title: Exploring awareness and help-seeking intentions for testicular symptoms among heterosexual, gay, and bisexual men in Ireland: A qualitative descriptive study.
abstract: BACKGROUND
  The incidence of malignant and benign testicular disorders among young men is on the rise. Evidence from three reviews suggest that men's knowledge of these disorders is lacking and their help-seeking intention for testicular symptoms is suboptimal. Qualitative studies have addressed men's awareness of testicular cancer, with none exploring their awareness of non-malignant diseases such as epididymitis, testicular torsion, and varicocele and none including sexual minorities.
  
  
  OBJECTIVE
  To explore, in-depth, heterosexual, gay, and bisexual men's awareness of testicular disorders and their help-seeking intentions for testicular symptoms in the Irish context.
  
  
  METHODS
  This study used a qualitative descriptive approach. Data were collected via face-to-face individual interviews and focus groups.
  
  
  METHODS
  Participation was sought from a number of community and youth organisations and one university in Southern Ireland.
  
  
  METHODS
  Maximum variation and snowball sampling were used to recruit a heterogeneous sample. A total of 29 men partook in this study. Participants were men, aged between 18 and 50 years, and residents of the Republic of Ireland.
  
  
  METHODS
  All interviews were audio-recorded and transcribed verbatim. Reflective field notes were taken following each interview. A summary of the interview was shared with selected participants for member-check. Data were analysed and validated by three researchers. Inductive qualitative analysis of manifest content was used. Latent content was captured in the field notes. Data analysis yielded two key themes.
  
  
  RESULTS
  The themes that emerged from the interviews were: Awareness of testicular disorders and their screening, and help-seeking intentions for testicular symptoms. Although most participants heard of testicular cancer, most did not know the different aspects of this malignancy including its risk factors, symptoms, treatments, and screening. Several men had a number of misconceptions around testicular disorders which negatively impacted their intentions to seek prompt help. Intentions to delay help-seeking for testicular symptoms were often linked to a number of emotional factors including fear and embarrassment, and social normative factors such as machoism and stoicism. In this study, culture was perceived by some participants as a barrier to awareness and help-seeking. In contrast, many believed that young men, especially those who self-identify as gay, are becoming increasingly interested in their own health.
  
  
  CONCLUSIONS
  Findings suggest the need to educate young men about testicular disorders and symptoms. This could be achieved through conducting health promotion campaigns that appeal to younger men, drafting national men's health policies, and normalising open discussions about testicular health at a young age.
authors.affiliation: School of Nursing and Midwifery, University College Cork, Cork, Ireland. Electronic address: msaab@ucc.ie.
authors.forename: Mohamad M
authors.initials: MM
authors.lastname: Saab
authors.affiliation: School of Nursing and Midwifery, University College Cork, Cork, Ireland.
authors.forename: Margaret
authors.initials: M
authors.lastname: Landers
authors.affiliation: School of Nursing and Midwifery, University College Cork, Cork, Ireland.
authors.forename: Josephine
authors.initials: J
authors.lastname: Hegarty
mesh_terms: D000293:Adolescent; D000328:Adult; D001364:Awareness; D001727:Bisexuality; D020010:Heterosexuality; D018451:Homosexuality, Male; D006801:Humans; D007494:Ireland; D008297:Male; D008875:Middle Aged; D010342:Patient Acceptance of Health Care; D036301:Qualitative Research; D013733:Testicular Diseases / Q000503:physiopathology*; D055815:Young Adult
keywords: Awareness; Help-seeking behaviour; Homosexuality; Intentions; Men; Qualitative research; Testicular cancer; Testicular diseases