title: Toward clinical care guidelines for supporting rehabilitative vaginal dilator use with women recovering from cervical cancer.
abstract: OBJECTIVE
  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.
  
  
  CONCLUSIONS
  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.
authors: Department of Psychology, York University, 142 Behavioural Science Building, 4700 Keele St, Toronto, Ontario M3J 1P3, Canada. kacullen@yorku.ca
authors: Kimberley
authors: K
authors: Cullen
authors: Karen
authors: K
authors: Fergus
authors: Tracey
authors: T
authors: DasGupta
authors: Iwa
authors: I
authors: Kong
authors: Marg
authors: M
authors: Fitch
authors: Catherine
authors: C
authors: Doyle
authors: Lauran
authors: L
authors: Adams
mesh_terms: D004106:Dilatation / Q000295:instrumentation* / Q000592:standards; D005260:Female; D006801:Humans; D008875:Middle Aged; D017410:Practice Guidelines as Topic; D002583:Uterine Cervical Neoplasms / Q000503:physiopathology* / Q000534:rehabilitation*; D014621:Vagina / Q000503:physiopathology*