Balancing gender issues in healthcare

A pilot education program is being implemented nationally to improve the skills of practice nurses in men’s health. By Linda Belardi.

While primary healthcare settings may appear to be gender neutral places, they are often biased towards women, says registered nurse and educator Del Lovett.

To address this health disparity and to improve the quality of care for men, Andrology Australia, which is funded by the federal Department of Health and Ageing, has piloted an education program to boost the skills of practice nurses in men’s health.

Lovett, who designed the pilot program, says men are often marginalised in primary healthcare settings and the majority of nurses lacked sound knowledge in this area.

“The national male health policy released in May 2010 identified that men were not being engaged as well as they should be and were clearly disadvantaged in the primary healthcare setting,” she says.

Eighteen practice nurses and staff from GP divisions and networks across Australia recently completed the training workshop in Melbourne, facilitated by Lovett and including guest speakers on indigenous health, and culturally and linguistically diverse communities. Under the train-the-trainer strategy, the 18 participants will assist staff within their own divisions of general practice.

The training program encourages nurses to develop strategies to engage men in conversation about their health.

“Men are often influenced by their partners, families and friends when considering seeking help – so it is important to take advantage of any opportunity when men present it and patterns of usage and access are changing,” says Lovett. Men often bring their children in for immunisation but the language used in child and maternal health is not inclusive of fathers, she says.

Government funding for primary healthcare can also skew the focus in the general practice.
Currently, Lovett says, the work of practice nurses can be too tightly geared to Medicare item numbers, which do not specify any areas related to men’s health.

“While there are Medicare item numbers for breast screening and pap smears there’s not a specific item number for men’s health. This pilot is about getting nurses to step outside of their comfort zone and to take on board the importance that men should have an equal opportunity in the primary healthcare setting.

“General practice and primary care workers are the gatekeepers of the health system. This program is about encouraging nurses not to put men’s health in the too hard basket.”

Lovett says Australia trails behind the diversified roles of practice nurses in New Zealand, the UK and Canada who have a history of delivering men’s health information in general practice settings.

Men were often reluctant to talk openly about their health, especially sensitive issues, and therefore often required a longer consultation. It was also important for practice nurses to encourage follow-up appointments through SMS reminders, she says.

“What we find with men is what we call ‘the door-handle response’. A nurse or GP finishes a consultation and when they open the door handle, that’s when men open up and want to talk about something that may be worrying them.”

Following a full evaluation of the train-the-trainer format, a national program is expected to commence from July next year. At least seven workplace workshops are currently being held between now and the end of February, with more expected in 2012. The education module has been developed for a range of settings including community health and general practice to address the needs of both rural and metropolitan environments.

Andrology Australia intends to offer the course as an online training module to extend its reach to the primary care workforce.

Andrology Australia developed the education program in consultation with a practice nurse reference group following a survey of Australian Practice Nurses Association members last year.

The majority of practice nurses said they had never undertaken professional education on male reproductive health topics such as erectile dysfunction and prostate disease, and did not know where to find evidence-based health resources.

For more information on the National Male Health Policy, visit http://www.health.gov.au/malehealthpolicy or www.andrologyaustralia.org

Fact Box:

Almost 50 per cent of the Australian male population has had a mental health condition, about one-quarter have a disability and close to one-third have a chronic health condition.

Half of all Australian men report being the victim of violence at least once in their lives.

Men are infrequent users of some health services, but are over-represented in others.

Australian men make fewer GP visits than women, only 40 per cent of men discuss healthy lifestyle issues with health professionals and 16 per cent of men do not use any Medicare services at all—however, a greater proportion of emergency department presentations are by men.

Source: The Australian Institute of Health and Welfare, The health of Australia’s males report, 2011

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