Discussion
Discussion
Chapter 18 Men’s Health Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc.
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Longevity and Mortality in Men Rates of longevity are increasing for both men and women. Gender disparity for life expectancy and mortality has decreased, but mortality rates for men remain higher than those for women. Factors influencing mortality rates include race or ethnic origin, socioeconomic status, and education. Males continue to be at risk for death resulting from unintentional injury and homicide. Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc. 2 Morbidity in Men’s Health Men tend to perceive themselves to be in better health than do women. Women are more likely to be ill, whereas men are at greater risk for death. Incidence rate for acute and chronic conditions is higher for women than for men; injuries are higher for men than women. Women have higher morbidity rates than men, but men have higher morbidity and mortality rates for conditions that are the leading causes of death. . Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc. 3 Precursors of Death Frequently NOT Addressed by the Present Health Care System Heart disease and stroke Hypercholesterolemia Hypertension Diabetes mellitus Obesity Type A personality Family history Lack of exercise Cigarette smoking Cancer Sunlight Radiation Occupational hazards Water pollution Air pollution Dietary patterns Alcohol Heredity Certain medical conditions Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc. 4 Men’s Use of Medical Care Men do not engage in health protective behaviors at frequently as women. Most men do not have routine check-ups, including screenings. Men seek ambulatory care less often than women. ➢ Men delay medical treatment → are sicker when they do seek health care → therefore they require more intensive medical care. Men tend to have longer lengths of stay in the hospital than women. Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc. 5 Male-Female Health Paradox Females are sicker, but males die sooner? – Verbrugge and Wingard (1987) Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc. 6 Male-Female Health Paradox (Cont.) Biological factors ➢ Genetics, effects of sex hormones, and physiological differences Influenced by genetics, hormones, and environment Socialization ➢ Men enculturate their sons to believe that risking personal injury demonstrates masculinity. ➢ Men are more likely to change health behaviors when supported by female family members. Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc. 7 Male-Female Health Paradox (Cont.) Orientation toward illness and prevention ➢ Stereotypical view of men as strong and invulnerable is incongruent with health promotion. ➢ Men lack the somatic awareness and are less likely to interpret symptoms as indicators of illness. ➢ Men may have a desire to rationalize symptoms and deny their susceptibility to disease, thus delaying treatment. Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc. 8 Male-Female Health Paradox (Cont.) Data collection on health behaviors may not be accurate: ➢ Males are less likely than females to participate in the data collection process. ➢ Social pressure for males to be less expressive (suppress their emotions) may help explain gender differences in reporting health behaviors. Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc. 9 Nurse’s Responsibilities with Men’s Health Use gender-specific interview techniques to obtain the most accurate health history. Be aware of personal gender bias in data collection. Be aware of the accuracy and interpretation of secondary sources of information. Help men learn how to provide support to the caregiver or to develop a caregiver role. Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc. 10 Nurse’s Responsibilities with Men’s Health (Cont.) Acknowledge that gender-linked behaviors increase risks: ➢ ➢ ➢ Lifestyle factors (e.g., use of tobacco, substance abuse, poor preventive health habits and stress, lack of emotional channels) Men’s unwillingness to seek preventive care Men’s unwillingness to seek health care when a symptom arises Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc. 11 Barriers to Health Care for Men Little effort has been made to create a malespecific health care climate Access to care ➢ Focused on maintaining an effective workforce ➢ Financial support for curative—not preventive— care ➢ Reluctance to take time off from work for care Lack of health promotion ➢ ➢ Disease prevention and health promotion not often reflected in a man’s perception of health Focus on disease cure in the present health care system Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc. 12 Men’s Health Care Needs Permission to have concerns about health and talk openly to others about them Support for the consideration of gender role and lifestyle influences on their physical and mental health Attention from professionals regarding factors that may result in illness or influence a man’s expression of illness, including such things as occupational factors, leisure patterns, and interpersonal relationships Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc. 13 Men’s Health Care Needs (Cont.) Information about how their bodies function, what is normal, what is abnormal, what action to take, and the role of proper nutrition and exercise Self-care: testicular and genital self-exams Physical exam and history-taking that include sexual and reproductive health and illness across the lifespan Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc. 14 Men’s Health Care Needs (Cont.) Treatment for problems of couples, such as interpersonal problems, infertility, family planning, sexual concerns, and STDs Help with fathering (i.e., being included as a parent in child care) Help with fathering as a single parent, particularly with a child of the opposite sex, in addressing the child’s sexual development and concerns Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc. 15 Men’s Health Care Needs (Cont.) Recognition that feelings of confusion and uncertainty in a time of rapid social change are normal and that they may mark the onset of healthy adaptation to change Adjustment of the health care system to men’s occupational constraints regarding time and location of health care sources Financial ways to obtain these goals Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc. 16 Primary Prevention Measures Provide health education and screening in the workplace Participate in interest groups and research focused on men’s health Encourage interest in physical fitness and lifestyle changes Include the male perception of health in policy formation Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc. 17 Secondary Prevention Measures Tailor health care clinics to men’s needs Provide screening services for men ➢ ➢ ➢ ➢ ➢ ➢ ➢ ➢ Dental examination: Yearly Eye examination: Every 3 to 5 years Blood pressure check: Every 2 years Blood cholesterol check for men aged 53 years and older Prostate examination: Every year after age 50; blacks every year after age 40 Colorectal screening: Every 3 to 5 years Tobacco use and cessation information every year One-time screening for abdominal aortic aneurysm for men 65 years old if the male has smoked – The U.S. Preventive Services Task Force (2004) Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc. 18 Tertiary Prevention Measures Provide rehabilitation with sex role and lifestyle considerations ➢ Provide counseling on lifestyle, role changes, and job retraining. ➢ Give men permission to express emotions. ➢ Adapt goal setting to meet men’s needs. ➢ Keep time away from work to a minimum. Develop new concepts of community care ➢ Provide specific services for men; adapt care to meet needs of male population in the community. Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc. 19
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