RESUMEN
Anxieties regarding cancer and screening have been consistently linked in prostate screening behavior with cancer-related anxieties generally thought to be higher among minority men. To date, however, the literature linking cancer anxieties to screening among diverse men remains predicated on self-reported anxiety. Research has yet to consider how "accurate" the reporting of anxiety may be among distinct groups of men or the possibility that anxiety may influence prostate cancer (PC) screening behavior through conscious and nonconscious channels; the current study tested for discrepancies between self-report and Stroop-ascertained general- and prostate-specific anxiety and their links to screening among 180 U.S.-born African American, U.S.-born European American, and immigrant Jamaican men. Men provided self-report information regarding trait and prostate-related anxiety and completed an emotional Stroop task. Mixed model ANOVAs showed that while U.S.-born African Americans had few discrepancies between self-report and Stroop-ascertained anxiety, Jamaicans reported greater PC anxiety than indicated by Stroop performance, while the opposite was true among U.S.-born Europeans. As expected, self-reported (but not Stroop-ascertained) PC anxiety predicted screening in multivariate analysis. Although men from different age and ethnic groups varied in the discrepancy between self-reported and Stroop-ascertained PC anxiety, the influence of avoidance-producing emotions appears to operate predominantly through conscious channels.
Asunto(s)
Ansiedad/psicología , Negro o Afroamericano/psicología , Miedo/psicología , Tamizaje Masivo/psicología , Neoplasias de la Próstata/etnología , Neoplasias de la Próstata/psicología , Población Blanca/psicología , Adulto , Negro o Afroamericano/estadística & datos numéricos , Ansiedad/etnología , Actitud Frente a la Salud , Humanos , Jamaica/etnología , Masculino , Persona de Mediana Edad , Personalidad , Antígeno Prostático Específico/análisis , Neoplasias de la Próstata/diagnóstico , Análisis de Regresión , Encuestas y Cuestionarios , Estados Unidos/epidemiología , Población Blanca/estadística & datos numéricosRESUMEN
PURPOSE/OBJECTIVES: To examine colorectal cancer (CRC) screening embarrassment among men and women from three ethnic groups and the associated physician gender preference by patient gender and ethnicity. DESIGN: Cross-sectional, purposive sampling. SETTING: Urban community in Brooklyn, NY. SAMPLE: A purpose-derived, convenience sample of 245 European American, African American, and immigrant Jamaican men and women (aged 45-70 years) living in Brooklyn, NY. METHODS: Participants provided demographics and completed a comprehensive measure of CRC screening embarrassment. MAIN RESEARCH VARIABLES: Participant gender and ethnicity, physician gender, and CRC screening embarrassment regarding feces or the rectum and unwanted physical intimacy. FINDINGS: As predicted, men and women both reported reduced fecal and rectal embarrassment and intimacy concern regarding same-gender physicians. As expected, Jamaicans reported greater embarrassment regarding feces or the rectum compared to European Americans and African Americans; however, in contrast to expectations, women reported less embarrassment than men. Interactions indicated that rectal and fecal embarrassment was particularly high among Jamaican men. CONCLUSIONS: Men and women have a preference for same-gender physicians, and embarrassment regarding feces and the rectum shows the most consistent ethnic and gender variation. IMPLICATIONS FOR NURSING: Discussing embarrassment and its causes, as well as providing an opportunity to choose a same-gender physician, may be promising strategies to reduce or manage embarrassment and increase CRC screening attendance.
Asunto(s)
Negro o Afroamericano/psicología , Neoplasias Colorrectales/etnología , Detección Precoz del Cáncer/psicología , Emociones , Prioridad del Paciente/etnología , Relaciones Médico-Paciente , Factores Sexuales , Población Blanca/psicología , Anciano , Neoplasias Colorrectales/diagnóstico , Estudios Transversales , Detección Precoz del Cáncer/estadística & datos numéricos , Femenino , Humanos , Jamaica/etnología , Masculino , Persona de Mediana Edad , Prioridad del Paciente/estadística & datos numéricos , Población UrbanaRESUMEN
OBJECTIVES: To examine the effect of race/ethnicity and fear characteristics on the initiation and maintenance of digital rectal examination (DRE) screening. METHODS: A total of 533 men from Brooklyn, New York, aged 45-70 years, were classified into 4 race/ethnic groups: U.S.-born whites, U.S.-born African-American, Jamaican, and Trinidadian/Tobagonian. The participants recorded the number of DREs in the past 10 years. The demographics and structural variables and prostate cancer worry and screening fear were measured using validated tools. RESULTS: Overall, 30% of subjects reported never having a DRE, and 24% reported annual DREs. African-American, Jamaican, and Trinidadian/Tobagonian men had greater prostate cancer worry and screening fear scores than did the white men (all P < .05). African-American, Jamaican, and Trinidadian/Tobagonian men were less likely to maintain annual DREs than white men (odds ratio 0.17, 0.26, and 0.16, respectively, all P < .05). The men with low screening fear were more likely to have had an initial DRE (OR 2.3, P < .05 vs high screening fear) but were no more or less likely to undergo annual DREs. Having a regular physician, comprehensive physician discussion, and annual visits were also associated with undergoing DREs. CONCLUSIONS: We identified several ethnically varying barriers and facilitators to DRE screening. African-American and African-Caribbean men undergo DRE less often and have greater prostate cancer worry and screening fear scores than did white men. Screening fear predicts the likelihood of undergoing an initial, but not annual, DRE screening. Access to a physician and annual visits facilitate DRE screening. Interventions that include both culturally sensitive education and patient navigation and considered whether patients should be initiating or maintaining screening might facilitate guideline-consistent screening.
Asunto(s)
Población Negra/psicología , Población Negra/estadística & datos numéricos , Tacto Rectal/psicología , Miedo , Conductas Relacionadas con la Salud/etnología , Aceptación de la Atención de Salud/etnología , Negro o Afroamericano/psicología , Negro o Afroamericano/estadística & datos numéricos , Anciano , Tacto Rectal/estadística & datos numéricos , Conocimientos, Actitudes y Práctica en Salud , Humanos , Cobertura del Seguro , Masculino , Persona de Mediana Edad , Indias Occidentales/etnologíaRESUMEN
The purpose of the present study was to develop the later life attachment literature by providing data contrasting patterns of attachment among 616 older men and women (aged 50 to 70) from seven ethnic groups in the United States: African Americans, English-speaking Caribbeans, Haitians, Dominicans, Puerto Ricans, Eastern Europeans, and European Americans. A multivariate analysis of the variance with ethnicity, gender, and income as factors predicting four dimensional styles of attachment (secure, dismissive, preoccupied, and fearful avoidant) revealed numerous ethnic differences in attachment styles. Most notably, Haitians reported greater dismissiveness than all other groups, with Eastern Europeans reporting more than Dominicans, Puerto Ricans, European Americans and African Americans. Haitians also reported lower fearful avoidance than all other groups. Dominicans and Puerto Ricans reported greater preoccupation than Haitians, African Americans, and English-speaking Caribbeans. The most notable interactions with gender and income revealed that although preoccupation was lower among African American, English-speaking Caribbean, Haitian, and European American women versus men, it was greater among Dominican, Puerto Rican, and Eastern European women, and that whereas security was generally high among European Americans notwithstanding income, income strongly impacted attachment security in other groups. These differences are interpreted in light of ethnic differences in historical, familial, and religious contexts. This study provides a glimpse into the ethnic and cultural diversity in the ways in which older adults relate to significant others.
Asunto(s)
Etnicidad , Apego a Objetos , Socialización , Negro o Afroamericano , Anciano , Femenino , Humanos , Entrevistas como Asunto , Masculino , Persona de Mediana Edad , New York , Indias Occidentales/etnología , Población Blanca/etnologíaRESUMEN
Emotional and cognitive characteristics have been studied in the context of women's cancer screening but have received scant attention in the study of men's screening behavior. Researchers know little about how such factors interact to predict screening or whether digital rectal examination (DRE) and prostate specific antigen (PSA) screens are predicted by the same characteristics. This study examines the relevance of emotional and cognitive characteristics to DRE and PSA screening among 180 U.S.-born African American, U.S.- born European American, and immigrant Jamaican men. The study identifies the expected effects in which fear is negatively related and efficacy beliefs positively related to DRE and PSA screening. Greater efficacy and (marginally) knowledge appear to "offset" the negative impact of fear on screening, and fear appears particularly relevant to DRE frequency. Results are discussed in terms of their implications for the development of health belief and self-regulatory models in the context of prostate cancer screening among minority men.
Asunto(s)
Tacto Rectal/estadística & datos numéricos , Conocimientos, Actitudes y Práctica en Salud , Antígeno Prostático Específico/sangre , Neoplasias de la Próstata/diagnóstico , Neoplasias de la Próstata/psicología , Negro o Afroamericano/estadística & datos numéricos , Humanos , Jamaica/etnología , Masculino , Neoplasias de la Próstata/etnologíaRESUMEN
Reports of stress and negative emotion are important predictors of health. However, whether discrete emotions or stress measures are more useful, whether they contribute independently to outcome, and whether they relate to health equally across ethnic groups remain unclear. In the current study, 207 US-born European American, US-born African American, Black English-speaking Caribbean, and Dominican men aged 40 years and older completed measures of somatic symptoms, trait emotions, and stress. Sadness and stress independently predicted symptom reports, even when examined concurrently, and with demographics controlled; trait anger did not predict symptoms. Moreover, the relations between trait emotions and symptoms varied across groups. Levels of sadness were associated with greater symptoms among US-born European American and Dominican men, but negatively associated among Black English-speaking Caribbean men, and the relations for anger also differed marginally across groups. The results underscore the importance of differentiating among discrete emotions and stress and considering ethnic interactions when examining reports of somatic symptomology. We suggest that the impact of psychological characteristics on health must be considered within cultural and ethnic contexts to be fully understood.