The journal of men's health & gender : the official journal of the International Society for Men's Health & Gender最新文献

Background

There has been an increasing scientific interest concerning childbirth-related fear among women. Few studies have paid attention to men's fear and its implications. This study investigates the experience of intense childbirth-related fear from the father's perspective.

Method

Twenty Swedish men who, in a previous survey, had assessed their fear related to childbirth as intense, were interviewed about what this experience had meant to them. The interviews were analyzed using the similarity–difference method in grounded theory.

Results

The men's fear was primarily related to ‘the health and life of their partner and child’, and their main worry concerned the woman. The presence of fear was often described as a ‘mental occupation’, but also as ‘increased vigilance’ or ‘bodily sensations’. The ways of dealing with this fear could be characterized as attempts to ‘increase the sense of control of the situation’ and to ‘diminish the very emotion of fear’. Most men had not expressed or spoken about their fear explicitly due to ‘thoughtfulness for one's partner’, feelings that there was ‘no point in talking about the fear’, and difficulties related to ‘gender constructions’. Despite their fear, all the men had attended the birth of their children; their motives were described from the viewpoints of ‘responsibility’, ‘involvement’ and ‘obligation’.

Conclusions

Experiencing intense fear related to childbirth constitutes a significant burden for expectant fathers. This calls for antenatal strategies for identifying and supporting fearful fathers in their own right without violating the autonomy of the pregnant woman.

The vulnerable health status usually preceding the onset of overt disability is often referred to as frailty. A stringent definition is elusive, but it may be viewed as a physiological syndrome, characterised by decreased reserve and diminished resistance to stressors, resulting from cumulative decline across multiple physiological systems and causing vulnerability to adverse outcomes. Many elements of frailty are related to the neurological system, metabolism, joints, bones and muscles. Central to frailty is the dramatic decline in muscle mass and strength with ageing. Therefore, sarcopenia seems to be the major determinant of frailty.

Several components of the frailty syndrome are related to the physiological actions of testosterone. Testosterone also has effects on psychological functioning. Testosterone (or its aromatisation product oestradiol) is required for the maintenance of bone mineral density. Testosterone also stimulates red blood cell formation.

Testosterone thus has a profound effect on body composition. A significant characteristic of ageing and a factor in frailty is the loss of muscle mass and the increase in fat mass. Androgens promote differentiation of mesenchymal multipotent cells into the myogenic lineage and inhibit their adipogenic differentiation, thus reversing the development of a downward spiral of loss of muscle mass and increase in fat mass. Skeletal muscles of older men are as responsive to the anabolic effects of testosterone as those of younger men, indicating that age as such should not be an impediment to elderly men benefiting from the anabolic effects of testosterone. So, while frailty is obviously a complex syndrome, some elements are androgen-associated and these may improve in men with subnormal testosterone levels.