Objectives
Men with Systemic Sclerosis (SSc) have a more severe clinical phenotype and reduced survival compared to women. No previous psychosocial studies have focused solely on men with SSc. This study aimed to explore experiences, coping strategies, and support preferences of men with SSc.
Methods
An international qualitative research study comprising seven focus groups (3 USA, 4 UK) of 25 men with SSc. Transcripts were analysed using reflexive thematic analysis.
Results
Three overarching themes and one underpinning theme were identified. In “impact of SSc on masculinity,” the men described an “impact on roles and activities,” reported “sex, intimacy, and erectile dysfunction” as a salient issue that may be overlooked by clinicians, and experienced challenges to “masculine self-image”. “Dealing with SSc” meant “always being prepared”, “becoming an expert”, and “balancing priorities” in responsibilities, activities, and symptom management. In “support for living with SSc” men were selective in “(Not) talking about SSc”, would “(reluctantly) accept help”, and described “preferences for support”. Underpinning these experiences was “facing an uncertain future” with some participants preferring not to focus on an unpredictable future, and others worrying about disease progression.
Conclusion
These novel data suggest SSc impacts male patients’ masculine identity and roles, and although they will accept practical help, they may mask the full emotional impact. Sex and intimacy are important overlooked issues with erectile dysfunction often not discussed at diagnosis. Further research should develop a self-management intervention for men with rheumatic diseases with a combination of disease specific and common core components.