title: Medical Help-Seeking for Sexual Concerns in Prostate Cancer Survivors.
abstract: BACKGROUND
  Although sexual dysfunction is common after prostate cancer, men's decisions to seek help for sexual concerns are not well understood.
  
  
  OBJECTIVE
  Describe predictors of actual prior help-seeking and intended future medical help-seeking for sexual dysfunction in prostate cancer survivors.
  
  
  METHODS
  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.
  
  
  METHODS
  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.
  
  
  RESULTS
  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 (R(2) = 0.56).
  
  
  CONCLUSIONS
  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.
authors.affiliation: Menzies Health Institute Queensland, Griffith University, Gold Coast, Qld, Australia; Cancer Council Queensland, Brisbane, Qld, Australia. Electronic address: melissa.hyde@griffith.edu.au.
authors.forename: Melissa K
authors.initials: MK
authors.lastname: Hyde
authors.affiliation: Menzies Health Institute Queensland, Griffith University, Gold Coast, Qld, Australia; Cancer Council Queensland, Brisbane, Qld, Australia.
authors.forename: Leah
authors.initials: L
authors.lastname: Zajdlewicz
authors.affiliation: Department of Urology, Royal Melbourne Hospital, Melbourne, Vic., Australia; Epworth Prostate Centre, Epworth Healthcare, Melbourne, Vic., Australia; Australian Prostate Cancer Research, Melbourne, Vic., Australia.
authors.forename: Addie C
authors.initials: AC
authors.lastname: Wootten
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
authors.forename: Christian J
authors.initials: CJ
authors.lastname: Nelson
authors.affiliation: Menzies Health Institute Queensland, Griffith University, Gold Coast, Qld, Australia; Prostate Cancer Foundation of Australia, Sydney, NSW, Australia.
authors.forename: Anthony
authors.initials: A
authors.lastname: Lowe
authors.affiliation: Menzies Health Institute Queensland, Griffith University, Gold Coast, Qld, Australia; Cancer Council Queensland, Brisbane, Qld, Australia; School of Social Science, The University of Queensland, Brisbane, Qld, Australia.
authors.forename: Jeff
authors.initials: J
authors.lastname: Dunn
authors.affiliation: Menzies Health Institute Queensland, Griffith University, Gold Coast, Qld, Australia; Cancer Council Queensland, Brisbane, Qld, Australia; Prostate Cancer Foundation of Australia, Sydney, NSW, Australia; Exercise Medicine Research Institute, Edith Cowan University, Perth, WA, Australia; Centre for Clinical Research, The University of Queensland, Brisbane, Qld, Australia.
authors.forename: Suzanne K
authors.initials: SK
authors.lastname: Chambers
keywords: Erectile Dysfunction; Prostate Cancer; Sexual Help-Seeking