Experiences and factors influencing the use of dilators by women with cancer who received pelvic radiotherapy at cancer diseases hospital in Lusaka, Zambia.

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Mwale, Alex
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The University of Zambia
Cancer of the cervix is one of the commonest cancers among women seen at Cancer Diseases Hospital in Lusaka, Zambia. Pelvic Radiotherapy is the main treatment modality used on Cervical Cancer patients. Pelvic Radiotherapy causes vaginal stenosis in women, but this stenosis can be prevented by regular sexual intercourse or use of vaginal dilator, which is recommended by many cancer organizations such as American Cancer Society. Despite the well-established benefits of using vaginal dilators, there was reluctance by women to adopt this practice as seen by the few numbers of survivors with vaginal stenosis at Cancer Diseases Hospital. The objective of this study was to explore the experiences and determine factors influencing the use of vaginal dilators by women with cervical cancer after receiving Pelvic Radiotherapy. This study utilized a mixed method design. The quantitative component utilized a cross sectional design and the qualitative component utilized a descriptive phenomenological design which allowed participants describe their "lived experiences" of using vaginal dilators. A total of 338 participants were interviewed for the quantitative component and 22 participants were purposefully selected and interviewed for the qualitative component. Quantitative data was analyzed with Statistical Package for Social Sciences. Descriptive statistics of frequency distribution and percentages were computed. Later a cross tabulation analysis was conducted using Chi-square and binary logistic regression. Thematic analysis was utilized for qualitative data. Five themes from the qualitative study emerged on how women experienced the use of vaginal dilator, such as uncomfortable dilators, pity for the husband, changed lifestyle, fear and embarrassment. The quantitative data revealed that 53.6% participants were adequately using the dilator. Three factors which were found to be predictors influencing the use of vaginal dilator are marital status (P-value =0.000), occupation (P-value =0.044), health education (P-value =0.015). The inadequate use was due to negative experiences and some factors such as marital status, occupation and IEC. This study recommends appropriate health education concerning the use of vaginal dilators and Ministry of Health to provide proper vaginal dilators not the 50mls syringes currently in use. Keywords: Cervical cancer, Radiotherapy, Experiences, Use of Vaginal dilators, Vagina stenosis
Pelvic radiotherapy. , Cervical cancer. , Vaginal stenosis.