PURPOSE: Pelvic radiotherapy for gynaecological cancer often leads to damage of the vaginal mucosa, resulting in stenosis (obstruction by scar tissue). Stenosis has been associated with sexual dysfunction and can hinder medical examinations to detect recurrence. The use of vaginal dilators is frequently recommended to prevent or minimise stenosis, but women are reluctant to use these devices. The aim of this study was to explore the patient experience of dilator use and identify the barriers and facilitators affecting compliance with clinician recommendations. METHODS: Women were eligible for the study if they had undergone pelvic radiotherapy for gynaecological cancer up to 2 years ago and received a vaginal dilator as part of their post-treatment rehabilitation. Fifteen participants completed a semi-structured interview. RESULTS: Barriers to dilator use included: uncertainty about how/when to use dilators, viewing it as a negative experience, lack of time or forgetting and the need for discretion due to an association with sex aids. Facilitators included: concern about stenosis, belief that dilators work, reminders of stenosis, acceptance of dilator use as part of their normal routine or an extension of medical treatment and focusing on positive aspects. These factors were incorporated into a model of dilator use based on the Health Belief Model. CONCLUSIONS: This is the first qualitative study to specifically investigate the patient experience of dilator use. The barriers and facilitators identified in this study and the proposed theory-based model provide new insights to inform future research and clinical management of dilator use.
PURPOSE: Pelvic radiotherapy for gynaecological cancer often leads to damage of the vaginal mucosa, resulting in stenosis (obstruction by scar tissue). Stenosis has been associated with sexual dysfunction and can hinder medical examinations to detect recurrence. The use of vaginal dilators is frequently recommended to prevent or minimise stenosis, but women are reluctant to use these devices. The aim of this study was to explore the patient experience of dilator use and identify the barriers and facilitators affecting compliance with clinician recommendations. METHODS:Women were eligible for the study if they had undergone pelvic radiotherapy for gynaecological cancer up to 2 years ago and received a vaginal dilator as part of their post-treatment rehabilitation. Fifteen participants completed a semi-structured interview. RESULTS: Barriers to dilator use included: uncertainty about how/when to use dilators, viewing it as a negative experience, lack of time or forgetting and the need for discretion due to an association with sex aids. Facilitators included: concern about stenosis, belief that dilators work, reminders of stenosis, acceptance of dilator use as part of their normal routine or an extension of medical treatment and focusing on positive aspects. These factors were incorporated into a model of dilator use based on the Health Belief Model. CONCLUSIONS: This is the first qualitative study to specifically investigate the patient experience of dilator use. The barriers and facilitators identified in this study and the proposed theory-based model provide new insights to inform future research and clinical management of dilator use.
Authors: Sherryl A Jeffries; John W Robinson; Peter S Craighead; Melanie R Keats Journal: Int J Radiat Oncol Biol Phys Date: 2006-03-20 Impact factor: 7.038
Authors: Stacy Tessler Lindau; Emily M Abramsohn; Shirley R Baron; Judith Florendo; Hope K Haefner; Anuja Jhingran; Vanessa Kennedy; Mukta K Krane; David M Kushner; Jennifer McComb; Diane F Merritt; Julie E Park; Amy Siston; Margaret Straub; Lauren Streicher Journal: CA Cancer J Clin Date: 2016-01-19 Impact factor: 508.702
Authors: John M Stahl; Jack M Qian; Christopher J Tien; David J Carlson; Zhe Chen; Elena S Ratner; Henry S Park; Shari Damast Journal: Support Care Cancer Date: 2018-09-05 Impact factor: 3.603
Authors: Sabrina Rosa de Lima Matos; Mariana Lucas Rocha Cunha; Sergio Podgaec; Eduardo Weltman; Ana Fernanda Yamazaki Centrone; Ana Carolina Cintra Nunes Mafra Journal: PLoS One Date: 2019-08-09 Impact factor: 3.240