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      “I can’t have it; I am a man. A young man!” – men, fibromyalgia and masculinity in a Nordic context

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          ABSTRACT

          Purpose: Research shows that gender has a substantial impact on the health behaviour such as expression of physical symptoms like persistent pains and aches. However, there is yet little knowledge about the gendered aspect of pain by men who suffer from typical female diseases like fibromyalgia. The purpose of the study was to elucidate the interplay between illness and gender by exploring life-stories of men who suffer from fibromyalgia.

          Methods: The data were collected through life-story interviews of eight men suffering from fibromyalgia. A narrative methodology for analysis was applied to explore the storytelling and the linguistic and performative aspects of the life-stories.

          Results: The masculine identity of the participants was re-negotiated by comparisons to other men and life before symptom onset, and by discussing expectations and beliefs of how men should act in contemporary societies. The transition from experiencing a strong, active and reliable body to experiencing a painful, vulnerable and helpless body was perceived as fundamental.

          Conclusions: Self-management and rehabilitation of fibromyalgia it is not only about learning to manage the symptoms but also about the struggle to find coherence in life through re-constructing gender identity that is acceptable both for the individual and for the community.

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          Most cited references37

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          'It's caveman stuff, but that is to a certain extent how guys still operate': men's accounts of masculinity and help seeking.

          It is often assumed that men are reluctant to seek medical care. However, despite growing interest in masculinity and men's health, few studies have focussed on men's experiences of consultation in relation to their constructions of masculinity. Those that have are largely based on men with diseases of the male body (testicular and prostate cancer) or those which have been stereotyped as male (coronary heart disease). This paper presents discussions and experiences of help seeking and its relation to, and implications for, the practice of masculinity amongst a diversity of men in Scotland, as articulated in focus group discussions. The discussions did indeed suggest a widespread endorsement of a 'hegemonic' view that men 'should' be reluctant to seek help, particularly amongst younger men. However, they also included instances which questioned or went against this apparent reluctance to seek help. These were themselves linked with masculinity: help seeking was more quickly embraced when it was perceived as a means to preserve or restore another, more valued, enactment of masculinity (e.g. working as a fire-fighter, or maintaining sexual performance or function). Few other studies have emphasised how men negotiate deviations from the hegemonic view of help-seeking.
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            Gender differences in health information behaviour: a Finnish population-based survey.

            Stefan Ek (2015)
            Narrowing the gaps in health outcomes, including those between men and women, has been a pronounced goal on the agenda of the Finnish health authorities since the mid-1980s. But still there is a huge gap in favour of women when it comes to life expectancy at birth. People's health information behaviour, that is how people seek, obtain, evaluate, categorize and use relevant health-related information to perform desired health behaviours, is a critical prerequisite to appropriate and consistent performances of these behaviours. With respect to gender, it has been noted that men often are unwilling and lack the motivation to engage with health-related information. The purpose of this study was to investigate how gender affects health information behaviour in the Finnish population aged 18-65 years. The survey data were collected via a questionnaire which was posted to a representative cross section consisting of 1500 Finnish citizens. The statistical analysis consists of ANOVA F-tests and Fisher's exact tests. The results show that women were more interested in and reported much more active seeking of health-related information, paid more attention to potential worldwide pandemics and were much more attentive as to how the goods they purchase in everyday life affect their health than men did. Women also reported receiving far more informal health-related information from close family members, other kin and friends/workmates than men did. Thus, to succeed in public health promotion and interventions the measures taken should be much more sensitive to the gender gap in health information behaviour.
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              “Brave Men” and “Emotional Women”: A Theory-Guided Literature Review on Gender Bias in Health Care and Gendered Norms towards Patients with Chronic Pain

              Background Despite the large body of research on sex differences in pain, there is a lack of knowledge about the influence of gender in the patient-provider encounter. The purpose of this study was to review literature on gendered norms about men and women with pain and gender bias in the treatment of pain. The second aim was to analyze the results guided by the theoretical concepts of hegemonic masculinity and andronormativity. Methods A literature search of databases was conducted. A total of 77 articles met the inclusion criteria. The included articles were analyzed qualitatively, with an integrative approach. Results The included studies demonstrated a variety of gendered norms about men's and women's experience and expression of pain, their identity, lifestyle, and coping style. Gender bias in pain treatment was identified, as part of the patient-provider encounter and the professional's treatment decisions. It was discussed how gendered norms are consolidated by hegemonic masculinity and andronormativity. Conclusions Awareness about gendered norms is important, both in research and clinical practice, in order to counteract gender bias in health care and to support health-care professionals in providing more equitable care that is more capable to meet the need of all patients, men and women.
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                Author and article information

                Journal
                Int J Qual Stud Health Well-being
                Int J Qual Stud Health Well-being
                ZQHW
                zqhw20
                International Journal of Qualitative Studies on Health and Well-being
                Taylor & Francis
                1748-2623
                1748-2631
                2019
                13 October 2019
                : 14
                : 1
                : 1676974
                Affiliations
                [a ]Faculty of Health and Wellbeing, Satakunta University of Applied Sciences , Pori, Finland
                [b ]Institute of Health and Society, University of Oslo , Oslo, Norway
                [c ]Department of interdisciplinary health sciences, Institute of Health and Society, University of Oslo , Oslo, Norway
                Author notes
                CONTACT Merja Sallinen merja.sallinen@ 123456samk.fi Faculty of Health and Wellbeing, Satakunta University of Applied Sciences , PL 1001, 28101 Pori, Finland
                Article
                1676974
                10.1080/17482631.2019.1676974
                6813418
                31607231
                633c6b82-b3e7-44ca-9be9-5275349b5dc7
                © 2019 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 02 October 2019
                Page count
                References: 46, Pages: 12
                Funding
                Funded by: European Union Seventh Framework Programme (FP7-PEOPLE-2013-COFUND)
                Award ID: 609020
                The research leading to these results has received funding from the European Union Seventh Framework Programme (FP7-PEOPLE-2013-COFUND) under grant agreement n° 609020 - Scientia Fellows.
                Categories
                Empirical Studies

                Health & Social care
                nordic countries,narrative research,life-story interview,chronic pain,gender
                Health & Social care
                nordic countries, narrative research, life-story interview, chronic pain, gender

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