男性在接受根治性前列腺切除术或其他非激素、积极的前列腺癌治疗后的性求助和护理需求。
Men's sexual help-seeking and care needs after radical prostatectomy or other non-hormonal, active prostate cancer treatments.
机构信息
School of Psychology, The University of Queensland, Brisbane, Queensland, Australia.
Menzies Health Institute Queensland, Griffith University, Southport, Queensland, Australia.
出版信息
Support Care Cancer. 2021 May;29(5):2699-2711. doi: 10.1007/s00520-020-05775-5. Epub 2020 Sep 26.
OBJECTIVE
To examine prostate cancer (PCa) survivors' sexual help-seeking intentions, behaviours, and unmet needs.
METHODS
In this prospective cohort study, men who underwent active, non-hormonal treatment completed baseline (N = 558) and 6-month follow-up (N = 387) questionnaires. Theory of planned behaviour (TPB) constructs (sexual help-seeking intention, perceived behavioural control (PBC), subjective norm, attitude), masculine values (e.g., sexual importance/priority, emotional self-reliance), sex life and functioning, sexual supportive care needs, distress (anxiety, depression), and sexual help-seeking behaviour were assessed.
RESULTS
Most men (M age = 64.6 years; M years post-diagnosis = 4.0) received prostatectomy (93%), reported severe erectile dysfunction (52%), ≥ 1 unmet sexual care need (66%), and sought help from a doctor (baseline 52%, follow-up 42%). Sexual care needs were significantly associated with poorer erectile function, reduced satisfaction with sex-life, valuing sex as important/integral to identity (masculine values), and increased depression (p ≤ 0.001). Sexual help-seeking intentions were significantly associated with valuing sex as important/integral to identity, recent help-seeking, greater confidence/control, perceiving support from important others, and positive attitudes, for sexual help-seeking (p < 0.001). Significant predictors of sexual help-seeking (follow-up) were baseline intentions, recent help-seeking (p < 0.001), and increased anxiety (p < 0.05).
CONCLUSIONS
Men's unmet sexual care needs, sexual help-seeking intentions, and behaviour appear driven by the importance/value attributed to sex, distress, positive feelings, support from others, and confidence for help-seeking. Psychosocial providers are well-placed to address men's concerns, yet few sought their assistance. Interventions to improve men's access to effective sexual care are needed, particularly focused on reframing masculine values about the importance of sex and leveraging TPB-based predictors of help-seeking.
目的
探讨前列腺癌（PCa）幸存者的性求助意向、行为和未满足的需求。
方法
在这项前瞻性队列研究中，接受积极非激素治疗的男性在基线（N=558）和 6 个月随访（N=387）时完成了问卷调查。采用计划行为理论（TPB）构念（性求助意向、知觉行为控制（PBC）、主观规范、态度）、男性价值观（如性重要性/优先级、情感自立）、性生活和功能、性支持性护理需求、困扰（焦虑、抑郁）和性求助行为进行评估。
结果
大多数男性（M 年龄=64.6 岁；M 诊断后年限=4.0 年）接受了前列腺切除术（93%），报告严重勃起功能障碍（52%），≥1 项未满足的性护理需求（66%），并向医生寻求帮助（基线 52%，随访 42%）。性护理需求与勃起功能更差、对性生活满意度降低、将性视为身份重要/不可或缺（男性价值观）以及抑郁增加显著相关（p≤0.001）。性求助意向与将性视为身份重要/不可或缺、近期求助、更大信心/控制、感知来自重要他人的支持以及积极态度显著相关（p<0.001）。性求助（随访）的显著预测因素是基线意向、近期求助（p<0.001）和焦虑增加（p<0.05）。
结论
男性未满足的性护理需求、性求助意向和行为似乎受到对性的重要性/价值、困扰、积极感受、他人支持以及寻求帮助的信心的驱动。心理社会提供者有能力解决男性的担忧，但很少有人寻求他们的帮助。需要采取干预措施，以改善男性获得有效性护理的机会，特别是侧重于重新构建关于性重要性的男性价值观，并利用 TPB 预测因素来促进求助。
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