Poster Presentation Clinical Oncology Society of Australia Annual Scientific Meeting 2017

“Talking woman to woman”: Peer-patient discussions about psychosexual issues and vaginal dilators following radiotherapy for gynaecological cancer within the PeNTAGOn trial (#396)

Emma Lamph 1 , Ilona Juraskova 1 2 , Zoe Butt 1 , Alana Fisher 1 2 , Ben Huntingdon 1 , Penelope Schofield 3 4 5
  1. School of Psychology, University of Sydney, Sydney, NSW, Australia
  2. Centre for Medical Psychology and Evidence-based Decision-making (CeMPED), University of Sydney, Sydney, NSW, Australia
  3. Department of Psychology, School of Health Sciences, Faculty of Health, Arts and Design, Swinburne University of Technology, Hawthorne, VIC, Australia
  4. Department of Behavioral Science in Cancer, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia
  5. Sir Peter MacCallum Department of Oncology, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Parkville, VIC, Australia

Aims:

Around half of women treated with radiotherapy for gynaecological cancer (GC) report psychosexual side-effects. Addressing GC patients’ psychosexual needs and discussing rehabilitation-aids (i.e., vaginal dilators) can reduce the impact of post-radiation side-effects and increase dilator use. Peer support interventions provide a potential platform to facilitate psychosexual discussions, however, the content of these discussions is yet to be examined. This study aimed to qualitatively explore the nature and content of peer-patient discussions about psychosexual issues and rehabilitation-aid use across the treatment trajectory.

Methods:

This research was conducted in the context of a protocolised nurse-peer support intervention for women with GC (PeNTAGOn, Schofield et al., 2013). Telephone discussions between 25 GC patient-peer pairings recorded at four time points (at pre-, mid-, end-, and 4 weeks post- radiotherapy), were purposefully selected on the basis of patient and clinical characteristics. Conversations were transcribed, and content analysed to generate themes and frequency data. Two researchers coded all transcripts.

Results:

Of the 25 peer-patient pairs selected (94 recordings), 8 (32%) discussed psychosexual issues at least once across the treatment trajectory, all pairs (100%) discussed use of dilators, and 16 (64%) discussed other rehabilitation aid or strategy (e.g. lubricant, pelvic floor exercises). Peers’ use of humour, analogies and sharing own experiences appeared to facilitate such discussions. Prominent themes included: (i) physical, psychological and logistical barriers to sexual activity and use of rehabilitation aids, (ii) peer responses to barriers, (iii) patient and peer perceptions of vaginal dilators.

Conclusions:

Even within a protocolised intervention, psychosocial discussions between GC patients and matched peers appear to be highly variable. However, lived experience of peers appears to be an important facilitator of discussing sensitive topics. Study findings will be used to inform training for peers to promote psychosocial adjustment and uptake of rehabilitation strategies.