and negative attitudes class. CONCLUSIONS Unique strategies to market clinical services to each of the various needs and concerns of these types of men may prove more beneficial than a generic outreach approach. We encourage mental health professionals to proactively educate men about their services and aim to reduce barriers for men seeking treatment.
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Affiliation(s)
- Preston C Morgan
- Human Development and Family Studies, Michigan State University, East Lansing, MI, USA
| | - M Hunter Stanfield
- Department of Psychology, Counseling, and Family Science, Lipscomb University, Nashville, TN, USA
| | - Jared A Durtschi
- Department of Applied Human Sciences, Kansas State University, Manhattan, KS, USA
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Male, Female, and Nonbinary Differences in UK Twitter Self-descriptions: A Fine-grained Systematic Exploration. JOURNAL OF DATA AND INFORMATION SCIENCE 2021. [DOI: 10.2478/jdis-2021-0018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Abstract
Purpose
Although gender identities influence how people present themselves on social media, previous studies have tested pre-specified dimensions of difference, potentially overlooking other differences and ignoring nonbinary users.
Design/methodology/approach
Word association thematic analysis was used to systematically check for fine-grained statistically significant gender differences in Twitter profile descriptions between 409,487 UK-based female, male, and nonbinary users in 2020. A series of statistical tests systematically identified 1,474 differences at the individual word level, and a follow up thematic analysis grouped these words into themes.
Findings
The results reflect offline variations in interests and in jobs. They also show differences in personal disclosures, as reflected by words, with females mentioning qualifications, relationships, pets, and illnesses much more, nonbinaries discussing sexuality more, and males declaring political and sports affiliations more. Other themes were internally imbalanced, including personal appearance (e.g. male: beardy; female: redhead), self-evaluations (e.g. male: legend; nonbinary: witch; female: feisty), and gender identity (e.g. male: dude; nonbinary: enby; female: queen).
Research limitations
The methods are affected by linguistic styles and probably under-report nonbinary differences.
Practical implications
The gender differences found may inform gender theory, and aid social web communicators and marketers.
Originality/value
The results show a much wider range of gender expression differences than previously acknowledged for any social media site.
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Lundvall M, Hörberg U, Palmér L, Carlsson G, Lindberg E. Young men's experiences of living with existential concerns: "living close to a bottomless darkness". Int J Qual Stud Health Well-being 2020; 15:1810947. [PMID: 32854600 PMCID: PMC7482899 DOI: 10.1080/17482631.2020.1810947] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
Introduction Young men may struggle in life with challenges of various concerns about their identity and who they want to be in life. Many health issues arise from social norms and wider societal determinations and for today’s young men, following such norms poses a risk of losing oneself. An essential part of health are connected to the existential dimensions in life and concerns who you are, and how well you know and understand yourself. However; little is known about what it means for young men to live a life with existential concerns. Purpose and method The purpose of this phenomenological study, based on reflective lifeworld research (RLR), is to describe young men’s experiences of living with existential concerns for which they have sought support. Eight lifeworld interviews were conducted. Results The results essentially show that young men living with existential concerns describe their situations as living close to a bottomless darkness. This is further described according to four constituents: enduring everyday life, striving for a solution, hearing an inner self-critical voice, and wearing a hard shell. Conclusion We conclude that strengthening young men’s health processes requires healthcare professionals to create an atmosphere where young men feel safe talking about existential concerns without feeling exposed and vulnerable.
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Affiliation(s)
- Maria Lundvall
- Faculty of Caring Science, Work Life and Social Welfare, University of Borås , Borås, Sweden
| | - Ulrica Hörberg
- Department of Health and Caring Sciences, Linnaeus University , Växjö, Sweden
| | - Lina Palmér
- Faculty of Caring Science, Work Life and Social Welfare, University of Borås , Borås, Sweden
| | - Gunilla Carlsson
- Faculty of Caring Science, Work Life and Social Welfare, University of Borås , Borås, Sweden
| | - Elisabeth Lindberg
- Faculty of Caring Science, Work Life and Social Welfare, University of Borås , Borås, Sweden
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16
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Oliffe JL, Broom A, Rossnagel E, Kelly MT, Affleck W, Rice SM. Help-seeking prior to male suicide: Bereaved men perspectives. Soc Sci Med 2020; 261:113173. [PMID: 32736099 DOI: 10.1016/j.socscimed.2020.113173] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 11/12/2019] [Accepted: 06/25/2020] [Indexed: 01/06/2023]
Abstract
Male suicide is a significant issue globally, and implicated are men's challenges around help-seeking and engagement with peer or professional mental health care. While men's reticence for help-seeking predominates as an explanatory gendered dimension for male suicide, there are significant caveats and complexities to fully understanding those practices in the context of men's mental illness and suicidality. The current photo-voice study offers considerable insight into such issues - through the eyes of the bereaved - retrospectively exploring accounts of the deceased's mental health help-seeking prior to the death. Using an interpretive design, and based on semi-structured individual photo-elicitation interviews with 20 men who had lost a male friend, family member or partner to suicide, three key dimensions were identified: 1) Entrapped by secrecy and concealing the need for help, in which the deceased hid their suicide risk and need for peer or professional mental health care; 2) Overwhelming illness that couldn't be helped, wherein the deceased had previously connected with an array of social supports and medical services but was estranged from peer and professional help ahead of the suicide, and 3) Services and systems providing ineffectual help, whereby the deceased was connected with mental health care shortly before the suicide. These themes reveal complex relations to help, and help-seeking in men lost to suicide, as well as bereaved men's reliance on normative masculinities as an explanatory framing of these practices. Discussed within a critical masculinities framework, the current study highlights the need to destigmatize men's mental illness and help-seeking as well as address significant health inequities to aid the efficiencies of men's suicide prevention programs.
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Affiliation(s)
- John L Oliffe
- School of Nursing, University of British Columbia, Vancouver, British Columbia, V6T 1Z3, Canada; Department of Nursing, University of Melbourne, Victoria, 3010, Australia.
| | - Alex Broom
- Faculty of Arts and Social Sciences, The University of Sydney, Sydney, NSW, 2006, Australia
| | - Emma Rossnagel
- School of Nursing, University of British Columbia, Vancouver, British Columbia, V6T 1Z3, Canada
| | - Mary T Kelly
- School of Nursing, University of British Columbia, Vancouver, British Columbia, V6T 1Z3, Canada
| | - William Affleck
- School of Nursing, University of British Columbia, Vancouver, British Columbia, V6T 1Z3, Canada
| | - Simon M Rice
- Orygen, The National Centre of Excellence in Youth Mental Health, Parkville, VIC, 3052, Australia; Centre for Youth Mental Health, University of Melbourne, Victoria, 3010, Australia
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17
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Edo-Izquierdo S, Martínez-Blanquet LJ, Rovira T. Hierarchy of the main factors predicting the decision to go to the doctor in a general population sample: A factorial survey design. PATIENT EDUCATION AND COUNSELING 2020; 103:1407-1414. [PMID: 32044189 DOI: 10.1016/j.pec.2020.02.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/11/2019] [Revised: 01/16/2020] [Accepted: 02/03/2020] [Indexed: 06/10/2023]
Abstract
OBJECTIVE To obtain a hierarchy of the main factors that predict the decision to go to the doctor when symptoms are not yet linked to a specific disease. METHOD 64 representative vignettes, combinations of nine factors, were presented to 168 adults between 28-60 years of age. RESULTS Multilevel multiple regression models were used to rank the main factors predicting urgency to see a doctor in order of importance: the interference of symptoms in daily activities (B = -1.29; p < .001), fear (B = -0.96; p < .001), pain (B = -0.90; p < .001), access to medical care (B = -0.64; p < .001) and confidence in the doctor (B = -0.27; <.05). Moreover, gender (B = 0.56; p < .05) and educational level (B =-0.31; p < .05) explained part of the interindividual variation in the daily symptoms' interference. CONCLUSION When a specific disease has not yet been diagnosed, daily symptoms' interference is the factor that most strongly increases the urgency to visit a doctor, especially among men and among people with a higher level of education. PRACTICE IMPLICATIONS To reduce delay, generic health prevention campaigns should place more emphasis on possible interference in daily activities than on the meaning of symptoms for health.
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Affiliation(s)
| | | | - Tatiana Rovira
- Department of Basic Psychology, Autonomous University of Barcelona, Spain.
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18
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Halpern JA, Darves-Bornoz AL, Fantus RJ, Keeter MK, Wren J, Bennett NE, Brannigan RE. Underutilization of primary medical care among men presenting for fertility evaluation. F S Rep 2020; 1:9-14. [PMID: 34223206 PMCID: PMC8244266 DOI: 10.1016/j.xfre.2020.04.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2020] [Accepted: 04/01/2020] [Indexed: 01/21/2023] Open
Abstract
Objective To determine the proportion of men presenting for fertility evaluation who reported having an established primary care physician (PCP). Design Retrospective, observational study. Setting Academic health center. Patient(s) All men presenting for initial male factor infertility consultation with a single reproductive urologist between 2002 and 2018. Intervention(s) Men were asked to provide the name of their PCP at the time of initial visit. Main Outcome Measure(s) Descriptive statistics characterized the proportion of men with a PCP at the time of evaluation and associations between PCP status and clinical characteristics. Result(s) Among 4,127 men presenting for initial fertility consultation, 844 (20.5%) reported having an established PCP, 480 (11.6%) reported no PCP, and 2,803 (67.9%) did not have data available. Among 1,302 men who had a prior primary care visit within our healthcare system, 414 (31.8%) had been seen within 1 year before their fertility evaluation. Men with an established PCP were slightly older than those without a PCP, with higher body mass index, and lower systolic blood pressure. Hormonal profiles were similar across groups, but men with an established PCP had a significantly higher total motile sperm count than those without a PCP, median 53 (interquartile range, 11–109) versus 35 (interquartile range, 8–98). Conclusion(s) More than one third of men presenting for fertility evaluation did not have an established PCP. Reproductive urologists are uniquely positioned to facilitate the critical relationship between young men and PCPs, which should be a key component of the male fertility treatment paradigm.
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Affiliation(s)
- Joshua A. Halpern
- Department of Urology, Northwestern University Feinberg School of Medicine, Chicago, Illinois
- Reprint requests: Joshua A. Halpern, M.D., 676 North St. Clair Street, Arkes 2300, Chicago, Illinois 60611.
| | - Annie L. Darves-Bornoz
- Department of Urology, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | | | - Mary Kate Keeter
- Department of Urology, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - James Wren
- Department of Urology, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Nelson E. Bennett
- Department of Urology, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Robert E. Brannigan
- Department of Urology, Northwestern University Feinberg School of Medicine, Chicago, Illinois
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19
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Shattuck EC, Perrotte JK, Daniels CL, Xu X, Sunil TS. The Contribution of Sociocultural Factors in Shaping Self-Reported Sickness Behavior. Front Behav Neurosci 2020; 14:4. [PMID: 32038193 PMCID: PMC6992553 DOI: 10.3389/fnbeh.2020.00004] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2019] [Accepted: 01/09/2020] [Indexed: 12/11/2022] Open
Abstract
Sickness behavior is an evolutionarily conserved phenomenon found across a diverse range of animals involving a change in motivational priorities to theoretically maximize energetic investment in immune function and recovery. Typical components of sickness behavior include reduced sociability and activity, changes in diet, and depressed affect. Importantly, however, sickness behavior appears to be subject to other demands of life history in animal models, including reproduction and offspring survival. Thus, "feeling sick" is often context dependent with possible effects on morbidity and mortality. While humans may not always face the same life history trade-offs, sociocultural norms and values may similarly shape sickness behavior by establishing internalized parameters for "socially appropriate sickness." We explore the role of these factors in shaping sickness behavior by surveying a national U.S. sample (n = 1,259). Self-reported and recalled sickness behavior was measured using the SicknessQ instrument, which has previously been validated against experimentally induced sickness behavior. After post-stratification weighting and correction for Type I error, generalized linear models showed that sickness behavior is significantly affected by various factors across sex and racial/ethnic groupings. Income below the national mean (b = 1.85, adj. p = 0.025), stoic endurance of pain and discomfort (b = 1.61, adj. p < 0.001), and depressive symptomology (b = 0.53, adj. p < 0.001) were each associated with greater sickness behavior scores. Familism (b = 1.59, adj. p = 0.008) was positively associated with sickness behavior in men, but not women. Endurance of pain and discomfort was associated with greater sickness behavior in Whites only (b = 1.94, adj. p = 0.002), while familism approached significance in African Americans only (b = 1.86, adj. p = 0.057). These findings may reflect different social contexts of sickness across demographic groups, which may in turn have important implications for pathogen transmission and recovery times, potentially contributing to health disparities.
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Affiliation(s)
- Eric C. Shattuck
- Institute for Health Disparities Research, College of Liberal and Fine Arts, The University of Texas at San Antonio, San Antonio, TX, United States
| | - Jessica K. Perrotte
- Department of Psychology, Texas State University, San Marcos, TX, United States
| | - Colton L. Daniels
- Department of Sociology, College of Liberal and Fine Arts, The University of Texas at San Antonio, San Antonio, TX, United States
| | - Xiaohe Xu
- Department of Sociology, College of Liberal and Fine Arts, The University of Texas at San Antonio, San Antonio, TX, United States
- School of Public Administration, Sichuan University, Chengdu, China
| | - Thankam S. Sunil
- Institute for Health Disparities Research, College of Liberal and Fine Arts, The University of Texas at San Antonio, San Antonio, TX, United States
- Department of Sociology, College of Liberal and Fine Arts, The University of Texas at San Antonio, San Antonio, TX, United States
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20
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Male Sexual and Reproductive Health-Does the Urologist Have a Role in Addressing Gender Inequality in Life Expectancy? Eur Urol Focus 2019; 6:791-800. [PMID: 31711931 DOI: 10.1016/j.euf.2019.10.009] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2019] [Revised: 09/09/2019] [Accepted: 10/17/2019] [Indexed: 12/21/2022]
Abstract
Despite considerable public health initiatives in the past century, there remains a significant gender inequality in life expectancy. The Global Burden of Diseases study has highlighted that the life expectancy for men is 70.5years, compared with 75.6years for women. This discrepancy in mortality appears to be related to a disproportionately higher number of preventable and premature male deaths. Whilst there has been an increased focus on men's health, as evidenced by the establishment of men's health charities and governmental legislation promoting equality, a recent World Health Organization report has highlighted that there is still a prevailing misconception that the higher rate of premature mortality amongst men is a natural phenomenon. We explore the association of male sexual and reproductive health-related diseases and the potential role of a urologist in addressing gender inequality in life expectancy. PATIENT SUMMARY: In this report, we discuss the causes for the gender gap in life expectancy and highlight that men continue to have a higher rate of premature death than women, which is associated with diseases of the male reproductive system. Furthermore, this not only appears to be related to a number of metabolic and lifestyle factors, but may also be the result of the increased risk of cancer in men with sexual and reproductive health-related diseases.
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21
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Idris DR, Forrest S, Brown S. Health help-seeking by men in Brunei Darussalam: masculinities and 'doing' male identities across the life course. SOCIOLOGY OF HEALTH & ILLNESS 2019; 41:1071-1087. [PMID: 30908680 DOI: 10.1111/1467-9566.12885] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Using data collected through semi-structured interviews and focus group discussions with 37 adult men living in Brunei Darussalam, this paper explores how masculinities and expectations about male roles across the life course influence men's perceptions, of and attitudes towards health and health help-seeking behaviour. Bruneian men gave accounts that consistently spoke of a series of masculine roles and associated attributes and behaviours, which mapped across the life course. Men described health and the steps that they had taken to protect their health in terms of responsibilities associated with being a breadwinner, provider of support for parents, role model and leader of the family. Whilst adherence to Bruneian norms about masculinity could obstruct men's engagement with health help-seeking, we also found that men mobilised their understanding of Bruneian masculinity such that it provided culturally legitimate way of engaging in health help-seeking. We conclude by considering implications for further development of conceptualisations of masculinities, particularly responding to the call to consider Connell's theory of 'hegemonic masculinity' in the context of the Global South. We also consider the implications of the findings of this research for policy and practice in provision of health promotion and services in Brunei.
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Affiliation(s)
- Deeni R Idris
- PAP Rashidah Sa'adatul Bolkiah Institute of Health Sciences, Universiti Brunei Darussalam, Bandar Seri Begawan, Brunei
| | - Simon Forrest
- Institute of Health and Society, Newcastle University, Newcastle Upon Tyne, UK
| | - Sally Brown
- School of Applied Sciences, Edinburgh Napier University, Scotland, UK
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22
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Persson S, Grogan S, Dhingra K, Benn Y. "I don't mind being ugly but I don't wanna have skin cancer": A qualitative study of attitudes to UV exposure and a facial morphing intervention in men 35 years and older. Psychol Health 2019; 34:1486-1503. [PMID: 31179747 DOI: 10.1080/08870446.2019.1622014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Objectives: Skin cancer is a growing problem globally. Older men have been largely ignored in previous research, even though men may generally be prone to riskier exposure to the sun than women. Past research suggests that appearance-focused techniques such as facial morphing can increase motivations to use sun protection among women of all ages, and younger men.Design: was qualitative, consisting of individual interviews.Methods: were semi-structured interviews with 25 older men, to examine attitudes to UV exposure and reactions to a facial morphing intervention. Interviews were subjected to thematic analysis.Results: Three themes were constructed: masculine UV exposure; appearance that's accepted; personal responsibility. The men did not identify gaps in their sun protection behaviour and demonstrated a lack of concern about ageing and appearance. These attitudes translated into a lack of motivation for behaviour change due to ageing acceptance. However, motivation to change behaviour came from health concerns resulting from the intervention.Conclusions: The men experienced different motivations and barriers for sun protection use than women of similar ages. Facial morphing can be effective with older men but may need to be reframed to focus on health implications and personal choice.
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Affiliation(s)
- Sofia Persson
- Manchester Metropolitan University, Manchester, United Kingdom
| | - Sarah Grogan
- Manchester Metropolitan University, Manchester, United Kingdom
| | - Katie Dhingra
- School of Social Sciences, Leeds Beckett University, Leeds, United Kingdom
| | - Yael Benn
- Manchester Metropolitan University, Manchester, United Kingdom
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23
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Do self-reported data accurately measure health inequalities in risk factors for cardiovascular disease? Int J Public Health 2019; 64:721-729. [DOI: 10.1007/s00038-019-01232-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2018] [Revised: 03/04/2019] [Accepted: 03/07/2019] [Indexed: 11/26/2022] Open
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Li PFJ, Wong YJ, Cawthra JN. I’d Like to Have All the Characteristics of a Hero: A Case Study of Strength-Centered Therapy. Clin Case Stud 2019. [DOI: 10.1177/1534650119837353] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Strength-centered therapy (ST) is a therapeutic model based on character strengths in positive psychology and social constructionist perspectives on psychotherapy. Although there is no documented empirical research on ST, research evidence indicates that interventions that identify and cultivate character strengths have consistently yielded positive outcomes in well-being. Some specific techniques adopted in ST have shown effectiveness in improving psychological outcomes. The present case study adds research evidence to the potential effectiveness of ST. This case study provides an analysis of ST with a 20-year-old White female client. The focus of this case study is to illustrate how ST techniques work with a real client. A total of 12 therapy sessions and pre- and post-therapy interviews and assessments with the client were recorded and transcribed for data analysis. The research team analyzed the data qualitatively, illustrated several ST therapeutic strategies, and explored the client’s experience of therapy in four phases of ST. Implications for practice and research are discussed.
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25
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Rochelle TL. "Take a Spoonful of Concrete and Harden the **** up!": How British Men in Hong Kong Talk About Health and Illness. Am J Mens Health 2019; 13:1557988319829334. [PMID: 30744486 PMCID: PMC6582375 DOI: 10.1177/1557988319829334] [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] [Indexed: 11/19/2022] Open
Abstract
The present study draws on semistructured focus group discussions conducted with
British men living in Hong Kong to examine how men’s constructions of
masculinity influence health behavior and attitudes. Twenty-eight men aged 21–51
years were divided into groups based on age (≤35 years and ≥36 years); length of
residence ranged from 2 to 20 years. Discussions were analyzed using open-ended
thematic analysis. Following intensive analysis of the transcripts, four
subthemes were identified and analyzed in greater detail: (a) health talk; (b)
help-seeking behavior; (c) health risk; and (d) health motivations. Findings
suggest a widespread endorsement of a hegemonic view of masculinity among men in
the present study. Men expressed reluctance in seeking help for illness,
regardless of age, particularly when experiencing symptoms of ill-health that
were deemed to be “minor.” However, help seeking was embraced when it was
perceived to impact masculinity, for example, when potentially related to sexual
performance or function. While men in the present study were sometimes
dismissive of health advice provided by family, they were more open and
responsive to seeking help upon the advice of male friends. Findings are further
discussed with reference to the relationships between masculinities and health;
implications for health are discussed.
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26
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Ewert C, Collyer A, Temple-Smith M. 'Most young men think you have to be naked in front of the GP': a qualitative study of male university students' views on barriers to sexual health. Sex Health 2018; 13:124-30. [PMID: 26691872 DOI: 10.1071/sh15217] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2015] [Accepted: 11/05/2015] [Indexed: 11/23/2022]
Abstract
UNLABELLED Background In Australia, 15- to 29-year-olds account for 75% of all sexually transmissible infection (STI) diagnoses. STI rates among young men are rising, with most diagnosed in general practice. Young men less frequently attend general practice than young women, and rarely present with sexual health issues, making it difficult for general practitioners (GPs) to offer opportunistic STI education and screening. Little is known of the barriers preventing male university students accessing general practice for sexual health care, or what would facilitate this. METHODS Semi-structured interviews were conducted with young men aged 18-24 years attending university between 2012 and 2014. Interviews were recorded, transcribed and analysed using content and thematic analysis. RESULTS Twenty-eight interviews of 26-50min duration found self-imposed views of masculinity, privacy and embarrassment as key barriers to accessing GPs for sexual health care. This was compounded by poor STI knowledge and not knowing when or where to go for care. Participants, except if they were international students, acknowledged school as an important source of sexual health education. The need for sexual health education at university was identified. While the Internet was a popular source, there were mixed views on the benefits of social media and text messaging for sexual health promotion. CONCLUSIONS Current expectations of young male university students to seek sexual health care or acquire sexual health information from medical care may be misplaced. Universities have an excellent opportunity to provide young men with appropriate sexual health information and could offer novel strategies to help young men look after their sexual health.
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Affiliation(s)
- Cameron Ewert
- Department of General Practice, The University of Melbourne, 200 Berkeley Street, Carlton, Vic. 3053, Australia
| | - Archibald Collyer
- Department of General Practice, The University of Melbourne, 200 Berkeley Street, Carlton, Vic. 3053, Australia
| | - Meredith Temple-Smith
- Department of General Practice, The University of Melbourne, 200 Berkeley Street, Carlton, Vic. 3053, Australia
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Walker R, Blumfield M, Truby H. Beliefs and advice-seeking behaviours for fertility and pregnancy: a cross-sectional study of a global sample. J Hum Nutr Diet 2018; 31:486-495. [PMID: 29659064 DOI: 10.1111/jhn.12554] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
BACKGROUND Pregnancy can motivate individuals to adopt lifestyle behaviours that protect the health of their offspring. The aims of the present study were to explore men's and women's beliefs about lifestyle, fertility and pregnancy, as well as where they seek advice. METHODS Participants (2185 women and 221 men, six unspecified) from 104 countries completed a questionnaire that explored their beliefs about what was important for a healthy pregnancy and their advice-seeking behaviours. Recruitment was via a Massive Open Online Course entitled 'Food as Medicine', with food, nutrient and health content. Comparisons of categorical data were performed using a chi-squared test (P = 0.05). RESULTS Eating a variety of fruits and vegetables and not smoking (both 93.7%) were the most frequently and equally ranked in the top-five factors for a healthy pregnancy. Taking prenatal supplements (26.8%) was considered to be less important. Participants in Westernised countries ranked not smoking or drinking alcohol as being significantly more important than those in other countries. Overall, doctors (47.7%) were the most common source of fertility and pregnancy advice. Larger proportions of those aged <40 years used the Internet (<40 years 44.1%, >40 years 18.2% χ2 = 152.7, P < 0.01) and social media (<40 years 16.1%, >40 years 3.6%; χ2 = 110.18, P < 0.01) for health information. CONCLUSIONS There is disconnection between beliefs and actions regarding the lifestyle behaviours considered to be important for a healthy pregnancy, particularly nutrition. Pregnancy advice-seeking has evolved, with younger men and women utilising the Internet and social media. Health professionals must consider new communication strategies to deliver evidence-based lifestyle advice, particularly for younger men and women and where access to healthcare is limited.
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Affiliation(s)
- R Walker
- Department of Nutrition, Dietetics and Food, Monash University, Notting Hill, VIC, Australia
| | - M Blumfield
- Department of Nutrition, Dietetics and Food, Monash University, Notting Hill, VIC, Australia
| | - H Truby
- Department of Nutrition, Dietetics and Food, Monash University, Notting Hill, VIC, Australia
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Shoskes DA, Vij SC, Shoskes A, Nyame Y, Gao T. Development of a Clinically Relevant Men's Health Phenotype and Correlation of Systemic and Urologic Conditions. Urology 2018; 114:77-82. [PMID: 29360485 DOI: 10.1016/j.urology.2017.12.035] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2017] [Revised: 12/07/2017] [Accepted: 12/28/2017] [Indexed: 11/18/2022]
Abstract
OBJECTIVE To develop a clinically relevant men's health phenotype and investigate the correlation between severity of urologic symptoms and systemic health conditions METHODS: Retrospective chart review was performed for men seeking care for benign prostatic hypertrophy, erectile dysfunction or chronic prostatitis or chronic pelvic pain syndrome. Urologic symptoms were assessed with the International Prostate Symptom Score, Sexual Health Inventory for Men, and National Institute of Health Chronic Prostatitis Symptom Score. Each was graded as absent or mild (0), moderate (1), or severe (2) and totaled for a urologic score (US). Seven comorbidities with known impact on urologic symptoms were similarly graded (0-2 for each) and totaled for a systemic score (SS). These domains were anxiety, cardiovascular, testosterone deficiency, insulin (diabetes), obesity, neurologic, and sleep apnea. RESULTS The study included 415 men with median age of 53.8 (range 19-92). Mean total US was 2.1 (range 0-6) and mean SS was 4.1 (0-12). There was a strong correlation between US and SS (Spearman Rho = 0.37, P < .00001) which was consistent regardless of age. The hierarchy of systemic condition impact on US was cardiovascular> neurologic> diabetes> anxiety> sleep apnea> obesity> testosterone. By cluster analysis the tightest correlations were age with cardiovascular, anxiety with CPPS, and diabetes with erectile dysfunction. CONCLUSION Systemic health conditions correlate strongly with urologic symptoms in men who present for urologic care. Phenotyping with ACTIONS (anxiety, cardiovascular, testosterone deficiency, insulin, obesity, neurologic, sleep apnea) can identify modifiable conditions that may impact urologic symptoms and outcome of interventions. Future validation in the general population is needed.
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Affiliation(s)
- Daniel A Shoskes
- Glickman Urologic and Kidney Institute, Cleveland Clinic Foundation, Cleveland, OH 44195
| | - Sarah C Vij
- Glickman Urologic and Kidney Institute, Cleveland Clinic Foundation, Cleveland, OH 44195.
| | - Aaron Shoskes
- Glickman Urologic and Kidney Institute, Cleveland Clinic Foundation, Cleveland, OH 44195
| | - Yaw Nyame
- Glickman Urologic and Kidney Institute, Cleveland Clinic Foundation, Cleveland, OH 44195
| | - Tianming Gao
- Glickman Urologic and Kidney Institute, Cleveland Clinic Foundation, Cleveland, OH 44195
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Blunt W, Gill DP, Sibbald SL, Riggin B, Pulford RW, Scott R, Danylchuk K, Gray CM, Wyke S, Bunn C, Petrella RJ. Optimization of the Hockey Fans in Training (Hockey FIT) weight loss and healthy lifestyle program for male hockey fans. BMC Public Health 2017; 17:916. [PMID: 29183291 PMCID: PMC5706169 DOI: 10.1186/s12889-017-4926-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2017] [Accepted: 11/19/2017] [Indexed: 11/15/2022] Open
Abstract
Background The health outcomes of men continue to be poorer than women globally. Challenges in addressing this problem include difficulties engaging men in weight loss programs as they tend to view these programs as contrary to the masculine narrative of independence and self-reliance. Researchers have been turning towards sports fans to engage men in health promotion programs as sports fans are typically male, and tend to have poor health habits. Methods Developed from the highly successful gender-sensitized Football Fans in Training program, Hockey Fans in Training (Hockey FIT) recruited 80 male hockey fans of the London Knights and Sarnia Sting who were overweight or obese into a weekly, 90-minute classroom education and group exercise program held over 12 weeks; a 40-week minimally-supported phase followed. A process evaluation of the Hockey FIT program was completed alongside a pragmatic randomized controlled trial and outcome evaluation in order to fully explore the acceptability of the Hockey FIT program from the perspectives of coaches delivering and participants engaged in the program. Data sources included attendance records, participant focus groups, coach interviews, assessment of fidelity (program observations and post-session coach reflections), and 12-month participant interviews. Results Coaches enjoyed delivering the program and found it simple to deliver. Men valued being among others of similar body shape and similar weight loss goals, and found the knowledge they gained through the program helped them to make and maintain health behaviour changes. Suggested improvements include having more hockey-related information and activities, greater flexibility with timing of program delivery, and greater promotion of technology support tools. Conclusions We confirmed Hockey FIT was an acceptable “gender-sensitized” health promotion program for male hockey fans who were overweight or obese. Minor changes were required for optimization, which will be evaluated in a future definitive trial. Trial registration NCT02396524 (Clinicaltrials.gov). Date of registration: Feb 26, 2015.
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Affiliation(s)
- Wendy Blunt
- Department of Family Medicine, Centre for Studies in Family Medicine, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada.,Lawson Health Research Institute, London, Ontario, Canada
| | - Dawn P Gill
- Department of Family Medicine, Centre for Studies in Family Medicine, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada.,Lawson Health Research Institute, London, Ontario, Canada.,School of Health Studies, Faculty of Health Sciences, Western University, London, Ontario, Canada.,Graduate Program in Health & Rehabilitation Sciences, Faculty of Health Sciences, Western University, London, Ontario, Canada
| | - Shannon L Sibbald
- Department of Family Medicine, Centre for Studies in Family Medicine, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada.,School of Health Studies, Faculty of Health Sciences, Western University, London, Ontario, Canada.,Graduate Program in Health & Rehabilitation Sciences, Faculty of Health Sciences, Western University, London, Ontario, Canada.,The Schulich Interfaculty Program in Public Health, Schulich School of Medicine and Dentistry, London, Ontario, Canada
| | - Brendan Riggin
- School of Kinesiology, Faculty of Health Sciences, Western University, London, Ontario, Canada
| | - Roseanne W Pulford
- Department of Family Medicine, Centre for Studies in Family Medicine, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada.,Lawson Health Research Institute, London, Ontario, Canada
| | - Ryan Scott
- School of Health Studies, Faculty of Health Sciences, Western University, London, Ontario, Canada.,Graduate Program in Health & Rehabilitation Sciences, Faculty of Health Sciences, Western University, London, Ontario, Canada
| | - Karen Danylchuk
- School of Kinesiology, Faculty of Health Sciences, Western University, London, Ontario, Canada
| | - Cindy M Gray
- Institute of Health and Wellbeing, College of Social Sciences, University of Glasgow, Glasgow, United Kingdom
| | - Sally Wyke
- Institute of Health and Wellbeing, College of Social Sciences, University of Glasgow, Glasgow, United Kingdom
| | - Christopher Bunn
- Institute of Health and Wellbeing, College of Social Sciences, University of Glasgow, Glasgow, United Kingdom
| | - Robert J Petrella
- Department of Family Medicine, Centre for Studies in Family Medicine, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada. .,Lawson Health Research Institute, London, Ontario, Canada. .,Graduate Program in Health & Rehabilitation Sciences, Faculty of Health Sciences, Western University, London, Ontario, Canada. .,School of Kinesiology, Faculty of Health Sciences, Western University, London, Ontario, Canada. .,Centre for Studies in Family Medicine, Western Centre for Public Health and Family Medicine, 2nd Floor, Western University, 1465 Richmond St, London, ON, N6G 2M1, Canada.
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Allmark N, Grogan S, Jeffries M. “I don’t want to let myself down or the charity down”: men’s accounts of using various interventions to reduce smoking and alcohol consumption. QUALITATIVE RESEARCH IN PSYCHOLOGY 2017. [DOI: 10.1080/14780887.2017.1393585] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Nigel Allmark
- Manchester Metropolitan University, Department of Psychology, Manchester, UK
| | - Sarah Grogan
- Manchester Metropolitan University, Department of Psychology, Manchester, UK
| | - Mark Jeffries
- University of Manchester, NIHR Greater Manchester Primary Care Patient Safety Translational Research Centre, Manchester, UK
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Vij SC, Turk A, Gao T, Shoskes DA. Correlation of self-reported urologic symptoms with systemic health conditions in minority men. Transl Androl Urol 2017; 6:883-887. [PMID: 29184787 PMCID: PMC5673818 DOI: 10.21037/tau.2017.07.12] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
Background To investigate the correlation between presence and severity of urologic symptoms and self-reported systemic health conditions in minority men. Methods Questionnaires were distributed at a Men’s Minority Health Fair. Urologic symptoms were assessed with the International Prostate Symptom Score (IPSS), Sexual Health Inventory for Men (SHIM) and NIH Chronic Prostatitis Symptom Score (CPSI). Each was graded as absent/mild [0], moderate [1] or severe [2] by standard criteria for each and totaled for a urologic score (US). Other questions included age, height/weight and queried heart disease, diabetes, anxiety/stress, sleep apnea and neurologic disease. A systemic score (SS) graded each plus obesity for 6 domains (0–2 for each). Results A total of 52 men completed the surveys with a mean age of 58.8 (range, 37–76) years. By symptom score criteria, 17 (33%) had 1 urologic condition, 19 (37%) had 2 and 5 (10%) had all 3. Mean total US was 1.9 (range, 0–6) and mean SS was 2.9 (range, 0–10). There was a strong correlation between US and SS (Spearman Rho =0.73, P<0.0001). The hierarchy of systemic condition impact on US was cardiovascular > anxiety > obesity > diabetes > sleep apnea > neurologic. By multivariable analysis, after adjusting for age, each systemic component strongly correlated with the US. The multivariable model with age plus all of the systemic scores predicted US more accurately than with any one of its components alone. Conclusions Self-reported systemic health conditions correlate strongly with presence and severity of urologic symptoms in minority men.
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Affiliation(s)
- Sarah Coleman Vij
- Glickman Urological and Kidney Institute, Cleveland Clinic Foundation, Cleveland, OH, USA
| | - Andrew Turk
- Glickman Urological and Kidney Institute, Cleveland Clinic Foundation, Cleveland, OH, USA
| | - Tianming Gao
- Glickman Urological and Kidney Institute, Cleveland Clinic Foundation, Cleveland, OH, USA
| | - Daniel A Shoskes
- Glickman Urological and Kidney Institute, Cleveland Clinic Foundation, Cleveland, OH, USA
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32
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Christianson M, Boman J, Essén B. "Men don't think that far" - Interviewing men in Sweden about chlamydia and HIV testing during pregnancy from a discursive masculinities construction perspective. SEXUAL & REPRODUCTIVE HEALTHCARE 2017; 12:107-115. [PMID: 28477922 DOI: 10.1016/j.srhc.2017.03.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2016] [Revised: 02/15/2017] [Accepted: 03/28/2017] [Indexed: 10/19/2022]
Abstract
OBJECTIVES We used qualitative research design to discursively explore expectant fathers' perceptions of chlamydia and HIV, and their masculinity constructions about testing, and explored how they talked about their potential resistance towards testing and their pre-test emotions. STUDY DESIGN Twenty men were offered chlamydia and HIV testing at the beginning of their partner's pregnancy. Those who agreed to be tested were interviewed in-depth; those who declined testing were also interviewed. The interviews were tape recorded and transcribed verbatim. The analysis was inspired by discourse analysis on masculinity. MAIN OUTCOME Three discursive themes: Men prefer to suppress their vulnerability to STIs, Body and biology differ between men and women and Men have mixed emotions around STI testing underscore the informants' conversations and sometimes conflicting thoughts about STI testing. CONCLUSION The majority of men talked about pregnancy as a feminine territory, raised uncertainties about men's roles in the transmission of STIs, and talked about women's and men's essentially different bodies and biology, where few men realised that they could infect both their partner and the unborn child. This knowledge gap that men have must become apparent to healthcare providers, and policy makers must give men equal access to the reproductive arena.
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Affiliation(s)
| | - Jens Boman
- Department of Clinical Microbiology, Umeå University, SE-901 85 Umeå, Sweden.
| | - Birgitta Essén
- Department of Women's and Children's Health/IMCH, Akademiska sjukhuset, SE-751 85 Uppsala, Sweden.
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Schlichthorst M, Sanci LA, Pirkis J, Spittal MJ, Hocking JS. Why do men go to the doctor? Socio-demographic and lifestyle factors associated with healthcare utilisation among a cohort of Australian men. BMC Public Health 2016; 16:1028. [PMID: 28185596 PMCID: PMC5103250 DOI: 10.1186/s12889-016-3706-5] [Citation(s) in RCA: 58] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Men use health services less often than women and frequently delay seeking help even if experiencing serious health problems. This may put men at higher risk for developing serious health problems which, in part, may explain men's higher rates of some serious illnesses and shorter life span relative to women. This paper identifies factors that contribute to health care utilisation in a cohort of Australian men by exploring associations between socio-economic, health and lifestyle factors and the use of general practitioner (GP) services. METHODS We used data from Ten to Men, the Australian Longitudinal Study on Male Health. Health care utilisation was defined in two ways: at least one GP visit in the past 12 months and having at least yearly health check-ups with a doctor. Associations between these two measures and a range of contextual socio demographic factors (education, location, marital status, country of birth, employment, financial problems etc.) as well as individual health and lifestyle factors (self-rated health, smoking, drinking, healthy weight, pain medication) were examined using logistic regression analysis. The sample included 13,763 adult men aged 18 to 55 years. Analysis was stratified by age (18 to 34 year versus 35 to 55 years). RESULTS Overall, 81 % (95 % CI: 80.3-81.6) of men saw a GP for consultation in the 12 months prior to the study. The odds of visiting a GP increased with increasing age (p < 0.01), but decreased with increasing remoteness of residence (p < 0.01). Older men, smokers and those who rate their health as excellent were less likely to visit a GP in the last 12 months, but those on daily pain medication or with co-morbidities were more likely to have visited a GP. However, these factors were not associated with consulting a GP in the last 12 months among young men. Overall, 39 % (95 % CI: 38.3-39.9) reported having an annual health check. The odds of having an annual health check increased with increasing age (p < 0.01), but showed no association with area of residence (p = 0.60). Across both age groups, the odds of a regular health check increased with obesity and daily pain medication, but decreased with harmful levels of alcohol consumption. CONCLUSION The majority of men (61 %) did not engage in regular health check-up visits, representing a missed opportunity for preventative health care discussions. Lower consultation rates may translate into lost opportunities to detect and intervene with problems early and this is where men may be missing out compared to women.
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Affiliation(s)
- Marisa Schlichthorst
- Melbourne School of Population and Global Health, the University of Melbourne, Melbourne, 3010 Australia
| | - Lena A. Sanci
- Department of General Practice, the University of Melbourne, Melbourne, 3010 Australia
| | - Jane Pirkis
- Melbourne School of Population and Global Health, the University of Melbourne, Melbourne, 3010 Australia
| | - Matthew J. Spittal
- Melbourne School of Population and Global Health, the University of Melbourne, Melbourne, 3010 Australia
| | - Jane S. Hocking
- Melbourne School of Population and Global Health, the University of Melbourne, Melbourne, 3010 Australia
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Leone JE, Rovito MJ, Mullin EM, Mohammed SD, Lee CS. Development and Testing of a Conceptual Model Regarding Men's Access to Health Care. Am J Mens Health 2016; 11:262-274. [PMID: 27698256 PMCID: PMC5675291 DOI: 10.1177/1557988316671637] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
Epidemiologic data suggest men often experience excessive morbidity and early mortality, possibly compromising family and community health over the lifespan. Moreover, the negative financial/economic consequences affected by poor male health outcomes also has been of great concern in the United States and abroad. Early and consistent access to preventative health care may improve health outcomes; however, men are far less likely to access these services. The purpose of this study was to understand what factors preclude men from accessing health care. We surveyed 485 participants using a 58-item online survey built from a conceptual model previously developed by the researchers using hegemonic masculinity theory, the theory of normative contentment, and the health belief model. For men, three items significantly ( ps < .05) predicted whether they had seen a health care provider in the past year: "I/Men do not access healthcare because I do not think there is anything wrong with me," "My health is only about me," and "I/Men do not access healthcare because most men in my family do not access healthcare." Other correlations of practical significance also were noted. Results suggest gender norms and masculine ideals may play a primary role in how men access preventative health care. Future programming targeting males should consider barriers and plan programs that are gender-sensitive in addition to being gender-specific. Clinical implications are discussed.
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Affiliation(s)
- James E Leone
- 1 Bridgewater State University, Bridgewater, MA, USA
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Reynolds GL, Fisher DG, Dyo M, Huckabay LM. Using the Bem and Klein Grid Scores to Predict Health Services Usage by Men. Behav Med 2016; 42:143-9. [PMID: 27337618 PMCID: PMC4979744 DOI: 10.1080/08964289.2016.1154003] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
We examined the association between scores on the Bem Sex Roles Inventory (BSRI), Klein Sexual Orientation Grid, and utilization of hospital inpatient services, emergency departments, and outpatient clinic visits in the past 12 months among 53 men (mean age 39 years). The femininity subscale score on the BSRI, ever having had gonorrhea and age were the three variables identified in a multivariate linear regression significantly predicting use of total health services. This supports the hypothesis that sex roles can assist our understanding of men's use of health services.
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Affiliation(s)
- Grace L. Reynolds
- Center for Behavioral Research & Services, California State University, Long Beach ,Health Care Administration Department, California State University, Long Beach
| | - Dennis G. Fisher
- Center for Behavioral Research & Services, California State University, Long Beach ,Psychology Department, California State University, Long Beach
| | - Melissa Dyo
- School of Nursing, California State University, Long Beach
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Grogan S, Parlane VL, Buckley E. Younger British men's understandings of prostate cancer: A qualitative study. J Health Psychol 2015; 22:743-753. [PMID: 26537520 DOI: 10.1177/1359105315613776] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
The purpose of this study was to explore young British men's understandings of prostate health and cancer of the prostate. A total of 16 White-British men between 31-50 years of age took part in interviews face-to-face or through computer-mediated communication. Thematic analysis broadly informed by grounded theory identified two key themes; 'limited knowledge about the prostate' and 'early detection & unpleasant procedures'. Accounts are discussed with reference to implications for improving men's understandings of prostate cancer, and likelihood of self-referral for prostate screening where necessary.
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Everett B, Zajacova A. Gender differences in hypertension and hypertension awareness among young adults. BIODEMOGRAPHY AND SOCIAL BIOLOGY 2015; 61:1-17. [PMID: 25879259 PMCID: PMC4896734 DOI: 10.1080/19485565.2014.929488] [Citation(s) in RCA: 158] [Impact Index Per Article: 17.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/06/2023]
Abstract
Previous research has shown that men have higher levels of hypertension and lower levels of hypertension awareness than women, but it remains unclear if these differences emerge among young adults. Using the National Longitudinal Study of Adolescent to Adult Health (Add Health), this study examines gender differences in hypertension and hypertension awareness among U.S. young adults, with special focus on factors that may contribute to observed disparities (N = 14,497). Our results show that the gender disparities in hypertension status were already evident among men and women in their twenties: women were far less likely to be hypertensive compared to men (12% vs. 27%). The results also reveal very low levels of hypertension awareness among young women (32% of hypertensive women were aware of their status) and even lower levels among men (25%). Finally, this study identifies key factors that contribute to these observed gender disparities. In particular, health care use, while not related to the actual hypertension status, fully explains the gender differences in hypertension awareness. The findings thus suggest that regular medical visits are critical for improving hypertension awareness among young adults and reducing gender disparities in cardiovascular health.
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Affiliation(s)
- Bethany Everett
- a Department of Sociology , University of Illinois at Chicago , Chicago , Illinois , USA
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Upton D, Taylor C. What are the support needs of men with multiple sclerosis, and are they being met? Int J MS Care 2015; 17:9-12. [PMID: 25741222 PMCID: PMC4338643 DOI: 10.7224/1537-2073.2013-044] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
BACKGROUND Multiple sclerosis (MS) is a chronic, degenerative condition of the central nervous system that can lead to high levels of disability and a range of psychological and social problems. Although considerable research has been conducted on the experience of living with MS and the disease's psychosocial consequences, much of this has focused on women, with the male perspective seldom considered. It is possible, therefore, that men differ from women in how they experience MS and the type of support or interventions that meet their needs. METHODS A literature review was undertaken to identify the specific support needs of men with MS, describe current support available to men with MS, and evaluate the extent to which these needs are met by current service provision. RESULTS The literature reviewed suggests that the needs of men with MS are different from those of women in terms of psychological factors such as well-being and mental health and support. CONCLUSIONS If interventions are to be evidence based, health-care professionals need to take into account the needs, desires, and capabilities of men with MS in the development of services. Further qualitative and quantitative research is required to address the gaps in the evidence base of support needs for men with MS.
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Affiliation(s)
- Dominic Upton
- Institute of Health and Society, University of Worcester, Worcester, UK
| | - Charlotte Taylor
- Institute of Health and Society, University of Worcester, Worcester, UK
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Scholz B, Crabb S, Wittert GA. "We've got to break down the shame": portrayals of men's depression. QUALITATIVE HEALTH RESEARCH 2014; 24:1648-1657. [PMID: 25212853 DOI: 10.1177/1049732314549020] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
News articles play a role in reproducing or challenging stigma. Stigma, in turn, can be a barrier to men's mental health help seeking. We used discursive analytic principles to analyze portrayals of men's communication about depression in news articles over a 5-year period. We found that news articles depicted men who were open about depression as experiencing positive outcomes such as recovery. Such depictions might challenge stigma associated with talking about mental health concerns. However, some articles problematically positioned depressed men as individually responsible for defying stigma and achieving recovery. We suggest that portraying depression as something that impacts a plurality of men is one way that media messages might dispel stigma. We drew recommendations from the findings about the language that could be used by media, mental health campaigns, and health service providers to mitigate the impact of stigma on men's mental health help seeking.
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Affiliation(s)
- Brett Scholz
- University of Canberra, Bruce, Australia Capital Territory, Australia
| | - Shona Crabb
- The University of Adelaide, Adelaide, South Australia, Australia
| | - Gary A Wittert
- The University of Adelaide, Adelaide, South Australia, Australia
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Langvik E, Nordahl HM. Anhedonic depression, history of depression, and anxiety as gender-specific risk factors of myocardial infarction in healthy men and women: The HUNT study. Health Psychol Open 2014; 1:2055102914557658. [PMID: 28070344 PMCID: PMC5193285 DOI: 10.1177/2055102914557658] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
This prospective study examines gender-specific psychological risk factors of myocardial infarction. Out of 41,248 participants free of coronary heart disease at baseline, 822 cases of myocardial infarction were identified in the Nord-Trøndelag Health Study or the mortality register. The participants completed the Hospital Anxiety and Depression Scale. Cholesterol, blood pressure, and waist–hip ratio were measured by medical staff. Smoking, diabetes, non-fatal myocardial infarction, and history of depressive episode were self-reported. Anhedonic depression (Hospital Anxiety and Depression Scale-D ≥8) was a significant predictor of myocardial infarction in women but not in men. Gender difference in risk estimate based on Hospital Anxiety and Depression Scale-D was significant (p < .01). History of depressive episode was a significant predictor of myocardial infarction in men. Symptoms of anxiety (Hospital Anxiety and Depression Scale-A ≥8) reduced the risk of having a myocardial infarction.
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Eckermann S. Avoiding a health system hernia and the associated outcomes and costs. Aust N Z J Public Health 2014; 38:303-5. [DOI: 10.1111/1753-6405.12277] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Affiliation(s)
- Simon Eckermann
- Australian Health Services Research Institute, Sydney Business School, University of Wollongong, New South Wales
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Mavin TJ, Roth WM. A Holistic View of Cockpit Performance: An Analysis of the Assessment Discourse of Flight Examiners. ACTA ACUST UNITED AC 2014. [DOI: 10.1080/10508414.2014.918434] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Pringle A, Zwolinsky S, McKenna J, Robertson S, Daly-Smith A, White A. Health improvement for men and hard-to-engage-men delivered in English Premier League football clubs. HEALTH EDUCATION RESEARCH 2014; 29:503-520. [PMID: 24659420 DOI: 10.1093/her/cyu009] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Unhealthy behaviours represent modifiable causes of non-communicable disease. In men, concern focuses on those (i) demonstrating the poorest health, exacerbated by a lack of awareness of the risks that their lifestyles pose and (ii) who neither consult their doctor nor use health services. Classed as 'hard-to-engage', distinctive strategies are needed to reach these men. Impact and process evaluations assessed the effect of a programme of men's health-delivered in/by English Premier League football clubs. Men attended match-day events and/or weekly classes involving physical activity and health education. Validated self-report measures for demographics and lifestyle behaviours were completed pre- and post-intervention. Intention-to-treat analysis was performed on pre-versus-post-intervention differences in lifestyle profiles, whereas interviews (n = 57) provided men's accounts of programme experience. Participants were predominantly white British (70.4%/n = 2669), 18-44 (80.2%/n = 3032) and employed (60.7%/n = 1907). One-third (n = 860) 'never' visited their doctor. Over 85% (n = 1428) presented with combinations of lifestyle risk factors. Intention-to-treat analysis showed improvements (P < 0.001) in lifestyle profiles. Interviews confirmed recruitment of men who were hard-to-engage and unhealthy. Men were attracted through football and/or the clubs, whereas specific design factors impacted on participation. Limitations include use of self-reports, narrow demographics, small effect sizes, lack of follow-up and the absence of non-completers in interviews.
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Affiliation(s)
- Andy Pringle
- Centre for Active Lifestyles, Institute of Sport, Physical Activity and Leisure, Leeds Metropolitan University, Leeds LS6 3QS, UK and Centre for Men's Health, Leeds Metropolitan University, Leeds LS1 3EE, UK
| | - Stephen Zwolinsky
- Centre for Active Lifestyles, Institute of Sport, Physical Activity and Leisure, Leeds Metropolitan University, Leeds LS6 3QS, UK and Centre for Men's Health, Leeds Metropolitan University, Leeds LS1 3EE, UK
| | - James McKenna
- Centre for Active Lifestyles, Institute of Sport, Physical Activity and Leisure, Leeds Metropolitan University, Leeds LS6 3QS, UK and Centre for Men's Health, Leeds Metropolitan University, Leeds LS1 3EE, UK
| | - Steven Robertson
- Centre for Active Lifestyles, Institute of Sport, Physical Activity and Leisure, Leeds Metropolitan University, Leeds LS6 3QS, UK and Centre for Men's Health, Leeds Metropolitan University, Leeds LS1 3EE, UK
| | - Andy Daly-Smith
- Centre for Active Lifestyles, Institute of Sport, Physical Activity and Leisure, Leeds Metropolitan University, Leeds LS6 3QS, UK and Centre for Men's Health, Leeds Metropolitan University, Leeds LS1 3EE, UK
| | - Alan White
- Centre for Active Lifestyles, Institute of Sport, Physical Activity and Leisure, Leeds Metropolitan University, Leeds LS6 3QS, UK and Centre for Men's Health, Leeds Metropolitan University, Leeds LS1 3EE, UK
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Yousaf O, Grunfeld EA, Hunter MS. A systematic review of the factors associated with delays in medical and psychological help-seeking among men. Health Psychol Rev 2013. [PMID: 26209212 DOI: 10.1080/17437199.2013.840954] [Citation(s) in RCA: 249] [Impact Index Per Article: 22.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Despite a growing literature on the factors associated with men's low rates of medical and psychological help-seeking, a systematic review of these is missing. Such an overview can help to inform health psychologists of the barriers to the performance of adaptive health behaviours, such as prompt help-seeking, and could inform theoretical advancements and the development of targeted interventions to facilitate prompt help-seeking among men. We systematically reviewed quantitative and qualitative empirical papers on factors associated with delays in men's medical and psychological help-seeking. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed, and we used the databases PsycINFO, Medline, Embase and PsycARTICLES (with keywords: men/male*/gender*, help*/seek* and health*/service*/utili*[sation]) for papers in English. 41 citations (amounting to 21,787 participants aged 15-80 + ) met the inclusion criteria. Approximately half of these used qualitative methodologies (i.e., semi-structured interviews and focus groups), while half used quantitative methodologies (i.e., questionnaires). We identify a number of recurring cognitive, emotional, health-service related and socio-demographic help-seeking factors/predictors from the 41 papers. Of these, the most prominent barriers to help-seeking were disinclination to express emotions/concerns about health, embarrassment, anxiety and fear, and poor communication with health-care professionals.
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Affiliation(s)
- Omar Yousaf
- a Department of Psychology , Institute of Psychiatry, King's College London , Guy's Campus, London SE19RT , UK
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den Engelsen C, Gorter KJ, Salomé PL, Rutten GE. One year follow-up of patients with screen-detected metabolic syndrome in primary care: an observational study. Fam Pract 2013; 30:40-7. [PMID: 22964079 DOI: 10.1093/fampra/cms052] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Early detection and appropriate treatment of metabolic syndrome (MetS) can modify cardiometabolic risk factors and prevent cardiovascular disease. Optimal screening outcomes require follow-up management of MetS. OBJECTIVE To investigate the natural course of events in the first year after positive screening for MetS in primary care with regard to follow-up behavior, medication prescription and lifestyle changes. METHODS Screening of 1721 apparently healthy primary care patients (20-70 years old) detected 473 new MetS cases. These people were asked to contact their general practice for subsequent advice and treatment. Data about follow-up behavior of the screening participants and prescription of cardiovascular medication were collected from the electronic medical file, and changes in lifestyle were collected by the practice nurse. RESULTS Of the 424 participants with screen-detected MetS for whom data about follow-up were available, 306 (72.2%) spontaneously contacted the practice. Antihypertensive, lipid-lowering and blood glucose-lowering medications were prescribed in 21.5%, 21.2% and 1.9% of the participants, respectively. Half of the participants for whom data about self-reported lifestyle changes were available reported to have increased their physical activity; 16.9% of the smokers quit smoking. Average weight loss was 2.1kg. CONCLUSIONS Screening for MetS followed by the advice to contact the general practice for lifestyle counseling and treatment had a substantial spontaneous follow-up. Although the changes in physical activity, weight loss and smoking abstinence are promising, further research will have to demonstrate whether they are sustainable.
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Affiliation(s)
- Corine den Engelsen
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands.
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