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"I'm No Superman": Understanding Diabetic Men, Masculinity, and Cardiac Rehabilitation
Craig M Dale1, Jan E Angus2, Lisa Seto Nielsen3
1University of Toronto, Toronto, Ontario, Canada craig.dale@utoronto.ca.
Insights
Men with coronary heart disease and Type 2 diabetes have low cardiac rehabilitation attendance. They adopt strategies to regain control, prioritizing masculine identity over biomedical advice, influencing participation.
Area of Science:
- Cardiology
- Public Health
- Sociology of Health
Background:
- Exercise-based cardiac rehabilitation (CR) is crucial for managing coronary heart disease (CHD).
- Men with CHD and Type 2 diabetes mellitus (T2DM) exhibit suboptimal CR attendance and completion rates.
- This demographic faces a poorer prognosis, highlighting a critical gap in care.
Purpose of the Study:
- To explore the experiences of Canadian diabetic men enrolled in CR programs.
- To understand the factors influencing their attendance and engagement with CR.
- To examine how gender and masculinity influence health guidance adherence.
Main Methods:
- Qualitative study involving 16 Canadian men with CHD and T2DM recently enrolled in CR.
- Analysis drawing on gender and masculinity theory.
- Exploration of participants' discursive positions regarding health guidance.
Main Results:
- Men adopted two primary discursive positions: 'working with experts' or 'rejection of biomedical knowledge'.
- These strategies aimed to restore a sense of competency diminished by illness.
- Rehabilitation of a positive masculine identity was a key priority for participants.
Conclusions:
- Variable CR participation among men is significantly influenced by gender, age, and employment status.
- Men's responses to health guidance are complex and can be contradictory.
- Healthcare interventions must consider the role of masculine identity in patient engagement.
Abstract:
Exercise-based cardiac rehabilitation (CR) programs help patients with coronary heart disease (CHD) reduce their risk of recurrent cardiac illness, disability, and death. However, men with CHD and Type 2 diabetes mellitus (T2DM) demonstrate lower attendance and completion of CR despite having a poor prognosis. Drawing on gender and masculinity theory, we report on a qualitative study of 16 Canadian diabetic men recently enrolled in CR. Major findings reflect two discursive positions men assumed to regain a sense of competency lost in illness: (a) working with the experts, or (b) rejection of biomedical knowledge. These positions underscore the varied and sometimes contradictory responses of seriously ill men to health guidance. Findings emphasize the priority given to the rehabilitation of a positive masculine identity. The analysis argues that gender, age, and employment status are powerful mechanisms of variable CR participation.
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