Dados do Resumo

Título

PREVENTION OF VAGINAL STENOSIS AFTER RADIOTHERAPY IN THE TREATMENT OF GYNECOLOGIC CANCER: TRACKING ACCEPTANCE AND ADHERENCE

Introdução

One of the treatments indicated for women with cervical and endometrial cancer includes brachytherapy, an internal radiation placed in the vaginal canal. Brachytherapy has both acute and late adverse effects, among which vaginal stenosis is highlighted, impacting quality of life, sexual habits, and the ability to undergo gynecological preventive exams. Therefore, the prevention and treatment of vaginal stenosis through pelvic physiotherapy and vaginal dilation is necessary.

Objetivo

To describe the acceptance and adherence to the vaginal stenosis prevention protocol and to identify limitations reported by patients in its execution.

Métodos

A cross-sectional, retrospective study was conducted with interviews about behaviors related to acceptance and adherence to the vaginal stenosis prevention protocol at the end of radiotherapy treatment in patients diagnosed with cervical and endometrial cancer. The study was conducted one year after the implementation of the vaginal stenosis prevention and treatment protocol at the institution. Data collection was performed through electronic medical records, which included sociodemographic and clinical data, as well as questionnaires reported by the women, applied either in person or online, using the RedCap platform for data management. This study was approved by the ethics committee, with approval number 6.416.765.

Resultados

36 women with a median age of 49 years, 18 (50.0%) had a diagnosis of cervical cancer and 18 (50.0%) of endometrial cancer. 7 (19.4%) underwent exclusive brachytherapy, and 29 (80.6%) underwent brachytherapy combined with radiotherapy. Regarding referral to the protocol, 28 (75.7%) were referred for physiotherapy; 18 (67.9%) scheduled and attended, 9 (32.1%) did not schedule. Additionally, 9 (32.1%) received physiotherapy at other institutions. Regarding difficulties, 10 (40.0%) did not report any, 3 (12.0%) mentioned fear of dilation, 2 (8.0%) insecurity, 3 (12.0%) sexual discomfort, 3 (12.0%) had no insurance coverage, 2 (8.0%) experienced recurrence, 2 (8.0%) forgot, 1 (4.0%) reported pain, and 1 (4.0%) mentioned distance from the hospital. Regarding facilitators, 7 (28.0%) reported a sense of connection and support, 14 (56.0%) received proper guidance, 3 (12.0%) had symptom improvement, 3 (12.0%) reported no facilitators, 1 (4.0%) noted an integrated service, and 1 (4.0%) mentioned other reasons.

Conclusões

Proper guidance and support were key factors in treatment adherence, promoting patient adherence to vaginal stenosis prevention. However, challenges such as fear of dilation, insecurity, sexual discomfort, lack of insurance coverage, and forgetfulness may impacted prevention continuity, highlighting the need for continuous and personalized support to overcome these barriers.

Palavras Chave

Oncology Nursing; Brachytherapy; Genital Neoplasms Female