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Toward clinical care guidelines for supporting rehabilitative vaginal dilator use with women recovering from cervical cancer

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Supportive Care in Cancer Aims and scope Submit manuscript

Abstract

Purpose

Building upon the findings of a recent qualitative investigation of women’s experiences with rehabilitative vaginal dilator use, the primary goal of this article is to outline a set of preliminary clinical care recommendations that health care professionals may draw upon in addressing women’s unique experiences with vaginal dilator use including their multifaceted struggles with the procedure, possibly enhancing adherence to this practice.

Methods

Ten women participated in in-depth interviews regarding their experiences with using the dilator as prescribed by their health care providers. Following the analysis of these interviews, members of the interdisciplinary research team met to review and discuss the development of clinical care recommendations stemming from these findings.

Results

Eight care recommendations aimed at addressing the concerns expressed by the women interviewed and at improving women’s overall experiences with rehabilitative dilator use emerged: (1) introduce the dilator in a light and straightforward manner; (2) enhance dilator accessibility; (3) introduce the vaginal dilator early on in treatment; (4) emphasize health maintenance over intercourse as a benefit of dilator use; (5) explore and acknowledge women’s values and views of sexuality; (6) increase awareness and sensitivity to emotional reactions; (7) enhance psychoeducational resources for supporting vaginal dilator use; and (8) ensure consistent institutional practice when introducing the dilator.

Conclusion

The clinical care recommendations proposed here reflect the various challenges women may encounter when using the vaginal dilator—which vary from practical to, for some, profoundly emotional—and are designed to better position health care providers to help women navigate these challenges.

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Acknowledgments

K. Cullen was supported by the Canadian Institute of Health Research (CIHR) Master’s Scholarship. This study was supported by Sunnybrook Health Sciences Center Practice-Based Research Award. As the first author, I have full control of all primary data and agree to allow the journal to review the data.

Conflict of interest

None

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Authors and Affiliations

  1. Department of Psychology, York University, 142 Behavioural Science Building (BSB), 4700 Keele St, Toronto, Ontario, M3J 1P3, Canada

    Kimberley Cullen & Karen Fergus

  2. Patient and Family Support, Odette Cancer Center, Sunnybrook Health Sciences Center, 2075 Bayview Ave, Toronto, Ontario, M4N 3N5, Canada

    Karen Fergus & Marg Fitch

  3. Department of Professional Nursing, Sunnybrook Health Sciences Center, 2075 Bayview Ave, Toronto, Ontario, M4N 3N5, Canada

    Tracey DasGupta

  4. Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Canada

    Tracey DasGupta

  5. Department of Oncology, Division of Radiation Oncology, McMaster University, 699 Concession Street, Hamilton, Ontario, L8V 5C2, Canada

    Iwa Kong

  6. Oncology Nursing, Odette Cancer Center, Sunnybrook Health Sciences Center, 2075 Bayview Ave, Toronto, Ontario, M4N 3N5, Canada

    Marg Fitch & Catherine Doyle

  7. Nursing Cancer Program, Odette Cancer Center, Sunnybrook Health Sciences Center, 2075 Bayview Ave, Toronto, Ontario, M4N 3N5, Canada

    Lauran Adams

Authors
  1. Kimberley Cullen
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  2. Karen Fergus
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  3. Tracey DasGupta
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  4. Iwa Kong
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  5. Marg Fitch
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  6. Catherine Doyle
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  7. Lauran Adams
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Corresponding author

Correspondence to Kimberley Cullen.

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Cullen, K., Fergus, K., DasGupta, T. et al. Toward clinical care guidelines for supporting rehabilitative vaginal dilator use with women recovering from cervical cancer. Support Care Cancer 21, 1911–1917 (2013). https://doi.org/10.1007/s00520-013-1726-6

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  • DOI: https://doi.org/10.1007/s00520-013-1726-6

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