hannah dale, gozde ozakinci, pauline adair & gerry humphris phd student, school of medicine,...
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Hannah Dale, Gozde Ozakinci, Pauline Adair & Gerry Humphris
PhD Student, School of Medicine, University of St. Andrews
Health Psychologist NHS Fife
[email protected] +441334 696336
Men’s cancer inequalitiesCancer incidence and mortality rates are worse for men
than women in most countries (Micheli et al., 2009; Jemal et al, 2011)
Single men have even worse outcomes than partnered men or single/partnered women (e.g. Konski et al, 2006)
May be affected by (All party parliamentary group on cancer, 2009):
poorer symptom awareness poorer help seeking lower uptake of screening programmes
Influence of psychosocial issues and health behaviours on mortality generally lack evidence or are disputed
Psychosocial and behaviour factorsLargely accepted that psychosocial factors and health
behaviours affect men’s experience of cancer Systematic review of psychosocial and behaviour change
interventions for men with cancerVery little evidence for effective interventionsNo interventions focussing on single men
Relationships between these factors in men not well understood Strongest evidence for social support influencing
psychosocial issuesMen also disadvantaged around help seeking and
uptake to services (Nekolaichuk et al, 2011)
Objectives
To examine relationships between social support, distress, lifestyle behaviours and
desire for help, in men with cancer
MethodsCross-sectional questionnaire study targeting all adult
men with a diagnosis of cancerAssessed:
Demographic factors (Relationship status, age, type of cancer(s), time since diagnosis, and postcode)
Distress (DT)Depression and anxiety (HADS)Social support (Social Provisions Scale)Health behaviours (5 point likert scale)Desire for more support
Recruited through the NHS in the East of ScotlandData from the Scottish Longitudinal study enables
comparable demographic details to be examined
Results; representativeness127 men with cancer participated
Mean age 62 (range 23-86)76% married
Compared to the Scottish Longitudinal Study data, the sample was comparable for most demographics. Slight under-representation from those living in urban
areas and those with skin cancerSlight over representation of those with cancers of the
male genital organs, respiratory and haematological cancers
Results; sample overviewMany participants reported good levels of support. 18-30% scored within the clinical range for distress. The majority of people were meeting government
guidelines for not smoking, and drinking a maximum of 21 units of alcohol per week.
Only 24% met guidelines for 5 or more pieces of fruit or vegetables per day
67% met guidelines for 2.5 hours
of exercise per week
Results 3; relationshipsLower levels of social support were linked to worse
psychological health, along with smoking.Psychological issues were linked to greater smoking, less
fruit and vegetable consumption and lower exercise levels.
Having poor scores for social support and psychological issues all predicted wanting help for that issue.
There were also links between psychological issues and wanting help to improve lifestyle issues
Results; modelling
.90
.39
.56
.74
Desire for help
.54
Support to reduce distress
Support to improve feelings
Support to improve diet
Support to increase exercise
.83
Distress
HADS Depression
HADS Anxiety Distress Thermometer
.69 .63
.89
Support
Total Social Support
-.07
-.61
Support
Distress
DiscussionPsychosocial issues may interact to affect help seeking
behaviour. When examined together, help seeking for both
psychological issues and health behaviours is affected by social support mediated by distress.
Since help seeking is facilitated though psychological health, psychological difficulties may act to legitimise help seeking.
Further research: qualitative interviews with men with cancer to explore reasons for help seeking along with barriers and facilitators to doing so.
Limitations & future researchLimitationsSmall sample sizeBroad range of cancersHADS 2 factor structurePath analysis for
meditational model
Future researchLongitudinal data would
build on thisLarger sample sizes
neededDifferent measures?
ConclusionsExperiencing distress may be pivotal in men with
cancer desiring more help. Distress appears to mediate the relationship
between social support and desire for more help for psychological issues and lifestyle behaviours. Self-reported lifestyle behaviour would appear not to
be implicated in these relationships. Interventions and services aimed at men with cancer
may need to tailor material to gain men’s acceptability to access help.