Clinical Registry Unit, Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia.
School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia.
PLoS One. 2019 Mar 7;14(3):e0211539. doi: 10.1371/journal.pone.0211539. eCollection 2019.
Previous research in Victoria, Australia, found differences in prostate cancer outcomes in regional and metropolitan areas. This investigation of undiagnosed men in regional areas and a metropolitan area of South Australia sought their perspectives on prostate cancer. Our aim was to learn whether men who had not been diagnosed could shed light on why men outside metropolitan areas tended to have poorer outcomes than metropolitan men. Our goal was to build on evidence contributing to improving outcomes in prostate cancer care. Semi-structured interviews were designed to elicit explanation and meaning. 15 men (10 metropolitan, 5 regional) not diagnosed with prostate cancer were recruited through widely-distributed flyers in medical and community settings. Interviews were recorded and transcribed; transcripts were analysed thematically. Five main themes were identified, four of which were prompted by the questions: Addressing prostate health, Experiences with and expectations of GPs, Differences in care between regional and metropolitan areas, and Achieving early diagnosis. The fifth theme arose spontaneously: Australian masculinity. Men identified as problematic the limited availability of GPs in regional areas, the lack of consistency in approaches to prostate cancer detection, and men's reluctance to seek medical care. Community-level strategies appear to be valued to encourage men to address prostate health. Maintaining and extending a systemic approach to prostate care may improve outcomes for men in Australia.
先前在澳大利亚维多利亚州的研究发现，前列腺癌在地区和大都市地区的治疗结果存在差异。本研究调查了南澳大利亚地区和大都市地区未被诊断出患有前列腺癌的男性，旨在了解这些未被诊断出患有前列腺癌的男性是否能够解释为什么非大都市地区的男性比大都市地区的男性的治疗结果更差。我们的目标是在改善前列腺癌治疗结果的证据基础上进一步探索。采用半结构化访谈设计，以引出解释和意义。通过在医疗和社区环境中广泛分发传单，招募了 15 名未被诊断出患有前列腺癌的男性（10 名来自大都市地区，5 名来自地区）。对访谈进行录音和转录；对转录本进行主题分析。确定了五个主要主题，其中四个是由以下问题引发的：前列腺健康问题、与全科医生的经验和期望、地区和大都市地区之间的护理差异以及早期诊断。第五个主题是自发出现的：澳大利亚男性气质。男性认为地区内全科医生数量有限、前列腺癌检测方法缺乏一致性以及男性不愿意寻求医疗护理等问题是有问题的。社区层面的策略似乎受到重视，以鼓励男性关注前列腺健康。维持和扩展前列腺护理的系统方法可能会改善澳大利亚男性的治疗结果。
