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Barriers to and strategies for dealing with vaginal dilator therapy - Female pelvic cancer survivors' experiences: A qualitative study
Sahlgrenska akademin.
Malmö universitet.
Sahlgrenska akademin.
Marie Cederschiöld University, Department of Health Care Sciences.
2023 (English)In: European Journal of Oncology Nursing, ISSN 1462-3889, E-ISSN 1532-2122, Vol. 62, article id 102252Article in journal (Refereed) Published
Abstract [en]

PURPOSE: Vaginal changes, a frequently reported late effect among women treated with pelvic radiotherapy, can result in sexual dysfunction and distress. Women are recommended vaginal dilator therapy after completed radiotherapy; however, low adoption has been recognized. This study aims to provide insight into women's difficulties with carrying out vaginal dilator therapy and their experiences of information.

METHODS: Face-to-face, semi-structured interviews were undertaken with 12 pelvic cancer survivors in a selected sample of women with difficulties adopting the therapy. Interviews were audio-recorded, transcribed and analyzed using qualitative content analysis.

RESULTS: One overarching theme, Being unprepared, emerged from three identified categories relating to Experience of received information, Experience of performing the therapy, and Motivation to perform the therapy. The women experienced the information as unrealistic and insufficient, and requested clearer and earlier information. Bleeding, pain, fear of cancer recurrence, and recalling memories from treatments were experienced. Women described intestinal symptoms, fatigue, and feeling that the therapy was self-harm as barriers to performing the therapy. They described creating routines, breathing exercises, relaxation, pre-warming the dilator and performing therapy together with their partner as helpful strategies.

CONCLUSIONS: Careful discussion, early and clear communication, psychoeducation and supportive follow-up of vaginal changes should be integrated into cancer treatment and follow up. Healthcare professionals should be aware of potential difficulties with vaginal dilator therapy and identify women in need of extended support. Research is required to investigate interventions that suit the needs of female pelvic cancer survivors.

Place, publisher, year, edition, pages
Elsevier, 2023. Vol. 62, article id 102252
Keywords [en]
Female cancer survivor, Late effect, Pelvic radiotherapy, Vaginal dilator therapy, Vaginal stenosis
National Category
Nursing
Identifiers
URN: urn:nbn:se:esh:diva-9998DOI: 10.1016/j.ejon.2022.102252PubMedID: 36603495OAI: oai:DiVA.org:esh-9998DiVA, id: diva2:1725548
Available from: 2023-01-11 Created: 2023-01-11 Last updated: 2024-02-09Bibliographically approved

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Dunberger, Gail

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