men's health

男性健康
  • 文章类型: Journal Article
    虽然健康的社会决定因素已经指导了公平工作与男性健康促进计划的剪裁,的作用,和潜力,这些干预措施中健康的商业决定因素很少得到解决,也知之甚少。虽然四种商业产品,烟草,酒精,超加工食品,和化石燃料,占全球死亡人数的三分之一以上,有必要认识到消费品行业可以对健康做出积极和消极的贡献。这篇文章开始了关于我们可以从中学到什么的急需的讨论,战略性地利用商业部门来播种,scale,并维持男性的健康促进计划。三个案例研究,在线体育博彩,啤酒和诺尼的崛起,和运动服,正在讨论。在线体育博彩和男性之间的联系解释了年轻人不成比例的参与和赌博成瘾,并建议立法终止赌博广告,并通过罚款和更高的税收来激励行业暴利。关于啤酒和诺尼的崛起,酿酒商基于其核心市场男性的消费模式和男性气概的变化,对无酒精啤酒进行了创新。Nonny提醒健康促进者了解其最终用户的价值观和行为,以增强程序的可接受性。详细介绍盔甲和露露柠檬,两个高度性别化但多样化的运动服装品牌,的复杂性,和潜力,强调了利用公共卫生和行业合作。一起来看,文章的研究结果表明,男性健康促进者应严格探索利用关键的商业实体和税收,以促进男性及其社区的健康。
    Although the social determinants of health have guided equity work with the tailoring of men\'s health promotion programs, the role of, and potential for, the commercial determinants of health in those interventions is rarely addressed and poorly understood. While four commercial products, tobacco, alcohol, ultra-processed food, and fossil fuels, account for more than a third of global deaths, there is a need to recognize that consumer goods industries can make both positive and negative contributions to health. This article begins much-needed discussions about what we might learn from, and strategically tap in the commercial sector to seed, scale, and sustain men\'s health promotion programs. Three case studies, online sports betting, beer and the rise of the nonny, and athleisurewear, are discussed. Connections between online sports betting and masculinities explain young men\'s disproportionate involvement and gambling addictions with recommendations to legislate an end to gambling advertisements and de-incentivize industry profiteering through penalties and higher taxes. Regarding beer and the rise of the nonny, brewers have innovated with non-alcoholic beer based on shifting consumption patterns and masculinities in their core market-men. The nonny reminds health promoters to know their end-user\'s values and behaviors to bolster program acceptability. Detailing Under Armour and Lululemon, two highly gendered but diversifying athleisurewear brands, the complexities of, and potential for, leveraging public health and industry collaborations are underscored. Taken together, the article findings suggest men\'s health promoters should rigorously explore tapping key commercial entities and tax revenues to advance the health of men and their communities.
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  • 文章类型: Journal Article
    美国联邦政策和基础设施未能明确考虑男性的健康,尤其是边缘化男性的健康状况不佳。这种对男性健康的忽视阻碍了国家改善人口健康的能力,为了实现性别健康公平,并更广泛地实现健康公平。扩大在联邦政策和基础设施中考虑性别的努力,将男子纳入其中,将男性命名为健康状况不佳需要政策关注的人群,在联邦机构建立男性健康办公室,并利用交叉透镜来制定和分析影响健康的政策,可能会对美国的人口健康和健康公平产生重大改善。使用疾病控制和预防中心的数据,我说明了死亡率和主要死亡原因的性别差异的持续存在,以及这些模式如何掩盖主要由边缘化男性驱动的健康性别差距。鉴于按性别和种族分别提供数据的普遍做法,当特定人群的健康值得关注时,很难识别。我利用黑人的案例来说明交叉方法的重要性,以及为什么男性的健康对于实现健康中的性别和种族平等至关重要。虽然性别平等主流化方法增强了国家考虑和解决妇女和女孩健康问题的能力,它没有扩大到包括男孩和男人。因此,我认为,如果我们的目标是实现健康公平,至关重要的是采用一种交叉方法,同时考虑影响个人和人群健康和福祉的所有因素。交叉方法将有助于努力同时探索实现种族,民族,和性别健康平等,这是由性别和性别相关因素之外的结构决定因素驱动的。
    United States\' federal policy and infrastructure fail to explicitly consider the health of men, particularly the poor health of marginalized men. This inattention to men\'s health hinders the nation\'s ability to improve population health, to achieve gender health equity, and to achieve health equity more broadly. Expanding efforts to consider gender in federal policy and infrastructure to include men, naming men as a population whose poor health warrants policy attention, creating offices of men\'s health in federal agencies, and utilizing an intersectional lens to develop and analyze policies that affect health would likely yield critical improvements in population health and health equity in the United States. Using data from the Centers for Disease Control and Prevention, I illustrate the persistence of sex differences in mortality and leading causes of death, and how these patterns mask gender gaps in health that are driven largely by marginalized men. Given the common practice of presenting data by sex and race separately, it is difficult to recognize when the health of specific groups of men warrants attention. I utilize the case of Black men to illustrate the importance of an intersectional approach, and why men\'s health is critical to achieving gender and racial equity in health. While a gender mainstreaming approach has enhanced the nation\'s ability to consider and address the health of women and girls, it has not expanded to be inclusive of boys and men. Consequently, I argue that if our goal is to achieve health equity, it is critical to employ an intersectional approach that simultaneously considers the full range of factors that influence individual and population health and well-being. An intersectional approach would facilitate efforts to simultaneously explore strategies to achieve racial, ethnic, and gender health equity, which are driven by structural determinants beyond sex and gender related factors.
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  • 文章类型: Journal Article
    目前,大多数不孕症男性不能被给予病因,这反映了缺乏有关配子生产的知识,以及它是如何受到遗传和环境的影响。未能认识到男性不育症的负担及其作为系统性疾病生物标志物的潜力。缺乏这种知识会导致患者通常被视为一个统一的群体,对他们来说,策略是使用医学辅助生殖(MAR)技术绕过因果关系。在这样做的时候,错过了预防合并症的机会,MAR的负担转移到了妇女身上。增进对男性生殖健康的了解,纵向和多国数据和样本收集中心至关重要。这些方案必须能够对遗传学的后果有一个综合的看法,表观遗传学和环境因素对生育和后代健康的影响。需要定义和可能改善MAR对受孕儿童的后果。本声明中固有的是必须促进生育力恢复和/或使用可用的侵入性最小的MAR策略。为了实现这一目标,必须严格测试协议,并鼓励向个性化医疗迈进。同样,公众的教育,需要政府和临床医生对不孕症的频率和后果进行研究。健康选择,包括男性避孕药,必须扩大,以及这种投资所包含的机会。与男性生殖健康有关的紧迫问题,在专家建议中确定了整个男科的范围。
    Currently, most men with infertility cannot be given an aetiology, which reflects a lack of knowledge around gamete production and how it is affected by genetics and the environment. A failure to recognize the burden of male infertility and its potential as a biomarker for systemic illness exists. The absence of such knowledge results in patients generally being treated as a uniform group, for whom the strategy is to bypass the causality using medically assisted reproduction (MAR) techniques. In doing so, opportunities to prevent co-morbidity are missed and the burden of MAR is shifted to the woman. To advance understanding of men\'s reproductive health, longitudinal and multi-national centres for data and sample collection are essential. Such programmes must enable an integrated view of the consequences of genetics, epigenetics and environmental factors on fertility and offspring health. Definition and possible amelioration of the consequences of MAR for conceived children are needed. Inherent in this statement is the necessity to promote fertility restoration and/or use the least invasive MAR strategy available. To achieve this aim, protocols must be rigorously tested and the move towards personalized medicine encouraged. Equally, education of the public, governments and clinicians on the frequency and consequences of infertility is needed. Health options, including male contraceptives, must be expanded, and the opportunities encompassed in such investment understood. The pressing questions related to male reproductive health, spanning the spectrum of andrology are identified in the Expert Recommendation.
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  • 文章类型: Journal Article
    背景:与可育男性相比,不育男性的整体健康状况较差。
    目的:我们的目的是i)评估与育龄男性相比,原发性夫妇不孕症男性的肾功能;和,ii)评估不育男性对精子质量的肾功能损害。
    方法:在本病例对照研究中,387名连续的欧洲白人不育男性与134名相同种族的育龄男性年龄相匹配。每位患者均可获得完整的临床和实验室数据。慢性肾脏病流行病学合作(CKD-EPI)功能用于估算肾小球滤过率(eGFR)计算。肾功能损害定义为eGFR<90ml/min/1.73m2,根据肾脏疾病改善全球结果标准。多变量logistic回归分析用于i)评估肾功能损害与不孕症状态之间的关联;并且,ii)研究不育男性的肾功能与精液分析异常之间的关联。
    结果:匹配后,34名(8.8%)不育男性描述了至少轻度未知的肾功能损害,而只有4名(3%)有生育能力的男性,4(3%)的不育症表现为明显的肾功能损害(eGFR<60ml/min/1.73m2)。在年龄方面没有差异,两组间BMI和合并症发生率比较(P均>0.05)。在调整了主要混杂因素后,不孕状态与eGFR降低的较高风险相关(OR3.20;1.21-5.2;p=0.002).相反,eGFR与不育男性精子异常无关。
    结论:在9%的无症状且未意识到的男性中发现了轻度肾功能损害。这项新发现证实了越来越多的数据,表明男性不育与整体男性健康状况较差以及需要量身定制的预防策略之间存在显着关联。本文受版权保护。保留所有权利。
    Infertile men have a worse overall health status than their fertile counterparts.
    We aimed to (1) compare kidney function in men presenting for primary couple\'s infertility with that of fertile men and (2) assess kidney function impairment toward sperm quality in infertile men.
    In this case-control study, 387 consecutive white-European infertile men were matched by age with 134 same-ethnicity fertile men. Complete clinical and laboratory data were available for each patient. The Chronic Kidney Disease Epidemiology Collaboration function was used for estimated glomerular filtration rate calculation. Kidney functional impairment was defined as an estimated glomerular filtration rate <90 mL/min per 1.73 m2 , according to the Kidney Disease Improving Global Outcomes criteria. Multivariable logistic regression analysis was used to (1) assess the association between kidney function impairment and infertility status and (2) investigate the association between kidney function and semen analysis abnormalities in infertile men.
    After matching, 34 (8.8%) infertile men depicted at least a mild unknown impairment of kidney function compared to only four (3%) fertile men, with four (3%) of the infertile presenting with an overt kidney function impairment (estimated glomerular filtration rate <60 mL/min per 1.73 m2 ). There were no differences in terms of age, body mass index and rate of comorbidities between the two groups (all p > 0.05). After adjusting for major confounders, infertility status was associated with a higher risk of reduced estimated glomerular filtration rate (odds ratio 3.20; 95% confidence interval 1.21-5.2; p = 0.002). Conversely, estimated glomerular filtration rate was not associated with sperm abnormalities in infertile men.
    Mild kidney function impairment was found in 9% of asymptomatic and unaware men presenting for primary couple\'s infertility investigation. This novel finding corroborates growing data on a significant association of male infertility with a poorer overall male health status and the need for tailored preventive strategies.
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  • 文章类型: Journal Article
    目的:基于进化的睡眠研究对于确定母亲和婴儿的母乳喂养和夜间睡眠接近度的相互依赖至关重要。关于共同睡眠的进化观点也经常强调睡眠接近的情感动机和潜在好处,包括父母与婴儿的结合。然而,对于母亲和父亲来说,婴儿睡眠位置和联系之间的这种潜在联系仍然没有得到充分研究。此外,在欧美背景下,同床与家庭压力和困难的儿童气质有关,主要是通过产妇报告。我们对父系心理社会动力学是否因家庭睡眠安排而有所不同知之甚少,尽管父亲和其他亲属经常出现在跨文化的共眠环境中。这里,我们的目标是帮助解决一些有关父亲和家庭睡眠安排的知识差距。
    方法:利用美国中西部父亲的样本(N=195),我们收集了社会人口统计学和调查数据来分析婴儿夜间睡眠位置之间的联系,父系的社会心理健康,父子关系,和婴儿气质。从父亲的报告,家庭通常被描述为孤独的睡眠,共享床上用品,或共享房间(不共享床铺)。
    结果:我们发现,经常合房或同床的父亲,分别,据报道,结合力比孤独的睡眠者强。同床共枕的父亲还报告说,他们的婴儿有更多的负面气质,并且由于与孩子的困难,他们也倾向于报告更大的育儿压力。
    结论:这些横断面结果有助于突出具有深层系统发育和进化史的实践,比如同睡,可以在社区内可变地表达,具有家庭依赖的利益或菌株的潜力。
    OBJECTIVE: Evolutionary-grounded sleep research has been critical to establishing the mutual dependence of breastfeeding and nighttime sleep proximity for mothers and infants. Evolutionary perspectives on cosleeping also often emphasize the emotional motivations for and potential benefits of sleep proximity, including for parent-infant bonding. However, this potential link between infant sleep location and bonding remains understudied for both mothers and fathers. Moreover, in Euro-American contexts bedsharing has been linked to family stress and difficult child temperament, primarily via maternal reports. We know relatively little about whether paternal psychosocial dynamics differ based on family sleep arrangements, despite fathers and other kin often being present in the cosleeping environment across cultures. Here, we aim to help address some of these gaps in knowledge pertaining to fathers and family sleep arrangements.
    METHODS: Drawing on a sample of Midwestern U.S. fathers (N=195), we collected sociodemographic and survey data to analyze links between infant nighttime sleep location, paternal psychosocial well-being, father-infant bonding, and infant temperament. From fathers\' reports, families were characterized as routinely solitary sleeping, bedsharing, or roomsharing (without bedsharing).
    RESULTS: We found that routinely roomsharing or bedsharing fathers, respectively, reported stronger bonding than solitary sleepers. Bedsharing fathers also reported that their infants had more negative temperaments and also tended to report greater parenting-related stress due to difficulties with their children.
    CONCLUSIONS: These cross-sectional results help to highlight how a practice with deep phylogenetic and evolutionary history, such as cosleeping, can be variably expressed within communities with the potential for family-dependent benefits or strains.
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  • 文章类型: Journal Article
    本文分析了两部关于年轻人神经性厌食症(AN)的经历的年轻成人(YA)小说,在医学人文研究对疾病文学描述的双重背景下,以及关于AN的更广泛的YA文学领域。在强调多样化文学叙事的重要性的同时,为了提高人们对男性和男孩中AN的普遍性的认识,并有助于减少耻辱,它还考虑了当前对文学对弱势读者的潜在有害触发影响的研究。它确定了AnnePercin的Pointdecóté(边缝)(2006年)和SimonBoulerice的JeanneMoreaualesourireàl'envers(JeanneMoreauHasAUpside-DownSmile)(2013年)作为文学中良好实践的示例,由于他们的主题关注男性经验,因为他们采用的叙事策略破坏了读者对厌食症特征的认同,避免直接关注可能引发厌食症的想法和行为的描述。它们还有助于通过对女同性恋的非判断性刻画来使AN的刻画多样化,同性恋,双性恋,和变性者(LGBT)主题,目前可用英语的同等YA小说中缺少的主题。文章进一步指出,包括小说在内的文学有助于围绕特定疾病的整体社会和文化话语,并可能影响患者的现实世界体验。但它本身就是一种特定的话语,需要用适当的工具阅读。它对叙事声音和主题内容的详细分析表明,文学研究领域的具体方法如何补充文学及其在心理健康话语中的地位的实证研究。
    This article analyses two young adult (YA) novels about young men\'s experience of anorexia nervosa (AN), within the dual contexts of medical humanities research into literary depictions of illness, and the broader field of YA literature about AN. While emphasising the importance of diverse literary narratives in order to raise awareness of the prevalence of AN in men and boys, and to contribute to the reduction of stigma, it also considers current research into the potentially harmful triggering effects of AN literature on vulnerable readers. It identifies Anne Percin\'s Point de côté (Side Stitch) (2006) and Simon Boulerice\'s Jeanne Moreau a le sourire à l\'envers (Jeanne Moreau Has An Upside-Down Smile) (2013) as examples of good practice in AN literature, due to their thematic focus on male experience, and because they employ narrative strategies that disrupt reader identification with the anorexic character, and avoid focusing directly on potentially triggering descriptions of anorexic ideas and behaviour. They also contribute to diversifying the portrayal of AN via non-judgmental portrayal of lesbian, gay, bisexual, and transgender (LGBT) themes, a topic absent from equivalent YA novels currently available in English. The article further argues that literature-including fiction-contributes to the overall social and cultural discourse surrounding specific illnesses and is likely to affect patients\' real-world experiences, but that it is a specific kind of discourse in its own right, which demands to be read with the appropriate tools. Its detailed analysis of narrative voice alongside thematic content demonstrates how specific approaches from the field of literary studies may complement empirical research into literature and its place within mental health discourse.
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  • 文章类型: Journal Article
    Previous research in Victoria, Australia, found differences in prostate cancer outcomes in regional and metropolitan areas. This investigation of undiagnosed men in regional areas and a metropolitan area of South Australia sought their perspectives on prostate cancer. Our aim was to learn whether men who had not been diagnosed could shed light on why men outside metropolitan areas tended to have poorer outcomes than metropolitan men. Our goal was to build on evidence contributing to improving outcomes in prostate cancer care. Semi-structured interviews were designed to elicit explanation and meaning. 15 men (10 metropolitan, 5 regional) not diagnosed with prostate cancer were recruited through widely-distributed flyers in medical and community settings. Interviews were recorded and transcribed; transcripts were analysed thematically. Five main themes were identified, four of which were prompted by the questions: Addressing prostate health, Experiences with and expectations of GPs, Differences in care between regional and metropolitan areas, and Achieving early diagnosis. The fifth theme arose spontaneously: Australian masculinity. Men identified as problematic the limited availability of GPs in regional areas, the lack of consistency in approaches to prostate cancer detection, and men\'s reluctance to seek medical care. Community-level strategies appear to be valued to encourage men to address prostate health. Maintaining and extending a systemic approach to prostate care may improve outcomes for men in Australia.
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  • 文章类型: Journal Article
    硒蛋白P(SELENOP)是血浆中的一种主要硒酶,与抗氧化特性有关,可能与肺癌有关;然而,支持证据有限。我们在一项病例对照研究中调查了诊断前血浆SELENOP浓度与肺癌风险之间的关系,该研究涉及403例病例和403例单独匹配的对照。通过夹心酶联免疫吸附测定测量诊断前血浆样品中的SELENOP浓度。病例在2003年至2010年之间被诊断为肺癌。使用多因素条件逻辑回归估计比值比(OR)和相应的95%置信区间(CI),以研究血浆SELENOP浓度与肺癌风险之间的关系。病例血浆SELENOP浓度略低于对照组(4.3±1.2对4.4±1.1mg/l,P差异=0.09)。然而,多变量分析显示,在所有参与者中,血浆SELENOP浓度与肺癌风险之间没有相关性(四分位数4与四分位数1的OR=1.08,95%CI=0.54-2.14),或吸烟状况或肿瘤侵袭性。相比之下,尽管案件数量有限,血浆SELENOP浓度与肺腺癌风险呈正相关(OR=5.38,95%CI=1.89-15.35,分别为三元组3和三元组1),而非肺鳞癌(OR=1.69,95%CI=0.43-6.70)。我们对生活在中国非硒缺乏地区的成年男性的研究几乎没有为诊断前血浆SELENOP浓度与肺癌风险之间的负相关提供支持。我们发现与肺腺癌风险呈正相关的发现需要谨慎解释。
    Selenoprotein P (SELENOP) is a major selenoenzyme in plasma and linked to antioxidant properties and possibly to lung cancer; however, supporting evidence is limited. We investigated the association between pre-diagnostic plasma SELENOP concentration and lung cancer risk in a case-control study of 403 cases and 403 individually matched controls nested within the Shanghai Men\'s Health Study. SELENOP concentration in pre-diagnostic plasma samples was measured by a sandwich enzyme-linked immunosorbent assay. Cases were diagnosed with lung cancer between 2003 and 2010. Multivariate conditional logistic regression was used to estimate odds ratios (OR) and the corresponding 95% confidence intervals (CI) for studying the association between plasma SELENOP concentration and lung cancer risk. Cases had slightly lower plasma SELENOP concentration than controls (4.3 ± 1.2 versus 4.4 ± 1.1 mg/l, P difference = 0.09). However, the multivariate analysis showed no association between plasma SELENOP concentration and lung cancer risk among all participants (OR = 1.08, 95% CI = 0.54-2.14 for quartile 4 versus quartile 1), or by smoking status or tumor aggressiveness. In contrast, although the number of cases was limited, plasma SELENOP concentration was positively associated with lung adenocarcinoma risk (OR = 5.38, 95% CI = 1.89-15.35 for tertile 3 versus tertile 1), but not with squamous cell lung carcinoma (OR = 1.69, 95% CI = 0.43-6.70). Our study of adult men living in selenium non-deficient areas in China provides little support for the inverse association between pre-diagnostic plasma SELENOP concentration and lung cancer risk. Our finding of a positive association with risk of lung adenocarcinoma needs to be interpreted with caution.
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  • 文章类型: Journal Article
    健康的社会决定因素对男性死亡率的影响不成比例。对利兹男性人口的健康状况进行了研究,以指导公共卫生委托决策。本文报告了与男性社会生活有关的数据。
    进行了一项横断面研究,包括对与教育程度有关的数据的描述性分析,住房,就业(包括福利申领人),婚姻状况和人际关系。考虑了整个城市的数据,并将其本地化在中部超级产出区(MSOA)级别,并根据剥夺指数进行了映射。
    从最早的评估中发现男孩的教育程度落后于女孩(早年基础阶段简介,46%vs.60%,P=0.00)至GCSE(53%vs.63%,P=0.00),让许多男人没有资格。失业的男性比女性多68%,更多的男人声称有好处。居住在社会住房中的男性更有可能住在高层公寓中。16-64岁的男性中几乎有50%是单身,有2254个孤独的父亲。
    似乎缺乏对当前跨城市数据的性别/性别分析。在贫困地区,出现了多种社会问题的复杂情况,在健康的社会决定因素方面存在明显的性别差异,男性似乎受到更大的负面影响。有必要进行更有针对性的规划,以接触和瞄准最贫困的内城地区的男孩和男人,这样就可以获得更高的服务交付效率。
    The social determinants of health have a disproportionate impact on mortality in men. A study into the state of health of the male population in Leeds was undertaken to guide public health commissioning decisions. This paper reports on the data relating to the social lives of men.
    A cross-sectional study was undertaken, comprising descriptive analysis of data relating to educational attainment, housing, employment (including benefit claimants), marital status and relationships. Data was considered for the whole city and localised at the Middle Super Output Area (MSOA) level and mapped against the Index of Deprivation.
    Boys\' educational attainment was found to be lagging behind girls\' from their earliest assessments (Early Years Foundation Stage Profile, 46% vs. 60%, P = 0.00) to GCSEs (53% vs. 63%, P = 0.00), leaving many men with no qualifications. There were 68% more men than women identified as being unemployed, with more men claiming benefits. Men living in social housing are more likely to be housed in high-rise flats. Almost 50% of men aged 16-64 are single, with 2254 lone fathers.
    There appears to be a lack of sex/gender analysis of current cross city data. In areas of deprivation a complex picture of multiple social problems emerges, with marked gender differences in the social determinants of health, with males seeming to be more negatively affected. There is a need for more focused planning for reaching out and targeting boys and men in the most deprived inner city areas, so that greater efficiency in service delivery can be obtained.
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  • 文章类型: Case Reports
    Current literature has overlooked the impact of chronic illness on masculine identity. We therefore aimed to investigate the impact of rheumatoid arthritis (a long term condition, affecting more women than men) on masculine identity. Six focus groups with 22 men with rheumatoid arthritis (RA) (data reported elsewhere) followed by five one-to-one interviews with men (English, mean age: 59 years) sampled to reflect a heterogeneous experience of life with RA based on knowledge gained from the focus groups. Transcripts were analysed using thematic analysis and are presented as individual case studies. Whilst the case studies provide five distinct experiences, common themes can be drawn across them, such as the importance of paid work. The men needed to renegotiate their masculine identity to deal with their RA. Two dealt with this by pushing through pain to retain masculine activities, two replaced masculine roles they could no longer do with other roles, and one rejected masculinity completely. Men with long term conditions may need to re-write their masculinity scripts to enable them to accept and adapt to their condition. However, some men struggle with this, which should be taken into consideration when designing self-management services for men with long term conditions.
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