specialty focus effectively. However, the study demonstrated that for PHCNs to be effective in communicating and establishing that rapport with men, they needed to be clear about their role in men’ s health, and have the education and knowledge to support that role. And most nurses in this study had not had specific men’ s health training or education, and they weren’ t clear about their role, particularly in the areas of men’ s sexual health, mental health and health promotion.
specialty focus effectively. However, the study demonstrated that for PHCNs to be effective in communicating and establishing that rapport with men, they needed to be clear about their role in men’ s health, and have the education and knowledge to support that role. And most nurses in this study had not had specific men’ s health training or education, and they weren’ t clear about their role, particularly in the areas of men’ s sexual health, mental health and health promotion.
What else did men expect from nurses? Well, men were unsure of what the role was in general practice, and they often confused the nurse with the reception staff.
But what we found in the study was that there were five qualities that men highlighted. These were humour, a non-judgmental approach, a caring approach, an empathetic approach, and a father-inclusive approach.
So I’ ll explain briefly what the findings were. They felt humour broke the ice and made them feel at ease, and it was very, very important. It was strongly identified by most men I interviewed.
The men talked about a non-judgmental approach: not to blame them for not being interested in their health, or for not looking after themselves. In fact, most men are interested in their health.
A caring and empathetic approach: some men emphasised the detachment of some of the healthcare professionals they’ d come in contact with, and feeling rushed quite often through appointments. They appreciated the time that nurses spent with them, and men felt they needed time to be able to seek health advice, and that sometimes the time that was allocated wasn’ t sufficient for them to ask the questions they wanted to or needed to know the answers to.
I also found that the younger men in the study would appreciate that health professionals had a father-inclusive approach. That is, if a man attended the medical practice with his family, the men expected to be acknowledged equally to the mother and the child during the consultation, and not ignored.
Most men in the study saw that the nurse could have a greater role in their healthcare, and this could free up the doctor to concentrate on diagnosing and treating patients, the things they do best.
And some of the barriers that men identified were cost and time. Some thought the extra costs of some GPs were too expensive, and they were annoyed about it, and they were also annoyed that they weren’ t getting value for money. Men thought that the services should be provided at times that suited men, particularly if they were working.
The other thing, and this I found very interesting, was being seen as a whinger or complainer, and not wanting to take up the doctor’ s time if there was nothing wrong with them. And that was quite a strong theme that came across.
Some men felt the environment of a general practice was unfriendly and they felt uncomfortable. They commented that it was often mostly female staff and maybe not catering as much for men.
The things men told me that helped were good relationships with health professionals, the GP or the nurse, and what they liked to see in a medical practice – which I found very interesting – was teamwork, and the relationships with all the staff. So that was something we hadn’ t realised before.
Certainly, they also talked about their partners, how that made a difference, that the partner was often the person that motivated them to see the GP. They also wanted good health information that was male-friendly. And they wanted to see more healthcare providers under the same roof and easily accessible.
What else did nurses in the study have to say about approaching men’ s health? Well, many were uncertain about what men’ s health meant, and this led them to feel they had less opportunity and less emphasis on providing an overall or holistic approach to the healthcare they provided.
They were uncertain of their scope of practice in men’ s health – and by that I mean the person has been educated, is competent and is authorised to perform activities. And many nurses felt they hadn’ t had those types of opportunities, and that some areas of men’ s health might not be within their scope of practice.
They said that often they had inadequate education in specific men’ s healthcare. This was seen by several of the PHCNs as being a gap they could provide in the services that they would like to provide for men. And most expressed the view that they required more training and education in gender-specific men’ s healthcare needs.
Some of the PHCNs want a greater role in men’ s healthcare, but this was at times limited by the focus of the general practitioner or the general practice. Some catered more for children and women, so that determined sometimes what the nurse could do.
Also, one of the things they commented on was the fact that the Medicare Benefits Schedule funding scheme didn’ t necessarily take onboard an item number for nurses to provide care. And the timeframe – they are very busy, and it’ s another thing they probably would have to do.
Finally, little or no education in the area of health promotion, which the nurses in this study thought was a large part of their role. This area of health promotion, or PHCNs providing this type of care, was clearly identified by the Australian National Male Health Policy, which was released in 2010. So it’ s been identified as an area that nurses should be involved in.
Some of the nurses described their approach to men’ s health as opportunistic.
Based on the findings, what other ways can the relationship between PHCNs and men be strengthened? This was a small study, so it’ s hard to generalise the findings across Australia. However, we identified some main areas. In the clinical area, or the work-related area, the nurses said they needed stronger collaborative relations between nursing and allied healthrelated disciplines, that even though there was a lot of discussion about these relationships, many nurses found it was not always the case where they worked.
In the area of education, the study revealed that there needs to be a men’ s health curriculum in schools of nursing; greater awareness of at-risk or hard-to-reach men; greater awareness of health literacy levels; an emphasis on health promotion, illness prevention and wellbeing; and basic mental health skills for nurses.
In the area of research, we need a national population study of the primary healthcare role in men’ s health and health promotion, as it can vary greatly from workplace to workplace. We also need to investigate how we can improve men’ s access to healthcare, and health promotion needs to be studied in more detail. And finally, we need a multidisciplinary approach to research, to develop evidence-based strategies to improve men’ s healthcare and health promotion. ■ nursingreview. com. au | 17