Measuring masculinity in the context of chronic disease

Masculine beliefs are influential in men’s responses to illness; however, current measures of masculinity may not be salient for highly prevalent chronic diseases such as prostate cancer. To address this gap, a contextualized measure of masculinity for men with prostate cancer was developed. A novel measure of masculinity, the Masculinity in Chronic Disease Inventory (MCD-I), was developed based on existing qualitative data and tested for acceptability and face validity with 19 men previously treated for prostate cancer. A cross-sectional survey of 403 Australian men with prostate cancer (Mage = 70.34 years; SD = 7.25) then assessed convergent, divergent, and discriminant validity for the MCD-I using existing reliable and valid measures of masculinity, masculine self-esteem, quality of life, erectile dysfunction, and sexual help seeking. A 6-factor structure for the MCD-I (22 items) was confirmed with good to excellent internal reliabilities (alpha = 0.69–0.92) for the subscale domains of Strength, Sexual Importance/Priority; Family Responsibilities; Emotional Self-Reliance; Optimistic Capacity; and Action Approach. Acceptable convergent and divergent validity was supported, and the MCD-I was also able to discriminate between men with severe versus moderate to mild erectile dysfunction (p = .002) and the Sexual Importance/Priority domain discriminated between men who had sought sexual advice and those who had not (p = .005). A contextual approach to measuring masculinity in men with prostate cancer may help avoid reductionist approaches for focusing on erectile dysfunction in these populations. This also presents a way forward for gender-sensitive psychosocial services and programs for men experiencing prostate cancer. (PsycINFO Database Record (c) 2018 APA, all rights reserved)