Medical Help-Seeking for Sexual Concerns in Prostate Cancer Survivors.

INTRODUCTION - Although sexual dysfunction is common after prostate cancer, men's decisions to seek help for sexual concerns are not well understood.

AIM - Describe predictors of actual prior help-seeking and intended future medical help-seeking for sexual dysfunction in prostate cancer survivors.

METHODS - A cross-sectional survey of 510 prostate cancer survivors assessed masculine beliefs, attitudes, support/approval from partner/peer networks (subjective norm), and perceived control as predictors of medical help-seeking for sexual concerns. A theory of planned behavior (TPB) perspective was used to examine actual prior and planned future behavior and contributing factors. Statistical analyses included multiple and logistic regressions.

MAIN OUTCOME MEASURES - Intention to see a doctor for sexual advice or help in the next 6 months was measured using the intention subscale adapted from the Attitudes to Seeking Help after Cancer Scale. Prior help-seeking was measured with a dichotomous yes/no scale created for the study.

RESULTS - Men were Mage 71. 69 years (SD = 7. 71); 7. 54 years (SD = 4. 68) post-diagnosis; received treatment(s) (58. 1% radical prostatectomy; 47. 1% radiation therapy; 29. 4% hormonal ablation); 81. 4% reported severe ED (IIED 0-6) and 18. 6% moderate-mild ED (IIED 7-24). Overall, 30% had sought sexual help in the past 6 months, and 24% intended to seek help in the following 6 months. Prior help-seeking was less frequent among men with severe ED. Sexual help-seeking intentions were associated with lower education, prior sexual help-seeking, sexual importance/ priority, emotional self-reliance, positive attitude, and subjective norm (R(2) = 0. 56).

CONCLUSIONS - The TPB has utility as a theoretical framework to understand prostate cancer survivors' sexual help-seeking decisions and may inform development of more effective interventions. Masculine beliefs were highly salient. Men who were more emotionally self-reliant and attributed greater importance to sex formed stronger help-seeking intentions. Subjective norm contributed most strongly to help-seeking intentions suggesting that health professionals/partners/peers have a key role as support mechanisms and components of psycho-sexual interventions.

Sexual medicine. 2016 Jan 11 [Epub ahead of print]

Melissa K Hyde, Leah Zajdlewicz, Addie C Wootten, Christian J Nelson, Anthony Lowe, Jeff Dunn, Suzanne K Chambers

Menzies Health Institute Queensland, Griffith University, Gold Coast, Qld, Australia; Cancer Council Queensland, Brisbane, Qld, Australia. Menzies Health Institute Queensland, Griffith University, Gold Coast, Qld, Australia; Cancer Council Queensland, Brisbane, Qld, Australia. , Department of Urology, Royal Melbourne Hospital, Melbourne, Vic. , Australia; Epworth Prostate Centre, Epworth Healthcare, Melbourne, Vic. , Australia; Australian Prostate Cancer Research, Melbourne, Vic. , Australia. , Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY, USA. , Menzies Health Institute Queensland, Griffith University, Gold Coast, Qld, Australia; Prostate Cancer Foundation of Australia, Sydney, NSW, Australia. , Menzies Health Institute Queensland, Griffith University, Gold Coast, Qld, Australia; Cancer Council Queensland, Brisbane, Qld, Australia; School of Social Science, The University of Queensland, Brisbane, Qld, Australia. , Menzies Health Institute Queensland, Griffith University, Gold Coast, Qld, Australia; Cancer Council Queensland, Brisbane, Qld, Australia; Prostate Cancer Foundation of Australia, Sydney, NSW, Australia; Exercise Medicine Research Institute, Edith Cowan University, Perth, WA, Australia; Centre for Clinical Research, The University of Queensland, Brisbane, Qld, Australia.

PubMed