MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Top Floor, 200 Renfield Street, Glasgow, G2 3QB, United Kingdom.
Academic Primary Care, University of Aberdeen, West Block, Polwarth Building, Foresterhill, Aberdeen, AB25 2ZD, United Kingdom.
Soc Sci Med. 2017 Oct;191:134-142. doi: 10.1016/j.socscimed.2017.09.015. Epub 2017 Sep 8.
Men are often portrayed - in research studies, 'common-sense' accounts and popular media - as reluctant users of health services. They are said to avoid going to the GP whenever possible, while women are portrayed, in presumed opposition, as consulting more readily, more frequently and with less serious complaints. Such stereotypes may inadvertently encourage doctors to pay greater heed to men's symptoms in 'routine' consultations. Although previous research has challenged this view with evidence, and suggested that links between gender identities and help-seeking are complex and fluid, gender comparative studies remain uncommon, and particularly few studies (either qualitative or quantitative) compare men and women with similar morbidity. We contribute here to gender comparative research on help-seeking by investigating men's and women's accounts of responding to symptoms later diagnosed as lung cancer. A secondary analysis of qualitative interviews with 27 men and 18 women attending Scottish cancer centres revealed striking similarities between men's and women's accounts. Participants were seen as negotiating a complex and delicate balance in constructing their moral integrity as, on the one hand, responsible service users who were conscious of the demands on health care professionals' time, and as patients who did not take undue risks with their health, in the context of an illness for which people are often held culpable, on the other. In accounting for their responses to symptoms, men and women drew equally on culturally-embedded moral frameworks of stoicism and responsible service use. Regardless of gender, the accounts portrayed participants as stoic in response to illness and responsible service users; and as people seeking explanations for bodily changes and taking appropriate and timely action. Our analysis challenges simplistic, 'common-sense' views of gendered help-seeking and highlights that both men and women need support to consult their doctor for investigation of significant or concerning bodily changes.
男性在研究、“常识”解释和大众媒体中常常被描绘成不情愿使用医疗服务的人。他们被说成是尽可能避免去看全科医生，而女性则被描绘成相反的情况，据说她们更愿意、更频繁地去看医生，而且症状也不那么严重。这种刻板印象可能会无意中鼓励医生在“常规”就诊中更加关注男性的症状。尽管之前的研究已经用证据挑战了这种观点，并表明性别认同和寻求帮助之间的联系是复杂和多变的，但性别比较研究仍然很少见，尤其是没有多少研究（定性或定量）比较具有相似发病率的男性和女性。我们通过调查男性和女性对后来被诊断为肺癌的症状的反应，为性别比较研究中的寻求帮助做出了贡献。对苏格兰癌症中心 27 名男性和 18 名女性的定性访谈进行的二次分析揭示了男性和女性的叙述之间惊人的相似之处。参与者被视为在构建自己的道德完整性方面进行了复杂而微妙的平衡，一方面是负责任的服务使用者，他们意识到医疗保健专业人员的时间需求，另一方面是在一种人们往往会受到指责的疾病背景下，不会对自己的健康承担不当风险的患者。在解释他们对症状的反应时，男性和女性同样借鉴了文化中根深蒂固的坚忍和负责任的服务使用道德框架。无论性别如何，这些叙述都将参与者描绘成对疾病坚忍、对服务负责的人；以及对身体变化寻求解释并采取适当和及时行动的人。我们的分析挑战了对性别化寻求帮助的简单、“常识”观点，并强调无论是男性还是女性，都需要支持来咨询医生，以调查身体的重大或令人担忧的变化。
