Advertisement

Psycho-Oncologie

, Volume 1, Issue 4, pp 265–275 | Cite as

Rôle de l’identité sexuée et de l’influence du genre pour l’analyse de l’expérience des soins de support en oncologie

  • Éric Dudoit
  • Lionel Dany
  • Stéphanie Blois
  • Corinne Cuvello
Article Original Dossier : « Sexualité et cancer »

Résumé

Cette étude a pour objectif l’examen de l’impact de l’identité sexuée sur la participation aux soins de support dans le contexte de la maladie cancéreuse. Deux analyses différentes ont été conduites dans le contexte d’un service d’oncologie médicale. Premièrement, nous avons examiné quantitativement la participation à différents soins de support (psycho-oncologie et interventions d’une infirmière clinicienne) pendant deux mois. Deuxièmement, nous avons réalisé 25 entretiens autour de l’expérience du soin avec des patients du service. L’analyse des activités de soin montre une participation plus importante des patientes. Le nombre d’interventions et leur durée moyenne sont significativement plus importants pour ces dernières. En outre, les patientes prennent plus fréquemment l’initiative de recourir à ces soins que les patients. Les données d’entretiens montrent différentes conceptions de la participation au soin. Des conceptions associées à la virilité et à une identité collective sont employées par les hommes pour expliquer leurs choix et besoins. Deux modèles de participation émergent des discours: un modèle de «mise à contribution» (plus fréquent chez les femmes) et un modèle de «mise à disposition» (plus fréquent chez les hommes). Ces résultats confirment une association entre dimensions sociales de l’identité et expérience de la maladie et du soin. Ce type d’analyse constitue un facteur clé pour comprendre les modèles de participation dans le contexte du soin psychosocial en oncologie.

Mots clés

Identité sexuée Genre Soins de support Cancer 

Role of sexual identity and gender in analyzing the experience of supportive care in oncology

Abstract

This study examines the impact of sexual identity on the participation of cancer patients in supportive care. Two different analyses were conducted within the context of an oncology department. First, we quantitatively examined the modalities of participation in different supportive care environments (psycho-oncologist and specialised nurse interventions) over a period of two months. Second, we conducted 25 interviews of patients of the oncology department on their care experiences. Analyses of the supportive care activities demonstrate a greater participation of female patients. The length and average number of interventions are significantly higher in this group. In addition, female patients initiate this kind of care more often than men. Interview data indicates different concepts of supportive care participation. Men use a number of concepts of virility and collective identity to explain their choices and needs. Two models of participation emerge from discussions: a contribution model (more frequent in women) and a disposal model (more frequent in men). These findings provide evidence of an association between the social dimensions of identity and experience of illness and care. This kind of analysis constitutes a key factor in understanding models of participation in the context of supportive care in oncology.

Keywords

Sexual identity Gender Supportive care Cancer 

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

Références

  1. 1.
    Addis ME, Mahalik JR (2003) Men, Masculinity, and the context of kelp seeking. Am Psychol 58: 5–14PubMedCrossRefGoogle Scholar
  2. 2.
    Aitken-Swan J, Easson EC (1959) Reactions of cancer patients on being told their diagnosis. BMJ 1: 779–783PubMedCrossRefGoogle Scholar
  3. 3.
    Aliaga C (2002) Les femmes plus attentives à leur santé que les hommes. INSEE Première, 869Google Scholar
  4. 4.
    Baider L, Koch U, Esacson R, Kalan De-Nour A (1998) Prospective study of cancer patients and their spouses: the weakness of marital strengh. Psychooncology 7: 49–56PubMedCrossRefGoogle Scholar
  5. 5.
    Bardin L (1977) L’analyse de contenu. Presses universitaires de France, ParisGoogle Scholar
  6. 6.
    Bataille P (2003) Un cancer et la vie. Balland, ParisGoogle Scholar
  7. 7.
    Blois S, Dany L, Roussel P, Morin M (2006) Croyances relatives à la douleur: rôle dans le rapport aux soins et l’ajustement chez des patients douloureux chroniques. Douleurs 7(5): 262–269Google Scholar
  8. 8.
    Bray F, Atkin W (2004) International cancer patterns in men: geographical and temporal variations in cancer risk and the role of gender. J Mens Health Gend 1(1): 38–46CrossRefGoogle Scholar
  9. 9.
    Chochinov HM, Tataryn DJ, Wilson KG, et al. (2000) Prognostic awareness and the terminally ill. Psychosomatics 41: 500–504PubMedCrossRefGoogle Scholar
  10. 10.
    Connell RW (1999) Men’s health: A research agenda and background report. Commonwealth Department of Health and Aged Care, CanberraGoogle Scholar
  11. 11.
    Courtenay WH (2000) Constructions of masculinity and their influence on men’s well-being: a theory of gender and health. Soc Sci Med 50: 1385–1401PubMedCrossRefGoogle Scholar
  12. 12.
    Coustou B (2000) Violences physiques et prises de risques. Baromètre Santé: premiers résultats 2000. CFES, VanvesGoogle Scholar
  13. 13.
    Cunningham-Burley S, Allbutt H, Garraway WM, et al. (1996) Perceptions of urinary symptoms and health-care-seeking behaviour amongst men aged 40–79 years. Br J Gen Pract 46: 349–352PubMedGoogle Scholar
  14. 14.
    Deans G, Bennett-Emslie GB, Weir J, Smith DC, et al. (1988) Cancer support groups-Who joins and why? Br J Cancer 58: 670–674PubMedGoogle Scholar
  15. 15.
    Fife BL, Kennedy VN, Robinson L (1994) Gender and adjustment to cancer: clinical implications. J Psychosoc Oncol 12: 1–20CrossRefGoogle Scholar
  16. 16.
    Folstad I, Karter AJ (1992) Parasites, bright males, and the immunocompetence handicap. Am Nat 139: 603–622CrossRefGoogle Scholar
  17. 17.
    Franks P, Bertakis K (2003) Physician gender, patient gender, and primary care. J Womens Health 12(1): 73–80CrossRefGoogle Scholar
  18. 18.
    George A, Fleming P (2004) Factors affecting men’s hel-seeking in the early detection of prostate cancer: implications for health promotion. J Mens Health Gend 1(4): 345–352CrossRefGoogle Scholar
  19. 19.
    Gerschick TJ, Miller AS (1995) Coming to terms. masculinity and physical disability. In: Sabo D, Gordon DF (eds) Men’s health and illness. Sage, Thousand Oaks, pp. 183–204Google Scholar
  20. 20.
    Gilbar O (1999) Gender as a predictor of burden and psychological distress of elderly husbands and wives of cancer patients. Psychooncology 8: 287–294PubMedCrossRefGoogle Scholar
  21. 21.
    Gisjbers van Wijk CMT, Vliet van KP, Kolk KP, et al. (1991) Symptom sensitivity and sex differences in physical morbidity: a review of health surveys in the United States and the Netherlands. Women Health 17: 91–124Google Scholar
  22. 22.
    Good GE, Sherrod NB (2004) The psychology of men and masculinity: research status and future directions. In: Unger RK (ed) Handbook of the psychology of women and gender. Wiley, New York, pp. 201–214Google Scholar
  23. 23.
    Green C, Pope CR (1999) Gender, psychosocial factors and the use of medical services: a longitudinal analysis. Soc Sci Med 48: 1363–1372PubMedCrossRefGoogle Scholar
  24. 24.
    Greimel ER, Padilla GV, Grant MM (1989) Gender differences in outcomes among patients with cancer. Psychooncology 7: 197–206CrossRefGoogle Scholar
  25. 25.
    Guilbert P, Baudier F, Gautier A (2001) Baromètre santé 2000. CFES, ParisGoogle Scholar
  26. 26.
    Guilbert P, Gautier A (2006) Baromètre santé 2005. INPES, Saint-DenisGoogle Scholar
  27. 27.
    Hazzard W (1990) The sex differential in longevity. In: Hazzard W, Endres R, Bierman E, Blass J (eds) Principles of Geriatric Medicine and Gerontology. McGraw Hill, New York, pp. 37–47Google Scholar
  28. 28.
    Hill C, Doyon F (2004) La fréquence des cancers en France: quoi de neuf depuis l’année dernière? Bull Cancer 91(1): 9–14PubMedCrossRefGoogle Scholar
  29. 29.
    Kraemer S (2000) The fragile male. BMJ 321: 1609–1612PubMedCrossRefGoogle Scholar
  30. 30.
    Krizek C, Roberts C, Ragan R, et al. (1999) Gender and cancer support group participation. Cancer Pract 7: 86–92PubMedCrossRefGoogle Scholar
  31. 31.
    Lazarus RS, Folkman, S (1984) Stress, Appraisal, and Coping. Springer, New YorkGoogle Scholar
  32. 32.
    Le Feuvre N (2003) Le «genre» comme outil d’analyse sociologique. In: Fougeyrollas-Schwebel D, Planté C, Riot-Sarcey M, Zaidman C (eds) Le genre comme catégorie d’analyse. L’Harmattan, Paris, pp. 39–52Google Scholar
  33. 33.
    Leigh H, Unegerer J, Percarpio B (1980) Denial and helplessness in cancer patients undergoing radiation therapy: sex differences and applications for prognostic. Cancer 45: 3086–3089PubMedCrossRefGoogle Scholar
  34. 34.
    Mathieu NC (1973) Homme culture et femme nature. L’Homme 13(3): 101–113Google Scholar
  35. 35.
    Micheli A, Mariotto A, Rossi AG, et al. (1998) The prognostic role of gender in survival of adult cancer patients: Eurocare Working Group. Eur J Cancer 34: 2271–2278CrossRefGoogle Scholar
  36. 36.
    Möller-Leimkühler AM (2002) Barriers to help seeking by men: a review of sociocultural and clinical literature with particular reference to depression. J Affect Disord 71: 1–9PubMedCrossRefGoogle Scholar
  37. 37.
    Moynihan C (1998) Theories of masculinity. BMJ 317: 102–175Google Scholar
  38. 38.
    Moynihan C, Bliss J, Davidson J, et al. (1998) Evaluation of adjuvant psychosocial therapy in patients with testicular cancer: randomised controlled trial. BMJ 316: 429–435PubMedGoogle Scholar
  39. 39.
    Nathanson C (1977) Sex roles as variables in preventive health behaviour. J Community Health 3: 142–155PubMedCrossRefGoogle Scholar
  40. 40.
    Parkin D, Bray F, Devesa S (2001) Cancer burden in the year 2000. The global picture. Eur J Cancer 37: 4–66.CrossRefGoogle Scholar
  41. 41.
    Pleck JH, Sonenstein FL, Ku LC (1994) Attitudes toward male roles among adolescent males: a discriminant validity analysis. Sex Roles 30: 481–501CrossRefGoogle Scholar
  42. 42.
    Pollard TM, Hyatt SB (1999) Sex, Gender and Health. Cambridge University Press, CambridgeGoogle Scholar
  43. 43.
    Potts MK, Burnam MA, Wells KB (1991) Gender differences in depression detection: a comparison of clinician diagnosis and standardised assessment. Psychol Assess 3: 609–615CrossRefGoogle Scholar
  44. 44.
    Reinert M (1999) Quelques interrogations à propos de «l’objet» d’une analyse de discours de type statistique et de la réponse «Alceste». Langage et Société 90: 57–70Google Scholar
  45. 45.
    Robinson ME, Wise EA, Gagnon C, et al. (2004) Influences of gender role and anxiety on sex differences in temporal summation of pain. J Pain 5(2): 77–82PubMedCrossRefGoogle Scholar
  46. 46.
    Schmid Mast M (2004) Dominance and gender in the physician-patient interaction. J Mens Health Gend 1(4): 354–358CrossRefGoogle Scholar
  47. 47.
    Seale C, Ziebland S, Charteris-Black J (2006) Gender, cancer experience and internet use: a comparative keyword analysis of interviews and online cancer support groups. Soc Sci Med 62: 2577–2590PubMedCrossRefGoogle Scholar
  48. 48.
    Tubiana M, Hill C (2004) Les progrès dans la lutte contre le cancer en France et dans l’union européenne. Oncologie 6: 229–244CrossRefGoogle Scholar
  49. 49.
    Vinsonneau G (2000) Culture et comportement. Armand Colin, ParisGoogle Scholar
  50. 50.
    Welzer-Lang, D (2004) Les hommes changent aussi. Payot, ParisGoogle Scholar
  51. 51.
    White A, Cash K (2004) The state of men’s health in Western Europe. J Mens Health Gend 1(1): 60–66CrossRefGoogle Scholar
  52. 52.
    Wise EA, Price DD, Myers CD, et al. (2002) Gender role expectations of pain: relationship to experimental pain perception. Pain 96: 335–342PubMedCrossRefGoogle Scholar
  53. 53.
    Zakowski SG, Harris C, Krueger N, et al. (2003) Social barriers to emotional expression and their relations to distress in male and female cancer patients. Br J Health Psychol 8: 271–286PubMedCrossRefGoogle Scholar

Copyright information

© Springer Verlag France 2007

Authors and Affiliations

  1. 1.Responsable de l’unité de psycho-oncologie du service d’oncologie médicaleCentre hospitalier de la Timone, service d’oncologie médicaleMarseille cedex 05France
  2. 2.Centre PsyCLÉuniversité de ProvenceAix-en-ProvenceFrance
  3. 3.Laboratoire de psychologie socialeuniversité de Provence, Aix-en-Provence Centre hospitalier de la Timone service d’oncologie médicaleMarseilleFrance
  4. 4.Coordinatrice du réseau OncorepMarseilleFrance

Personalised recommendations