Psychoeducational group increases vaginal dilation for younger women and reduces sexual fears for women of all ages with gynecological carcinoma treated with radiotherapy

Purpose: The association between radiotherapy for gynecological carcinoma a nd sexual dysfunction is well established. Regular vaginal dilation is wide ly recommended to these women as a way for them to maintain vaginal health and good sexual functioning, However, the compliance rate with this recomme ndation is low. The purpose of this study was to test the effectiveness of a group psychoeducational program based on the "information-motivation-beha vioral skills" model of behavior change in increasing the rate of complianc e. Methods and Materials: Thirty-two women with Stage I or II cervical or endo metrial carcinoma who were being treated with radiotherapy were randomized and received either the experimental group program or the control intervent ion that consisted of written information and brief counseling. Outcome mea sures included global sexual health, knowledge about sexuality and cancer, fears about sexuality after cancer, and vaginal dilation compliance, Results: Younger women attending the experimental program (44.4%) were sign ificantly more likely to follow recommendations for vaginal dilation than t hose who received the control intervention (5.6%), Women, regardless of age , who received the experimental intervention reported less fear about sex a fter cancer treatment. The older women who received the experimental interv ention gained more sexual knowledge. There was no evidence that the experim ental intervention improved global sexual health. Conclusions: This is the first controlled study to provide evidence of an i ntervention's effectiveness 1, in increasing women's vaginal dilation follo wing radiotherapy for gynecological carcinoma and 2, in reducing their fear s about sex after cancer. Most women, particularly younger women, are unlik ely to follow the recommendation to dilate unless they are given assistance in overcoming their fears and taught behavioral skills, (C) 1999 Elsevier Science Inc.