Health Seeking Behavior Associated With Prostatism among Men Aged Over Forty Years in Nyamira County, Kenya

Abstract

Prostatism refers to obstruction of the bladder neck due to an enlargement of the prostate as men age leading to urinary difficulties. Prostatism symptoms are majorly irritative and obstructive. The obstructive ones include hesitancy, the need to initiate micturition and a weakened urinary stream while the irritative ones which are usually more troublesome to patients includes urgency, frequency as well as nocturia. The study sought to assess the health seeking behavior with regards to Prostatism among adult men in this area. The study mainly focused on the individual factors, health system factors, IPSS scores and attitude of men towards Prostatism. This study was cross sectional study which was conducted at Nyamira County. The study utilized qualitative and quantitative research methods in order to obtain the required information from respondents. Quantitative data collection was done by use of open and closed ended questionnaires while qualitative data was collected through focused group discussions with adult Men. Confidentiality of information collected was observed and consent was sought from the respondents before collecting any form of information from them. A total of 387 respondents from 18 villages representing 3 villages from six sub locations of Nyamira south and Masaba wards that were randomly selected, were interviewed representing 91.7% response rate. The tools that the researcher used included questionnaire and focused group discussion guides. Descriptive data was analyzed with the aid of the Statistical Package for Social Sciences (SPSS) version 20.0 with the help of Microsoft Excel programme to generate frequency tables, graphs and pie-charts. Inferential statistics was calculated using Chi- Square tests (p=0.005) done at 95% confidence level to determine the linkage between the Variables. Most people in Nyamira County live in rural settings where the awareness levels and knowledge on Prostatism is low, health facilities and providers are few. The study found that the overall uptake level of Prostatism services was 12.1%. Chi-square analysis revealed significant relationship between age (0.001), educational level (0.001), seriousness of condition(0.02), whether screening helps prevent Prostatism (0.001), knowledge about Prostatism screening(0.021), cost of screening (0.001), having medical insurance(0.001), reception and quality of care (0.01), distance to health facility (0.001), fear of Prostatism (0.001), risk of developing Prostatism(0.043), believe it was embarrassing to be screened(0.001), scared of screening results(0.001), whether one discussed health concerns with professionals(0.001), believe that one can live a longer life with condition (0.001) and uptake of Prostatism services. International prostate symptoms scale (IPSS) tool was used to determine individual scores for the respondents with 49.4% reporting mild (0-7), 35.4% moderate (8-19) and 15.2% severe symptoms (20-35). The findings of this study will help policy makers, facility administrators and care providers to shape comprehensive healthcare policies and programs targeting Prostatism services. This will help address stigma and myths associated with Prostatism, increase awareness about the services and thereby increase uptake of Prostatism services among men over forty years and above