Hannah Dale, Gozde Ozakinci, Pauline Adair & Gerry Humphris

PhD Student, School of Medicine, University of St. Andrews

Health Psychologist NHS Fife

hd18@st-andrews.ac.uk +441334 696336

Men’s cancer inequalitiesCancer incidence and mortality rates are worse for men

than women in most countries (Micheli et al., 2009; Jemal et al, 2011)

Single men have even worse outcomes than partnered men or single/partnered women (e.g. Konski et al, 2006)

May be affected by (All party parliamentary group on cancer, 2009):

poorer symptom awareness poorer help seeking lower uptake of screening programmes

Influence of psychosocial issues and health behaviours on mortality generally lack evidence or are disputed

Psychosocial and behaviour factorsLargely accepted that psychosocial factors and health

behaviours affect men’s experience of cancer Systematic review of psychosocial and behaviour change

interventions for men with cancerVery little evidence for effective interventionsNo interventions focussing on single men

Relationships between these factors in men not well understood Strongest evidence for social support influencing

psychosocial issuesMen also disadvantaged around help seeking and

uptake to services (Nekolaichuk et al, 2011)

Objectives

To examine relationships between social support, distress, lifestyle behaviours and

desire for help, in men with cancer

MethodsCross-sectional questionnaire study targeting all adult

men with a diagnosis of cancerAssessed:

Demographic factors (Relationship status, age, type of cancer(s), time since diagnosis, and postcode)

Distress (DT)Depression and anxiety (HADS)Social support (Social Provisions Scale)Health behaviours (5 point likert scale)Desire for more support

Recruited through the NHS in the East of ScotlandData from the Scottish Longitudinal study enables

comparable demographic details to be examined

Results; representativeness127 men with cancer participated

Mean age 62 (range 23-86)76% married

Compared to the Scottish Longitudinal Study data, the sample was comparable for most demographics. Slight under-representation from those living in urban

areas and those with skin cancerSlight over representation of those with cancers of the

male genital organs, respiratory and haematological cancers

Results; sample overviewMany participants reported good levels of support. 18-30% scored within the clinical range for distress. The majority of people were meeting government

guidelines for not smoking, and drinking a maximum of 21 units of alcohol per week.

Only 24% met guidelines for 5 or more pieces of fruit or vegetables per day

67% met guidelines for 2.5 hours

of exercise per week

Results 3; relationshipsLower levels of social support were linked to worse

psychological health, along with smoking.Psychological issues were linked to greater smoking, less

fruit and vegetable consumption and lower exercise levels.

Having poor scores for social support and psychological issues all predicted wanting help for that issue.

There were also links between psychological issues and wanting help to improve lifestyle issues

Results; modelling

.90

.39

.56

.74

Desire for help

.54

Support to reduce distress

Support to improve feelings

Support to improve diet

Support to increase exercise

.83

Distress

HADS Depression

HADS Anxiety Distress Thermometer

.69 .63

.89

Support

Total Social Support

-.07

-.61

Support

Distress

DiscussionPsychosocial issues may interact to affect help seeking

behaviour. When examined together, help seeking for both

psychological issues and health behaviours is affected by social support mediated by distress.

Since help seeking is facilitated though psychological health, psychological difficulties may act to legitimise help seeking.

Further research: qualitative interviews with men with cancer to explore reasons for help seeking along with barriers and facilitators to doing so.

Limitations & future researchLimitationsSmall sample sizeBroad range of cancersHADS 2 factor structurePath analysis for

meditational model

Future researchLongitudinal data would

build on thisLarger sample sizes

neededDifferent measures?

ConclusionsExperiencing distress may be pivotal in men with

cancer desiring more help. Distress appears to mediate the relationship

between social support and desire for more help for psychological issues and lifestyle behaviours. Self-reported lifestyle behaviour would appear not to

be implicated in these relationships. Interventions and services aimed at men with cancer

may need to tailor material to gain men’s acceptability to access help.

Thank you

Any Questions?

hd18@st-andrews.ac.uk+441334 696336