An effective group psychoeducational intervention for improving compliance with vaginal dilation: a randomized controlled trial.
OBJECTIVE
Although vaginal dilation is often recommended to minimize or prevent vaginal scarring after pelvic radiotherapy, compliance with this recommendation has historically been very low. Therefore, effective intervention strategies are needed to enhance compliance with vaginal dilation after radiotherapy for gynecologic cancer.


METHODS
This study was a randomized controlled clinical trial of a psychoeducational intervention specifically designed to increase compliance with vaginal dilation. The information-motivation-behavioral skills model of enhancing compliance with behavioral change was the basis for the intervention design. Forty-two sexually active women, 21 to 65 years of age, diagnosed with Stages Ic-III cervical or endometrial cancer, who received pelvic radiotherapy, were randomized to either the experimental psychoeducational group or the information-only control group. Assessment via questionnaire occurred before treatment and at 6-week, 6-month, 12-month, 18-month, and 24-month follow-up. Assessment via interview also occurred at 6-month, 12-month, 18-month, and 24-month follow-up.


RESULTS
The psychoeducational intervention was successful in increasing compliance with vaginal dilation.


CONCLUSIONS
This study is the first randomized controlled study to demonstrate the effectiveness of an intervention in increasing compliance with the use of vaginal dilators.
Jeffries
Sherryl A
SA
Department of Psychosocial Resources, Tom Baker Cancer Centre, Calgary, Alberta, Canada.
Robinson
John W
JW
Craighead
Peter S
PS
Keats
Melanie R
MR
D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D004106:Dilatation / Q000523:psychology* / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D008875:Middle Aged; D010349:Patient Compliance / Q000523:psychology* / Q000706:statistics & numerical data; D010353:Patient Education as Topic / Q000379:methods*; D011446:Prospective Studies; D013997:Time Factors; D016312:Treatment Refusal / Q000706:statistics & numerical data; D014621:Vagina / Q000528:radiation effects*