Does Perceived Loneliness Matter for Diverse Older Men and Their Prostate-Specific-Antigen Testing Behaviors? (original) (raw)
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Nursing: Research and Reviews, 2016
The purpose of this research was to examine intrapersonal and community factors associated with prostate cancer screening (PCS) among African-American (AA) males of ≥40 years from a nationally representative data set in the US. The theory of planned behavior was utilized as the theoretical framework. Patients and methods: A cross-sectional secondary analysis employed data from the National Health and Nutrition Examination Survey in the US. The sample consisted of 377 AA males. The primary outcome variables were two PCS tests, the digital rectal exam (DRE) and the prostate-specific antigen test. Logistic regression models were developed to test for associations between the PCS tests and the factors of interest. Results: The factors of age, education, and access to a health care facility were associated with AA males receiving the DRE. The age group of 40-49 years was least likely to receive the DRE when compared to the age group of ≥70 years. Similarly AA males without a college degree were also least likely to receive the DRE when compared to AA males with a college degree. AA males with access to health care were more likely than those without access to receive the DRE. Age <70 years along with church attendance was associated with AA males receiving the prostate-specific antigen test. Conclusion: Differences were present for significant associations among intrapersonal and community variables and the two PCS exams. A culturally sensitive approach is necessary for understanding factors associated with PCS among AA males, which is central to designing and appropriately targeting public health interventions to decrease the health disparity of prostate cancer among this high-risk population.
Cancer Epidemiology Biomarkers & Prevention, 2008
Prostate cancer is the second leading cause of cancer deaths among US men. Early detection is associated with drastically improved 5-year survival rates. It is unclear, however, what psychosocial factors motivate or discourage men from taking advantage of both prostate specific antigen testing (PSA) and digital rectal examination (DRE). The goal of the current study was to identify psychosocial factors that influence screening behavior for prostate cancer in a cohort of 2,447 men. In 1990, a randomly selected cohort of Caucasian men, ages 40-79 years, from Olmsted County, MN were enrolled in the study. These men completed a questionnaire containing queries on family history of prostate cancer, concern about getting prostate cancer and marital status. Medical and laboratory records were reviewed to determine the number DRE exams (1989)(1990)(1991)(1992)(1993)(1994)(1995)(1996) and PSA tests (1989and PSA tests ( -1998. Frequent screening was defined as the upper 25 th percentile for number of DREs (>4) or PSAs (>3). Men who have a family history and men who worry or have concern about prostate cancer were more likely (OR=1.5, 95%CI=1.2, 2.0 and OR=1.9, 95%CI=1.4, 2.5) to seek screening compared to those without a family history or worry. The association between family history and frequent screening was similar in men who were married or living with someone (OR=1.7, 95%CI=1.2, 2.2), however it was reduced among men who live alone (OR=0.6, 95%CI=0.2, 1.8). These data suggest that psychosocial factors such as family history, worry or concern about prostate cancer and marital status may play an important role in men's decisions about prostate cancer screening.
Black men are more likely to be diagnosed with prostate cancer compared with White men. Despite advances in prevention and treatment strategies, disparities in prostate cancer among Black men persist. While research on the causes of higher incidence and mortality is ongoing, there is limited evidence in the existing literature that clearly speaks to the potential psychological or social factors that may contribute to disparities in prostate cancer incidence. Given the lack of attention to this issue, we review scientific evidence of the ways in which social factors, including socioeconomic status and racial segregation, as well as psychological factors, like depression and anxiety, are related to subsequent prostate cancer risk, which could occur through behavioral and biological processes. Our objective is to illuminate psychosocial factors and their context, using a racial disparity lens, which suggests opportunities for future research on the determinants of prostate cancer. Ultimately, we aim to contribute to a robust research agenda for the development of new prostate cancer prevention measures to reduce racial disparities.
Supportive Care in Cancer, 2014
Objectives Men's response to ill health is framed as a "battleground" for the enactment of masculinities. With an increase in diagnoses of men's cancers, there is a need to better understand the features which influence timely access to diagnostic services. This study explored the ways in which men account for the timing of their diagnosis of prostate cancer. Methods Thirty semi-structured interviews were conducted with men and, where possible, their partner. Data were analyzed with reference to framework analysis. Results Relationships, including spousal, familial, and friendships, appear pivotal in informing men's help-seeking behaviors. Friends and partners were often critical in facilitating access to primary care. Following their own diagnosis, this virtuous cycle of encouragement led many men to encourage others to seek medical attention for prostate tests. Conclusions Interpersonal relationships are a missing dimension in models of delay. We need to know more about how to use relationships, in addition to traditional routes, to harness health promotion messages. Interpersonal relationship, including partners and social networks, may be powerful conduits and may prove effective mechanisms to identify and access men most at risk of prostate cancer.
Journal of Public Health, 2020
Aim Concerns around loneliness leading to increased healthcare use persist in spite of a mixed evidence base and lack of adjustment for key potential confounders. We investigated the associations among loneliness, health and healthcare use in older adults including stratification to investigate whether these associations differ by gender. Subject and methods Secondary analysis of a nationally representative sample of 8175 community-dwelling adults aged 50 years and over from The Irish Longitudinal Study on Ageing (TILDA). Primary outcomes were self-reported general practitioner (GP) and emergency department (ED) visits in the past 12 months. Negative binomial and logistic regression analysis was used to investigate associations between loneliness and healthcare use, later adjusting for potential mediators (health and health behaviours). Results Loneliness was consistently positively associated with number of GP visits according to both cross-sectional and longitudinal analyses, with...
Conceptualizing Loneliness in Health Research.pdf
Journal of Theoretical and Philosophical Psychology, 2018
Increasing attention is being paid to loneliness, and to its impact on the health of older people, across numerous disciplines including psychology, public health, social policy, and psychiatry. In tandem, there has been increasing interest in the impact of social factors on health. However, definitions of loneliness are disparate, and a consensus on its meaning is arguably lacking. Often, loneliness is conflated with similar but distinct concepts such as social isolation, absence of social support, or a lack of social connectedness. We submit that the concept of loneliness requires clarification, especially in the extant health literature. We attempt to synthesize theories of loneliness provide a framework for future interventions. We further argue that the necessary clarification can be achieved using both empirical and nonempirical methodologies, under a transdisciplinary effort. We describe the potential for psychology, public health, and philosophy to come together to achieve this conceptual clarity around loneliness and to develop effective interventions on this problematic experience as a result.
Prostate cancer screening between low-income African-American and Caucasian men☆
Urologic Oncology: Seminars and Original Investigations, 2005
Objective: African-Americans (AA) are more likely than Caucasians (CA) to be diagnosed with advanced prostate cancer, perhaps due to delayed detection. We investigated racial differences in prostate cancer screening according to age and socioeconomic and demographic indices in a large and predominantly low-income population.
Loneliness, health, and mortality in old age: A national longitudinal study
Social Science & Medicine, 2012
This study examined the relationship between loneliness, health, and mortality using a U.S. nationally representative sample of 2,101 adults aged 50 years and over from the 2002 to 2008 waves of the Health and Retirement Study. We estimated the effect of loneliness at one point on mortality over the subsequent six years, and investigated social relationships, health behaviors, and health outcomes as potential mechanisms through which loneliness affects mortality risk among older Americans. We operationalized health outcomes as depressive symptoms, self-rated health, and functional limitations, and we conceptualized the relationships between loneliness and each health outcome as reciprocal and dynamic. We found that feelings of loneliness were associated with increased mortality risk over a 6-year period, and that this effect was not explained by social relationships or health behaviors but was modestly explained by health outcomes. In cross-lagged panel models that tested the reciprocal prospective effects of loneliness and health, loneliness both affected and was affected by depressive symptoms and functional limitations over time, and had marginal effects on later self-rated health. These population-based data contribute to a growing literature indicating that loneliness is a risk factor for morbidity and mortality and point to potential mechanisms through which this process works.