Medical Help-Seeking for Sexual Concerns in Prostate Cancer Survivors

• Published in: Sexual medicine 2016-03, Vol.4 (1), p.e7-e17
• Main Authors: Hyde, Melissa K., Zajdlewicz, Leah, Wootten, Addie C., Nelson, Christian J., Lowe, Anthony, Dunn, Jeff, Chambers, Suzanne K.
• Format: Article
• Language: English
• Subjects: Erectile Dysfunction; Original Research; Prostate Cancer; Sexual Help-Seeking
• ISSN: 2050-1161; 2050-1161
• DOI: 10.1016/j.esxm.2015.12.004

Although sexual dysfunction is common after prostate cancer, men's decisions to seek help for sexual concerns are not well understood. Describe predictors of actual prior help-seeking and intended future medical help-seeking for sexual dysfunction in prostate cancer survivors. 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. 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. 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 (R2 = 0.56). 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.