Understanding the Distress and Coping of Men with Cancer Indicates the Integration of Comprehensive and Accessible Information into Standard Treatment Paths (#157)
There is now replicated meta-analytic evidence that men can enjoy twice the effect size from psycho-oncological intervention targeting distress than women, and there are other indications that people from vulnerable socio-demographic groups also benefit more. These outcomes may be due to elevated baseline distress associated with disadvantage, isolation, and masculine norms, meaning that men – particularly those from vulnerable groups – stand to gain more from intervention. Notwithstanding, men generally underutilise services.
This New Zealand qualitative 'action research' project investigated the nature of men's cancer-related distress and coping, and proposed changes in medical and psycho-social service delivery to better address men's needs, making use of their coping strengths. The sampling strategy and size were designed to ensure that the demographic characteristics of poorer provincial regions were amply represented. Twenty-seven men (including six Maori) who were in palliative care, on 'watchful waiting', or who had recently been curatively treated, were interviewed in depth. Data were thematically analysed producing models of distress and coping, and a metaphor for distress processing. These were verified in discussion with participants from the most vulnerable groups, and intervention suggestions were also discussed with them and with two more privileged participants.
The nub of the models and processing metaphor was (lack of) information / knowledge about cancer, its treatment and hospital processes, and available support services. Other research has shown that men are disadvantaged in their knowledge of health and health services. The thrust of the intervention suggestions called for a paradigm shift towards recognising the fundamental importance of providing timely, comprehensive, and accessible information as part of standard medical treatment paths. Six strategies for achieving this were proposed. At time of writing, dissemination of theoretical findings and intervention suggestions has begun with provider and stakeholder groups at both local and national levels, and has been received with enthusiasm.