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MEN’S HEALTH

The Practice Nurse’s

Handbook

IAN PEATE

MEN’S HEALTH

The Practice Nurse’s Handbook

MEN’S HEALTH

The Practice Nurse’s

Handbook

IAN PEATE

Copyright © 2007 John Wiley & Sons Ltd, The Atrium, Southern Gate, Chichester,

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Library of Congress Cataloging-in-Publication Data

Peate, Ian.

Men’s health : the practice nurse’s handbook / Ian Peate.

p. ; cm.

Includes bibliographical references and index.

ISBN 978-0-470-03555-9 (alk. paper)

1. Men–Health and hygiene. 2. Men–Diseases. 3. Nursing. I. Title.

[DNLM: 1. Health. 2. Men. 3. Nursing Care–methods. 4. Genital Diseases, Male–nursing.

5. Health Promotion. WY 100 P363m 2007]

RC48.5.M464 2007

616.0081–dc22 2007011287

A catalogue record for this book is available from the British Library

ISBN: 978-0-470-03555-9

Typeset in 10/12 pt Times by Thomson Digital.

Printed and bound in Great Britain by TJ International Ltd, Padstow, Great Britain.

This book is printed on acid-free paper responsibly manufactured from sustainable forestry in which at

least two trees are planted for each one used for paper production.

For all the Practice Nurses who are taking forward the role

and function of the nurse.

Contents

About the author ix

Acknowledgements xi

Introduction 1

1 Masculinities and gender 13

2 Promoting health: the male perspective 27

3 Male health inequalities 51

4 Men as risk takers 65

5 Young men and boys 83

6 Contraception 103

7 Sexually transmitted infections 119

8 Osteoporosis 145

9 Obesity 167

10 Erectile dysfunction 187

11 Smoking and the male reproductive tract 215

12 Working with specifi c groups of men 241

13 Psychological issues and the male 263

14 Male cancers 285

15 Exercise and sports injury 321

Word list 341

Index 355

About the author

Ian Peate, EN(G), RGN, DipN (Lond), RNT, BEd(Hons), MA(Lond), LLM

Address for correspondence:

Associate Head of School

School of Nursing and Midwifery

Faculty of Health and Human Sciences

University of Hertfordshire

Hatfi eld

Hertfordshire AL10 9AB

Acknowledgements

I would like to acknowledge and thank many fi ne people for their help and support,

and in particular Frances Cohen, Mark Smith and Lyn Cochrane, and Anthony Peate

for his help with the illustrations. Without the continued support and encouragement

of my partner Jussi Lahtinen my endeavours would never be realised.

I thank the staff at the Royal College of Nursing for their help and the staff at John

Wiley & Sons for their expert assistance.

Introduction

Being a man should not seriously damage your health, conclude White and Banks

(2004) in their chapter in a men’s health text. The maxim is used at the beginning of

this text to remind the practice nurse of the fact that being a man in some instances

can and does seriously damage their health. Men are much less likely to visit their

general practice than women. Those men who are aged under 45 years visit their

general practice only half as often as women; it is only when they become older that

the gap narrows signifi cantly.

PRACTICE NURSING

The role and function of the practice nurse continues to evolve and change. Most

practice nurses are employees of the practice and most practices are run as small

businesses with self-employed doctors who contract their services to the NHS; the

GP (usually) becomes the practice nurse’s boss. Concern regarding the health of men

and the provision of services and care to men are just two aspects of the role and

function of the practice nurse.

The lack of focus on gender and men by the Department of Health (DH) – for

example, in the gender-neutral approach adopted by the NHS Cancer Plan (DH,

2000) and some National Service Frameworks – is the antithesis of government

attempts to mainstream gender in all aspects of policy (Department of Trade and

Industry, Women and Equality Unit, 2003). The important issue of men’s health is

beginning to receive the attention it deserves; however, men remain visibly absent

from most health policy at local and national levels. The practice nurse, at a local

level, can intervene and ensure that gender as a determinant of health is raised and

included when policy and strategy are being addressed. Men and boys should be

actively encouraged to participate in consultations about the development of health

services and policy formulation that will meet their needs effectively.

All forms of health service provision must become more accessible to men, and

this includes the services provided by the general practice. There are many innovative

and creative approaches being made in order to provide men with services that are

accessible and ‘male-friendly’. Developments may include the provision of services

in the workplace, schools, youth clubs, working men’s clubs and sports venues –

locations where men congregate. The NHS Improvement Plan (DH, 2004b) reports

that everyone will have fair access to primary care that is near their home or work￾place; this may help men, who are notorious for being reluctant users of primary

care, particularly if their specifi c needs are not taken into account.