A randomised controlled trial of a psycho-educational booklet to improve psychosexual adjustment for women undergoing pelvic radiotherapy for gynaecological or anorectal cancer. — ASN Events
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A randomised controlled trial of a psycho-educational booklet to improve psychosexual adjustment for women undergoing pelvic radiotherapy for gynaecological or anorectal cancer. (#98)

Franchelle Lubotzky 1 , Phyllis Butow 1 2 , Caroline Hunt 1 , Susan Carroll 3 , Stephen R Thompson 4 , Michael Jackson 4 , Anubhav Tewari 2 , Ilona Juraskova 1 2
  1. School of Psychology, The University of Sydney, Sydney, NSW, Australia
  2. Centre for Medical Psychology and Evidence-based Decision-making (CeMPED), The School of Psychology, The University of Sydney, Sydney, NSW , Australia
  3. Department of Radiation Oncology, Royal Prince Alfred Hospital, Sydney, NSW, Australia
  4. Department of Radiation Oncology, Prince of Wales Hospital, Sydney, NSW, Australia

Background and aims

Women treated with pelvic radiotherapy (PRT) for gynaecological and anorectal cancer report a high number of sexual problems and unmet information needs with regards to post-treatment psychosexual adjustment. There is suboptimal adherence to rehabilitation aids (e.g., vaginal dilators), and a paucity of resources to facilitate post-radiation rehabilitation and reduce distress in this setting. This randomised controlled trial aimed to evaluate the effectiveness of a patient psycho-education booklet designed to facilitate PRT-related communication, management and adjustment, in this population.

Methods

A total of 82 women (79% response rate) scheduled for PRT to treat gynaecological/anorectal cancer were randomised to receive either the intervention booklet (N=44) or standard PRT information booklet (N=38). Self-report questionnaires assessed: adherence to rehabilitation strategies (i.e. vaginal dilators, lubricants and pelvic floor exercises), knowledge of PRT side-effects and rehabilitation strategies, PRT-related distress, and sexual functioning/satisfaction at pre-PRT baseline, and at 3, 6, and 12 months post-treatment. 

Results

Controlling for 3-month follow-up scores, at 6 and 12 months, intervention participants reported significantly greater use of vaginal dilators and higher levels of knowledge of PRT effects and rehabilitation options, compared to control participants (all p<0.05). The intervention group expressed more positive feedback than controls in terms of booklet content, presentation and helpfulness, at 3-month follow up (p<0.001). Booklet knowledge was associated with adherence to PRT rehabilitation strategies. No significant group differences were found on depression, anxiety, post-traumatic stress or sexual functioning/satisfaction.

Conclusions

RCT findings suggest that the psycho-educational booklet was effective in promoting the uptake of a recommended rehabilitation strategy, i.e. a vaginal dilator and educating these women about PRT-related side-effects and rehabilitation options. Moreover, the booklet’s effectiveness in addressing information and rehabilitation needs appears sustainable across many months post PRT.  Future research should elucidate the booklet’s effectiveness in women with greater psychological and sexual functioning/satisfaction needs.

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