This paper reports the findings of a phenomenological study to understand and interpret the experience of a group of men before, during and after their attendance at a charity-based service for the early detection of prostate cancer.
Methods:
A comprehensive review of the literature on men's help-seeking behaviour regarding their health was undertaken. Semi-structured interviews were then conducted with a purposive sample of 12 men who had attended the service in the previous 3 months.
Results:
Resultant data showed that men experience social, psychological and structural barriers to help-seeking including a threat to masculinity, embarrassment, fear and guilt at using an under-resourced health service. Participants attended the service due to a variety of motivating factors which are often complex and interrelated. However, fear of cancer, the value of early detection, the media and encouragement by women were key cues to action. Participants felt reassured and empowered by the process, largely due to the interpersonal and communication skills of health professionals working within the early detection service.
Conclusions:
The findings highlight the need for health policy makers and health promoters to understand men's help-seeking behaviour, provide them with information in a relevant and meaningful way and provide services for the early detection of prostate cancer which should be of high quality and person-centred.
Get full access to this article
View all access options for this article.
References
1.
FitzpatrickD., GavinA., MiddletonR., CatneyD.Cancer in Northern Ireland 1993–2001: a comprehensive report. Belfast: N. Ireland Cancer Registry; 2004.
2.
MooreR, HarrissonS, MasonC, OrrJ. An assessment of health inequalities in two Northern Ireland communities: an ethnographic approach - Report for the Department of Health and Social Services, March 1997.Belfast: School of Nursing, The Queen's University of Belfast; 1997.
3.
GoodG.E., DellD.M., MintzL.B.Male role and gender role conflict: relations to help seeking in men. J Couns Psychol, 1989; 36:295–300.
MoynihanC.Theories in health care and research, theories of masculinity. BMJ, 1998; 317:1072–1075.
6.
WeinsteinN.Unrealistic optimism about disease susceptibility: conclusions from a community-wide sample. J Behav Med, 1987; 10:481–500.
7.
KilmartinC.T.The masculine self. New York: Macmillan; 1994.
8.
Department of Health. The state of the public health 1992. London: HMSO; 1993.
9.
TudiverF., TalbotY.Why don’t men seek help? Family physicians’ perspectives on help-seeking behavior in men. J Fam Pract, 1999; 48:47–52.
10.
GerrardM., GibbonsF.X., BenthinA.C., HesslingR.M.A longitudinal study of the reciprocal nature of risk behaviour and cognitions in adolescents: what you do shapes what you think, and vice versa. Health Psychol, 1996; 15:344–354.
11.
Cunningham-BurleyS., AllbuttH., GarrawayW.M., LeeA.J., RussellE.B.Perceptions of urinary symptoms and health-care-seeking behaviour amongst men aged 40–79 years. Br J Gen Pract, 1996; 46:349–352.
12.
PopeC., MaysN.Researching parts other methods cannot reach: an introduction to qualitative methods in health and health services research. BMJ, 1995; 311:42–45.
13.
ParahooA.K.Nursing research: principles, process and issues. Basingstoke: Macmillan Press Limited; 1997.
14.
MorseJ.M.Designing funded qualitative research. In: DenzinN.K., LincolnY.S., editors. Handbook of qualitative research. Thousand Oaks, California: Sage Publications; 1994. p. 220–235.
15.
BergumV.Being a phenomenological researcher. In: MorseJ.M., editor. Qualitative nursing research: a contemporary dialogue. Rev ed.. Newbury Park: Sage Publications; 1991. p. 55–71.
16.
MorseJ.M.Strategies for sampling. In:MorseJ.M., editor. Qualitative nursing research: a contemporary dialogue. Rev ed.. Newbury Park: Sage Publications; 1991. p. 127–145.
RubinH.J., RubinI.S.Qualitative interviewing: the art of hearing data. Thousand Oaks: Sage Publications; 1995.
19.
BrittenN.Qualitative interviews in medical research. BMJ, 1995; 311:251–253.
20.
ColaizziP.F.Psychological research as the phenomenologist views it. In: ValleR., KingM., editors. Existential phenomenological alternatives for psychology. New York: Oxford University Press; 1978. p. 48–71.
21.
CrottyM.Phenomenology and nursing research. Melbourne: Churchill Livingstone; 1996.
22.
BeauchampT.L., ChildressJ.F.Principles of Biomedical Ethics. 5th ed.. Oxford: Oxford University Press; 2001.
23.
HearnJ.Research in men and masculinities: some sociological issues and possibilities. Aust N Z J Sociol, 1994; 30:47–70.
24.
StoltenbergJ.Refusing to be a man: essays on sex and justice. Portland, OR: Breitenbush; 1989.
25.
RosenstockI.M., StrecherV.J., BeckerM.H.Social learning theory and the Health Belief Model. Health Educ Q, 1988; 15:175–183.
26.
SchwarzerR.Self efficacy in the adoption and maintenance of health behaviours: theoretical approaches and a new model. In: SchwarzerR., editor. Self efficacy: thought control of action. Washington DC: Hemisphere; 1992. p. 217–243.
27.
StroebeW., StroebeM.S.Social psychology and health. Milton Keynes: Open University Press; 1995.
28.
NaidooJ., WillsJ.Health promotion, foundations for practice. London: Bailliere Tindall; 1994.
29.
DownieR.S., TannahillC., TannahillA.Health promotion: models and values. 2nd ed.. Oxford: Oxford University Press; 1996.
30.
FlemingP.Health promotion for individuals, families and communities. In: LongA., editor. Interaction for practice in community nursing. Basingstoke: Macmillan Press; 1999. p. 228–259.
31.
RappaportJ.Studies in empowerment: Introduction to the issue. Prev Hum Serv, 1984; 3:1–7.
32.
ThompsonS.C.Will it hurt less if I control it? A complex answer to a simple question. Psychol Bull, 1986; 90:89–101.
33.
AjzenI.The theory of planned behaviour. Organ Behav Hum Decis Processes, 1991; 50:179–211.
34.
ReddyD.M., FlemmingR., AdessoV.J.Gender and health. Int Rev Health Psychol, 1992; 1:1–32.
35.
EckesT.Features of men, features of women: assessing stereotypic beliefs about gender subtypes. Br J Soc Psychol, 1994; 33:107–123.
36.
SchoolerC., ChaffeeS.H., FloraJ.A., RoserC.Health campaign channels: tradeoffs among reach, specificity and impact. Hum Commun Res, 1998; 24:410.
37.
WhiteA.K., BanksI.Help-seeking in men and the problems of late diagnosis. In: KirbyR., CarsonC., KirbyM., FarahR., editors. Men's health. 2nd edn.. London: Martin Dunitz & Parthenon Publishing; 2004.
38.
O’DellK.J., VolkR.J., CassA.R., SpannS.J.Screening for prostate cancer with the prostate-specific antigen test: are patients making an informed decision?. J Fam Pract, 1999; 48:679–681.
WilsonJ.Acknowledging the expertise of patients and their organisations. BMJ, 1999; 319:771–774.
41.
CharlesC., WhelanT., GafniA.What do we mean by partnership in making decisions about treatment?. BMJ, 1999; 319:780–782.
42.
CharlesC., GafniA., WhelanT.Decision making in the physician-patient encounter: revisiting the shared treatment decision making model. Soc Sci Med, 1999; 49:651–661.
43.
DearnaleyD.P., KirbyR.S., KirkD., MaloneP., SimpsonR.J., WilliamsG.Diagnosis and management of early prostate cancer. Report of a British Association of Urological Surgeons Working Party. BJU Int, 1999; 83:18–33.
