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- AGING MEN'S HEALTH BOOK - PCCA?
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Order at www. Field of medicine: Men's health, geriatrics, urology, and endocrinology. Format: Hardcover book. Audience: Providers treating middle-aged and older men. Content: The book contains 20 chapters.
A Case-Based Approach
It begins with an introduction to the practice of preventive gerontology, an area of study that aims to decrease biological age. The author reviews possible reasons for why women live longer than men; diagnostic concerns in the evaluation of androgen decline in aging men and andropause; and how declining androgen levels may affect a man's response to chronic diseases and geriatric syndromes.
The author presents controversies in the management and treatment of prostate cancer in Chapter 17 and discusses various types of hormone replacement therapy in the final chapters. Highlights: One of the major strengths of the book is its clinical relevance. Case scenarios illustrate the specific chapter highlights and the controversies of treating the patient discussed Citations Citation.
Published: Ann Intern Med. DOI: Related Topics. Sign in below to access your subscription for full content. Buy This Article Subscribe. You will be redirected to acponline. Create Your Free Account Why? The topics were initially sorted in order of importance by using the means and secondly by the median. At the end of the survey, participants were invited to add any topic s that they believed should be included in a men's health curriculum for family medicine residency training programs.
A case-based approach was used for the qualitative portion of the research.
Cases can come in a variety of forms. In this study individual cases interviews with program directors as well as group cases Focus groups were used [ 4 ]. The responses from the quantitative questionnaire formed the basis of the semistructured interviews that were conducted with selected program directors. Some aspects of the questionnaire were used to prompt discussion in the focus groups. The discussions within the focus groups were recorded with both audio and video recording equipment and later transcribed.
Videotaping was used only to identify different speakers during transcription. Interviews with program directors were only voice recorded. These interviews and focus groups were transcribed by the researcher and imported into the NVivo Version 9 software [ 5 ]. Each interview and each focus group were treated as an individual case.
Through deductive reasoning, certain themes were identified from the questionnaire data. This implies that general statements were synthesised into more specific statements. Further themes or nodes evolved as the transcriptions were analysed. Although both the qualitative and quantitative aspects of the study had questions about past and current training in men's health, this paper will focus on what participants think that the content of a men's health curriculum for family medicine residency training should contain.
The author was involved in all aspects of this project, including conducting the interviews and focus groups as well as transcribing the interviews and analyzing the data.
In one case, two different sites in the same program returned a survey. Even though the number of responses might appear low, it is still considered above expected when taken into consideration the overwhelming number of surveys that ends up on program directors' desks. The rank list of problems identified from group one sexual and reproductive health is represented in Table 1.
Table 2 represents the rank list for topics related to general health and Table 3 presents the rank list for procedures. No new topics were added by any of the participants in the quantitative section of the study. List of male sexual and reproductive health topics identified by program directors in order of importance. List of topics related to general health identified by program directors in order of importance. Theme 1. Need for Men's Health Curriculum. Following are some of the quotes from Program Directors and practicing physicians regarding a men's health curriculum in Family Medicine Residency Training Programs.
Theme 2. Topics to Include in a Men's Health Curriculum. The participants were asked to think of different topics that they would like to see in a men's health curriculum. Most of the topics that were listed in the quantitative questionnaire were mentioned again in the interviews and focus groups. Some of the other topics that were discussed are mentioned in the following quotes.
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Mental health issues came up in several of the interviews and focus groups. Even though the Program Directors did not rank it very high, participants in the focus groups reported that they would have liked to be more competent in dealing with priapism and Peyronie's disease. When it came to procedures, no new procedures were mentioned that had not already been covered in the survey responses of the program directors. Theme 3. Structure of a Men's Health Curriculum. The focus groups were asked how they would have preferred to learn about men's health issues as a student or a resident.
The idea of a men's health clinic, preferably in an academic setting, was discussed and received favorably by other participants of the urban focus group:. The majority of the top ten topics listed in Table 1 did not come as a huge surprise. These were topics that most family physicians deal with on a daily basis. The only topic that ranked higher than expected was that of andropause or, as it is now known, late onset hypogonadism LOH [ 6 ].
This could be due to the fact that several new testosterone replacement products became available in Canada in the last few years and some media attention has been directed that way. Family physicians might therefore feel some pressure in becoming competent regarding this issue. Even though some conditions in Table 1 have not been ranked at all by program directors, it does not mean that it is not important. In hindsight, it might have been interesting to have given the same lists to members of the focus groups to complete and see how if at all it differs from the ranking of the program directors.
With the rank list of topics listed in Table 2 , it was interesting to note how high nonphysical issues were ranked.
One would expect that cardiovascular disease in men would be high on the list since it remains one of the highest causes of mortality in men second only to cancer [ 7 ]. Instead the mental health or psychiatric conditions such as abuse, alcoholism, and general psychiatry were prominent. The list of procedures that were ranked in Table 3 held no surprises at all. The majority of these procedures form part of the core procedure list that is used in most family medicine residency training programs in Canada [ 8 ].
These are procedures that family medicine residents expect to be taught and that the general public expect that family physicians will be able to perform.
Topics that were identified and discussed in the interviews and focus groups reflect the variety of issues that family physicians deal with on a regular basis. It was also clear that the participants mostly practicing physicians did not feel comfortable dealing with issues related to men's health.
Aging Men's Health: A Case-based Approach - Google книги
Many of the participants told stories about how they learned many of these skills after being in practice for a while. If family physicians can become competent in these skills before they start their practice, this could cut down on many unnecessary and costly referrals to specialists. The topics that were identified as important to incorporate into a men's health curriculum compare well to curricula developed in the UK, Australia, and the State of Hawaii [ 9 — 11 ].
There are many topics that are common to other curricula, but not all of them are unique to men's health. If one only focuses on male-specific issues, the American Academy of Family Physicians also identified male baldness as a unique and separate topic in their curriculum [ 12 ].
www.bgb-stbg.de/wp-includes/4390-spionage-app-fuer.php The College of Family Physicians of Canada has goals and objectives for general care of the adult in their standards for accreditation [ 13 ]. It is however essential to separate the unique issues related to men's health into a separate curriculum as is the case with women's health in order for it to receive the importance it warrants. This study was performed in a Canadian context and can therefore not neccesarily be extrapolated to other countries.
The sample size in each of the different components is quite low due to the small number of possible participants. This has been addressed in the methodology section. Some of the surveys contained the minimum required answers and did not contain any further ideas. It would have been helpful if participants could have added information that was not part of the questionnaires.
The fact that the principle author was the only person conducting the interviews and analyzing the data could be seen as a limitation. This was unfortunately an expectation as this study formed part of an Ph. Participants in both the quantitative and qualitative aspects of the study provided lists of men's health issues that could and should be seen as competencies that family medicine residents attain during their training.