Psychoeducational group increases vaginal dilation for younger women and reduces sexual fears for women of all ages with gynecological carcinoma treated with radiotherapy

• Published in: International journal of radiation oncology, biology, physics Vol. 44; no. 3; pp. 497 - 506
• Main Authors: Robinson, John W, Faris, Peter D, Scott, Carol B
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 01.06.1999; Elsevier
• Subjects: Adult; Age Factors; Aged; Analysis of Variance; Biological and medical sciences; Coitus - psychology; Dilatation; Dyspareunia - psychology; Dyspareunia - therapy; Endometrial Neoplasms - psychology; Endometrial Neoplasms - radiotherapy; Fear - psychology; Female; Genital system. Mammary gland; Gynecological neoplasm; Humans; Longitudinal Studies; Medical sciences; Middle Aged; Patient Compliance; Patient Education as Topic - methods; Program Evaluation; Radiation Injuries - psychology; Radiation Injuries - therapy; Radiotherapy; Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects); Sexual dysfunction; Sexual rehabilitation; Uterine Cervical Neoplasms - psychology; Uterine Cervical Neoplasms - radiotherapy; Vagina - radiation effects; Vaginal dilation; Vaginal stenosis; Vaginal dilation; Sexual rehabilitation; Gynecological neoplasm; Radiotherapy; Vaginal stenosis; Sexual dysfunction; Human; Indication; Stenosis; Instrumentation therapy; Vagina; Vaginal diseases; Instrumental dilatation; Uterine cervix; Case control study; Malignant tumor; Female genital diseases; Reeducation; Uterine diseases; Complication; Female; Endometrium; Sexual function
• ISSN: 0360-3016; 1879-355X
• DOI: 10.1016/S0360-3016(99)00048-6

Purpose: The association between radiotherapy for gynecological carcinoma and sexual dysfunction is well established. Regular vaginal dilation is widely recommended to these women as a way for them to maintain vaginal health and good sexual functioning. However, the compliance rate with this recommendation is low. The purpose of this study was to test the effectiveness of a group psychoeducational program based on the “information-motivation–behavioral skills” model of behavior change in increasing the rate of compliance. Methods and Materials: Thirty-two women with Stage I or II cervical or endometrial carcinoma who were being treated with radiotherapy were randomized and received either the experimental group program or the control intervention that consisted of written information and brief counseling. Outcome measures included global sexual health, knowledge about sexuality and cancer, fears about sexuality after cancer, and vaginal dilation compliance. Results: Younger women attending the experimental program (44.4%) were significantly more likely to follow recommendations for vaginal dilation than those who received the control intervention (5.6%). Women, regardless of age, who received the experimental intervention reported less fear about sex after cancer treatment. The older women who received the experimental intervention gained more sexual knowledge. There was no evidence that the experimental intervention improved global sexual health. Conclusions: This is the first controlled study to provide evidence of an intervention’s effectiveness 1. in increasing women’s vaginal dilation following radiotherapy for gynecological carcinoma and 2. in reducing their fears about sex after cancer. Most women, particularly younger women, are unlikely to follow the recommendation to dilate unless they are given assistance in overcoming their fears and taught behavioral skills.