THE INFLUENCE OF REPRODUCTIVE HEALTH DISORDERS ON THE LIFE QUALITY OF MEN

ñêëàäî-Abstract The purpose of the publication is to conduct a medical and sociological study of changes in the quality of life components of men diagnosed with reproductive health disorders. Materials and Methods. The publication is based on the results of a medical and sociological study conducted among 810 men.


THE INFLUENCE OF REPRODUCTIVE HEALTH DISORDERS ON THE LIFE QUALITY OF MEN Introduction
Quality-of-life assessment is widely used in clinical trials as an informative method of patient feedback.Contemporary scientific research on the effectiveness of methods of diagnosis, treatment, and monitoring of patients with various diseases involves studying the dynamics of changes in the components of their quality of life.The obtained results complement the detailed information on the impact of diagnostic and therapeutic manipulations and the peculiarities of the disease on physical, and psycho-emotional state, as well as the ability to continue social interaction.The study results of changes in individual components of life quality become an effective mechanism for developing measures to prevent them [1-5].
The issue of studying the quality of life in reproductive disorders, especially among men who apply for medical care much more passively than women, is relevant.There are very few similar studies focusing on gender-specific changes in the quality of life in reproductive disorders.
The purpose of the research is to conduct a medical and sociological study of changes in the components of life quality of men diagnosed with reproductive health disorders.

Materials and Methods
The research involved the results of a medical and sociological study among men (810 persons), who, after a comprehensive medical examination, were divided into the main (402 persons with diagnosed reproductive health disorders) and control (408 persons) groups.To study changes in quality of life components, a universal and standardized questionnaire SF-36 (Medical Outcomes Study Short-Form 36) was used.The obtained results, having full comparability of the obtained values, reliably reflect the impact of the disease on the change in the components of the quality of life.Results are presented as percentages, and comparisons between groups were made using Pearson's chisquare test.If the expected value in one of the cells of the frequency table was less than 5, Fisher's exact test was used.Quantitative indices were compared using the Mann-Whitney U-test.

Results
The analysis of the study results involved grouping the signs that characterized changes in the physical and psychological components of the quality of life of men diagnosed with reproductive health disorders.
The study of changes in the physical component of life quality included detailed changes according to the following scales: physical functioning; role (social) functioning and the ability to further interact in society against the background of changes in physical condition due to the disease; pain intensity; general self-assessment of health.Thus, according to the PF -Physical Functioning scale, it was found that the majority of men in both the intervention and control groups did not feel any restrictions when performing moderate physical activities, such as cleaning, moving the table, picking mushrooms, berries, etc. (75.4% and 83.8%, respectively); walking up the stairs to one floor (72.7% and 93.6%); a walk of one-quarter length (72.7% and 93.6%); walking a distance of several blocks (70.2% and 80.6%, respectively).At the same time, heavy physical activities for respondents from the main group were slightly limited, including strength sports, running and lifting weights (69.9% vs. 43.4%,respectively); walking up several flights of stairs (62.9% vs. 20.3%);walking for a distance of more than 1 kilometer (71.9% and 15.7%, respectively).The final calculations (as determined by the standardized SF-36 methodology) of the number of conventional units of assessment on the PF -Physical Functioning scale revealed slightly lower values of calculation units in the main group (495.6 conventional units) compared to the control group (573.75 conventional units).
A comparative assessment of the RP -Role-Physical Functioning scale also revealed slightly lower values of calculation units in the intervention group (605.0 conventional units) compared to the control group (723.75 conventional units).Thus, a significant proportion of respondents from the main group had to do less than they would like to do due to health problems with significant physical activity (73.9% and 31.6%,respectively), and felt restricted in their physical work (38.8% and 18.4%, respectively), faced the need to apply additional effort when performing physical work or other activities related to physical activity (39.6% and 17.2%, respectively), and also reduced the time previously spent on physical activity (44.8% and 22.3%, respectively).
The results of the BP -Bodily Pain scale showed that only 19.4% of men from the main group and 39.0% of men from the control group did not feel any physical pain during the last month.At the same time, 51.5% of men from the main group and 35.0%from the control group reported mild (insignificant) pain.The specified physical pain moderately prevented 24.6% of men from the main and 9.5% from the control groups from doing daily work around the house, as well as outside the home.The revealed insignificant difference in the value of the final calculation units on the BP -Bodily Pain scale in the main (368.88 conventional units) and control (404.7 conventional units) groups proves that the emerging reproductive health disorders in men in most cases are not accompanied by significant physical pain.
The results of calculations based on the GH -General Health scale showed that only 10.2% of the main group and 18.14% of the control group of men consider their health to be excellent, while the majority of respondents rated their health as very good (28.1% and 33.1%, respectively) and good (47.76% and 39.0%, respectively).
More than half of men from the main group -57.2% and 21.8% from the control group noted that they consider their bodies to be susceptible to disease.Some respondents indicated that they expected their health to deteriorate (22.9% of the main group and 2.5% of the control group).In general, 29.2% of men from the main group and 18.4% from the control group consider their health to be worse than that of most of their acquaintances.Perhaps this is why the final calculations on the GH -General Health scale revealed a generally low selfassessment of men's health in both the main and control groups, with a significant difference between them (main group -278.7 conventional units and the control -381.73 conventional units).
Calculations of the general index of Physical health -PH changes in the quality of life of men revealed that the total calculated values in the main (9747.4conventional units) and control (10178.5 conventional units) groups differ in favor of the latter by only 4.4%, which, in turn, proves the presence of a weak (less than 5.0%) negative impact of reproductive health disorders on the physical component of men's quality of life.The study of changes in the psychological component of health included: self-assessment of changes in the components of mental health; peculiarities of role functioning due to changes in the patient's psycho-emotional state under the influence of the disease; and assessment of changes in social functioning and life activity.
The calculated values based on the results of the study of the Mental Health scale showed rather low final values in both the control and the main group of men, with a lower value in the main group (273.04 conventional units) compared to the control group (351.36 conventional units).Such results are due to the established difference in the study of the emotional state and feelings of men of the main and the control groups.It was found that some of the respondents, especially from the main group, often (34.1% vs. 12.3% in the control group) or sometimes (30.1% vs. 40.2%,respectively) are very nervous.Almost every tenth person in the main group (10.2% vs. 3.7% in the control group) noted that most of the time they felt so depressed that nothing could cheer them up at that moment.Only 4.0% of surveyed men (2.5% in the main group and 5.6% in the control group) reported feeling calm and satisfied all the time, while half of the respondents reported this feeling often (29.6% and 25.4%, respectively) or only sometimes (37.3% and 16.4%).Only 47.6% of men in the main group and 11.0% in the control group reported feeling fully energized.Less than half of the respondents felt sadness and depression rarely (27.1% in the main group and 36.0% in the control group) or sometimes (24.9% and 29.9%, respectively).Feelings of happiness over the past month were often noted by 26.0% of respondents (22.4% from the main and 29.8% from the control groups).
The results of the assessment of role functioning peculiarities that arose under the influence of emotions over the past month (scale RE -Role-Emotional) revealed that a significant number of men from the main group had to reduce the time spent on their usual work or other household tasks due to changes in their emotional state (68, 4 % vs. 19.1 % of the control group), and also had to do less than they wanted to (73.4 % vs. 21.8%, respectively), performing their daily tasks less carefully than usual (69.7 % vs. 20.1 %, respectively).The final calculations of the evaluation values of the quality of life components assessment by the RE -Role-Emotional scale revealed a significant difference in the values of the main (519.67 conventional units) and control (732.0 conventional units) groups.
The study of the impact of emotional state on the social functioning of men using the SF -Social Functioning scale showed that negative emotions provoked by the presence of reproductive health disorders in men slightly interfered (51.7% vs. 35.5%,respectively) with spending time with family, children, neighbors and in the team.Less than half of the respondents in the main (48.6%) and the control (44.7%) groups noted that their physical and emotional state over the past month only rarely prevented them from actively communicating with people, visiting friends and relatives.On the other hand, 18.1% of the main group and 10.8% of the control group reported that this situation occurred "most of the time" over the past month, and another 8.2% of men in the main group and only 0.2% of the control group reported that it happened all the time over the past month.The final calculations of the values on the SF -Social Functioning scale revealed a difference in the values of the main (365.875 conventional units) and the control (412.375 conventional units) groups, which confirmed the hypothesis that reproductive health disorders have an impact on the emotional state, social functioning and quality of life of men.
Based on the results of self-assessment of vitality using the VT -Vitality scale, it was found that only 16.2% of men in the main group and 21.3% in the control group reported a constant cheerful mood over the past month.One-third of the respondents reported feeling cheerful most of the time (30.1%, including 23.6% in the main group vs. 36.5% in the control group) or often (29.9%,including 34.8% in the main group vs. 25.0% in the control group).Only group felt full of strength and energy all the time, while the majority rarely felt this way (47.6% vs. 11.0% in the control group).One-third of the interviewed men from the main group (33.1% vs. 10.8% in the control group) often felt tired, and another third (14.4% vs. 2.4%, respectively) felt tired all the time or most of the time (23.4 % versus 4.4%, respectively).Every fifth person in the main group reported feeling constantly tired (19.1% vs. 2.2% in the control group).A smaller proportion of men in the main group (38.6% vs. 18.1% in the control group) reported feeling tired frequently in the past month.The total calculations of the values on the VT -Vitality scale showed low values in both the main and the control groups of respondents, with their slightly higher values in favor of the latter (341.1 conventional units in the control group vs. 261.55conventional units in the main group).
The final calculations of the main components of life quality of men revealed that the calculated values characterizing changes in the Mental Health -MH component in the main (12628.0conventional units) and control (17542.0conventional units) groups of men differed significantly in favor of the latter (by 38.9%).At the same time, the calculations of the total Physical health component -PH in the main (9747.4conventional units) and control (10178.5 conventional units) groups differed in favor of the latter by only 4.4%.
Based on the listed above, it can be reasonably concluded that men who suffer from reproductive health disorders experience a significant negative impact on their psychological well-being.This impact is characterized by emotional disorders, a decrease in vital activity, as well as fatigue and exhaustion.The total calculations revealed the presence of a difference (23.9%) between the main (22375.4conventional units) and the control (27720.5 conventional units) groups, which confirms the ability of reproductive health disorders to reduce the quality of life of men by almost a quarter (Fig. 1).

Discussion
The obtained results allow us to reasonably claim that reproductive health disorders in men have a significant negative impact on the psychological component of their quality of life, with disturbances in the emotional sphere and a decrease in vital activity, accompanied by fatigue and exhaustion.Given the limited research on the gender-specific aspects of changes in life quality of men in the context of reproductive disorders.Our results provide a foundation for developing measures to prevent these disorders.

Conclusions
The results of a medical and sociological study established changes in the quality of life components of men diagnosed with reproductive health disorders.It has been proven that these disorders negatively affect the physical (4.4%) and psychological (38.9%) components of life quality.The total calculations confirm the ability of reproductive health disorders to reduce life quality of men by almost a quarter (23.9%).

Social Medicine, Health Care Management Ñîö³àëüíà ìåäèöèíà, îðãàí³çàö³ÿ îõîðîíè and Hygiene çäîðîâ'ÿ òà ã³ã³ºíà
Conclusions.According to the results of a medical and sociological study, changes in the components of life quality of men were identified in individuals diagnosed with reproductive health disorders.The study confirmed that the disorders negatively affect physical (4.4%) and psychological (38.9%) components of life quality.The overall calculations confirm the ability of reproductive health disorders to reduce the life quality of men by almost a quarter (23.9%).