Older men?s concerns about their urological health: a qualitative study

Abstract

While there has been widespread recent interest in men's health issues, and prostate cancer in particular, there have been few studies to determine which issues are important from the viewpoint of men themselves. This study was undertaken to identify genitourinary issues of concern to older men. A series of 19 focus groups involved 137 men and 14 women from a broad demographic background. Men expressed consistent concern about urinary symptoms, prostate cancer and sexual function. They revealed misunderstanding and a desire for more information about all issues. Urinary symptoms had a high impact on quality of life that could be made worse by environmental constraints such as working conditions and availability of toilets. Prostate cancer was a concern in all groups, even those at low risk, and men believed that screening for prostate cancer should be offered. Men believed sexuality was not recognised as an issue of concern to older people. Potential barriers to health action included stoicism, not talking about health issues and poor relationships with doctors. The study suggests a substantial need for community and professional education and for health promotion focused on preventable morbidity.

Troubling stoicism: Sociocultural influences and applications to health and illness behaviour

“…Likewise, evidence that cognitive therapies are efficacious treatments for distress disorders (Nathan & Gorman, 2002) suggests that stoicism may be an adaptive orientation. On the other hand, stoicism has been found to generate harmful inertia in the face of some medical symptoms (Hinton, 1994;Pinnock et al, 1998). More broadly, it could be proposed that stoic minimization of difficulties and consequent negative attitudes to seeking professional help may generate detrimental consequences for mental health and wellbeing.…”

“…In hindsight, using a modern setting, it has been mooted as 'stoical' and virtuous behaviour. Pinnock et al (1998) in their study of older men's concerns about their urological health suggest that stoicism was evident in those who did not seek help from their doctor because they feared uncovering something that was wrong, such as prostate cancer, or because they would have to take time off work and, therefore, let others down. The authors noted that the men particularly feared prostate cancer because of the additional threat to sexual function.…”

“…It is to the importance of context that we now turn. Pinnock et al (1998) state that 'tales of stoicism', as told by their respondents, spoke of 'suffering', 'failing', 'making do' and ultimately 'dying' without seeking help. Reasons such as having to take time off work, fear that something might be wrong or fear of being seen as a hypochondriac can be attributed to external factors that influence their actions.…”

“…Bendelow (1993: 290) suggests that the ontological security of women is less threatened by the admission of pain than it is in men for whom 'the psychological structure of masculinity is predisposed to inhibit the admission of vulnerability'. Pinnock et al (1998) attribute delays in and refusals to seek help among Australian men with urological problems to a stoical attitude, where stoicism defined illness as 'weakness'. We feel that this may be a part of the problem in the gendering of stoicism.…”

“…The conceptualization of stoicism has been largely overlooked in the sociology of health and illness, receiving most attention from behavioural psychology researchers. Murray et al (2008) and Pinnock et al (1998) note this to be an oversight, particularly in relation to its potential explanatory power in health, for example, having a stoic attitude has been reported as one way in which older people cope with the effects of chronic pain (Cairncross et al, 2007;Helme and Gibson, 1999). Such stoic attitudes are seemingly defined by a reluctance to label symptoms as painful to others and are commonly related to under-reporting of mild or weak pain.…”