« Figure it out on your own »: a mixed-method study on pelvic health survivorship care after gynecologic cancer treatments

Author:

Bernard Stéphanie1,Wiebe Ericka2,Waters Alexandra3,Selmani Sabrina3,Turner Jill4,Dufour Sinéad5,Tandon Puneeta6,Pepin Donna7,McNeely Margaret L.8

Affiliation:

1. École des sciences de la réadaptation, Faculté de médecine, Université Laval

2. Faculty of Medicine and Dentistry, University of Alberta

3. Département de radio-oncologie, Centre Intégré de Santé et de Services Sociaux du Bas-St-Laurent

4. Cross Cancer Institute, Alberta Health Services

5. School of Rehabilitation Science, Faculty of Health Sciences, McMaster University

6. Department of Medicine, Division of Gastroenterology (Liver Unit), University of Alberta

7. Ovarian Cancer Canada

8. Department of Physical Therapy, Faculty of Rehabilitation Medicine, University of Alberta

Abstract

Abstract Purpose. Pelvic health issues after treatment for gynecological cancer are common. Due to challenges in accessing physiotherapy services, exploring virtual pelvic healthcare is essential. This study aims to understand needs, preferences, barriers, and facilitators for a virtual pelvic healthcare program for gynecological cancer survivors. Methods. A multi-center, sequential mixed-methods study was conducted. An anonymous online survey (N=50) gathered quantitative data on pelvic health knowledge, opportunities, and motivation. Focus groups (N=14) explored patient experiences and consensus on pelvic health interventions and virtual delivery. Quantitative data used descriptive statistics and focus group analyses employed inductive thematic analysis. Findings were mapped to the Capability, Opportunity and Motivation (COM-B) behavior change model. Results. Participants reported lacking knowledge about pelvic health interventions and capability related to the use of vaginal dilators and continence care. Barriers to opportunity included lack of healthcare provider initiated pelvic health discussions, limited time in clinic with healthcare providers, finding reliable information, and cost of physical therapy pelvic health services. Virtual delivery was seen favorably and may help to address motivational barriers related to embarrassment and frustration with care. Conclusion. Awareness of pelvic healthcare is lacking among people treated for gynecological cancer. Virtual delivery of pelvic health interventions is perceived as a solution to enhance access while minimizing travel, cost, embarrassment, and exposure risks. Implications for cancer survivors. A better understanding of the pelvic health needs of individuals following gynecological cancer treatments enables the development of tailored virtual pelvic floor rehabilitation interventions which may improve access to pelvic health survivorship care.

Publisher

Research Square Platform LLC

Reference24 articles.

1. International Agency for Research on Cancer., GLOBOCAN 2020. 2023: Global Cancer Observatory (https://gco.iarc.fr/).

2. Pelvic-Floor Properties in Women Reporting Urinary Incontinence After Surgery and Radiotherapy for Endometrial Cancer;Bernard S;Phys Ther,2017

3. Characterizing pelvic floor muscle function and morphometry in survivors of gynecological cancer who have dyspareunia: a comparative cross-sectional study;Cyr M-P;Phys Ther,2021

4. Chemoradiation for cervical cancer treatment portends high risk of pelvic floor dysfunction;Miguel TP;PLoS ONE,2020

5. Pelvic floor disorders in women with gynecologic malignancies: a systematic review;Ramaseshan AS;Int Urogynecol J,2018

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