Psychosocial Challenges of Young Men Affected by Cancer
Psychosocial Challenges of Young Men Affected by Cancer
Despite frustrations stemming from expectations of masculinity, some men discussed examples of effective support that could be modeled by nursing practitioners. First, men need to find outlets to express feelings, which might be a challenge for those lacking appropriate communication skills or support networks. Speaking out risks losing other men's emotional support, but the resulting catharsis seems to outweigh the cost; men who do seek the help of others praise the experience. Responses suggest that an ideal scenario would include ways for men to express feelings without threatening masculine identity; for example, using humor to introduce the topic and promote coping during support exchanges (Chapple & Ziebland, 2004; Oliffe, Ogrodniczuk, et al., 2009). Of course, dealing with cancer as a joint effort requires extensive conversation and sharing. Communication training and handouts encouraging men to discuss difficult topics have served as successful prompts among older men diagnosed with prostate cancer and may do the same for younger men (Kripalani et al., 2007; Nelson & Kenowitz, 2013).
The openness of men in the online forum suggests that expressing thoughts and feelings may be easier through the relative anonymity of digital media, a strategy that nurses can proactively recommend. Consistent with prior work (Chapple, Salinas, Ziebland, McPherson, & Macfarlane, 2007; Seale, Ziebland, & Charteris-Black, 2006), the online data indicate that sensitive issues, such as sexuality and emotions, benefit from online anonymity and can meet the desire for opportunities to discuss sensitive topics.
Connecting men through other activities, not explicitly connected with cancer, such as sports or exercise (Carless & Douglas, 2008) and religious groups (Tarakeshwar et al., 2006), received strong support in the interview and focus group findings in accordance with research demonstrating positive connections between activity and mental-health outcomes (Hefferon, Mallery, Gay, & Elliot, 2013; Mason & Holt, 2012), as well as spirituality and well-being in men and young adult survivors (Krupski et al., 2006; Park, Edmondson, Hale-Smith, & Blank, 2009). The focus, then, is not on men's cancer experiences, but on a shared interest that can be a conduit for cancer-related conversation and, therefore, gender- and age-appropriate support.
Limitations of the current study include a primary data set of de-identified text that existed prior to the study, removing the ability to probe. Although the researchers worked to address this through interviews, digitally reported behaviors and motivations were not subject to exploration. In addition, individuals living in households earning less than $30,000 per year and Spanish-dominant Hispanic adults living in the United States are less likely to use online support (Zickuhr & Smith, 2012), and these groups were not present in the focus group or interviews. For participants far removed from diagnosis and treatment, subsequent aging may have influenced their views on masculinity. Therefore, the data offer a piece of the young adult male cancer experience but cannot be applied to all demographics or diagnoses.
Implications for Nursing Practice
Despite frustrations stemming from expectations of masculinity, some men discussed examples of effective support that could be modeled by nursing practitioners. First, men need to find outlets to express feelings, which might be a challenge for those lacking appropriate communication skills or support networks. Speaking out risks losing other men's emotional support, but the resulting catharsis seems to outweigh the cost; men who do seek the help of others praise the experience. Responses suggest that an ideal scenario would include ways for men to express feelings without threatening masculine identity; for example, using humor to introduce the topic and promote coping during support exchanges (Chapple & Ziebland, 2004; Oliffe, Ogrodniczuk, et al., 2009). Of course, dealing with cancer as a joint effort requires extensive conversation and sharing. Communication training and handouts encouraging men to discuss difficult topics have served as successful prompts among older men diagnosed with prostate cancer and may do the same for younger men (Kripalani et al., 2007; Nelson & Kenowitz, 2013).
The openness of men in the online forum suggests that expressing thoughts and feelings may be easier through the relative anonymity of digital media, a strategy that nurses can proactively recommend. Consistent with prior work (Chapple, Salinas, Ziebland, McPherson, & Macfarlane, 2007; Seale, Ziebland, & Charteris-Black, 2006), the online data indicate that sensitive issues, such as sexuality and emotions, benefit from online anonymity and can meet the desire for opportunities to discuss sensitive topics.
Connecting men through other activities, not explicitly connected with cancer, such as sports or exercise (Carless & Douglas, 2008) and religious groups (Tarakeshwar et al., 2006), received strong support in the interview and focus group findings in accordance with research demonstrating positive connections between activity and mental-health outcomes (Hefferon, Mallery, Gay, & Elliot, 2013; Mason & Holt, 2012), as well as spirituality and well-being in men and young adult survivors (Krupski et al., 2006; Park, Edmondson, Hale-Smith, & Blank, 2009). The focus, then, is not on men's cancer experiences, but on a shared interest that can be a conduit for cancer-related conversation and, therefore, gender- and age-appropriate support.
Limitations
Limitations of the current study include a primary data set of de-identified text that existed prior to the study, removing the ability to probe. Although the researchers worked to address this through interviews, digitally reported behaviors and motivations were not subject to exploration. In addition, individuals living in households earning less than $30,000 per year and Spanish-dominant Hispanic adults living in the United States are less likely to use online support (Zickuhr & Smith, 2012), and these groups were not present in the focus group or interviews. For participants far removed from diagnosis and treatment, subsequent aging may have influenced their views on masculinity. Therefore, the data offer a piece of the young adult male cancer experience but cannot be applied to all demographics or diagnoses.
