Aims: Though unmet sexual care needs are common to men with prostate cancer (PCa), little is known about sexual help-seeking in this population. The theory of planned behaviour (TPB) is one of the most widely examined models of health-related behaviours and may assist in understanding this issue. Utilising the TPB framework, this study examines the sexual help-seeking intentions, behaviours, and care needs of PCa survivors.
Methods: Men diagnosed with PCa completed online questionnaires at baseline (n=599) and six months later (n=414). Assessments included measures of help-seeking intentions and behaviours, TPB variables (attitudes, norms, and perceived behavioural control), erectile function, sexual desire, and care needs.
Results: Participants were M=64 years old, 3.9 years post-diagnosis, and 87% had undergone radical prostatectomy. Half (53%) reported severe erectile dysfunction, 78% had mild-moderately reduced sexual desire, and 53% had unmet sexual care needs. Greater needs were predicted by poorer sexual quality of life (p<.001), placing greater value on sex (p<.001), and more severe depression (p=.002). Greater intention to seek sexual help was predicted by younger age (p=.03), less time since diagnosis (p=.03), having recently sought sexual help (p<.001), greater perceived control (p<.001), and a more positive attitude (p<.001). At follow-up, 53% had accessed help in the past six months, most often from a doctor (65%) or another PCa survivor (58%). Men who had intended at baseline to seek sexual help were 1.8x more likely to have sought help at follow-up (p<.001), and those had recently sought help at baseline were 4.3x more likely to have also done so at follow-up (p<.001).
Conclusions: Men with PCa experience significant sexual difficulties and frequently have unmet sexual care needs. Potentially modifiable TPB variables (norms, attitudes, and perceived control) predicted men's intentions to seek sexual help, but did not directly influence their help-seeking behaviours.