Attitudes and practices contributing to vaginal stenosis among cervical cancer survivors receiving brachytherapy at CDH in Lusaka, Zambia.

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Date
2022
Authors
Matipa, Royda Chibale
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The University of Zambia
Abstract
Radiation therapy, the leading cervical cancer treatment procedure to the pelvic region has a high likelihood to cause vaginal stenosis. Poor attitudes and practices towards preventive measures contributes largely to the development of vaginal stenosis in women receiving brachytherapy. This study aimed at determining attitudes and practices that contribute to vaginal stenosis among cervical cancer survivors receiving brachytherapy at Cancer Diseases Hospital in Lusaka (CDH) in Lusaka, Zambia. A descriptive cross-sectional study design was employed which used a researcher administered questionnaire. Systematic sampling was used to sample 163 participants who met the inclusion criteria of being on brachytherapy at the time of the study or for 12 months prior to the study. Data was analyzed using SPSS version 25 utilizing chi square statistic to test associations. The relationships were considered significant only when the P-value was less than 0.05 margin of error at 95% confidence interval. Ethical clearance to conduct the study was obtained from UNZABREC (REF. 1770-2021) and National Health Research Authority. The study established a 42.3% prevalence of vaginal stenosis among the study population at Cancer Diseases Hospital (CDH) with the overall practice level in this study showed that the (76%) of the respondents reported good practices. They used preventive measures such as having regular penetrative sex, used of vaginal dilators and were using preventing measures regularly.While the overall attitude level among the study population showed that the majority (93.9%) of the respondents exhibited negative attitude towards vaginal dilators and would skip therapy because of discomfort and guiltiness. Religion and tradition contributed highly to poor attitudes towards preventive measures. Vaginal stenosis was slightly more common among Pentecostals (55.6%) and Adventists (52.9%) compared to Catholics (26.7%) and other religious groups (35.9%) (p=0.019). The study found that religion was independently associated with vaginal stenosis (OR=3.52, CI=1.27 – 9.51, P=0.015: OR=3.92, CI=1.49 – 10.3, P=0.005). Radiation-induced VS was a commonly observed side effect following treatment with pelvic RT for cervical cancer patient. With the magnitude of adiotherapy-induced vaginal stenosis (RTIVS) emerging at 42.3%, efforts should be channelled towards overcoming religious, traditional, cultural and personal impediments contributing to vaginal stenosis in women with cervical cancer receiving brachytherapy.
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Thesis of Master of Science in Midwifery, Women and Child Health Degree.
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