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The sexual health of female rectal and anal cancer survivors: results of a pilot randomized psycho-educational intervention trial.

ABSTRACT: Sexual dysfunction is a frequently reported consequence of rectal/anal cancer treatment for female patients.The purpose of this study was to conduct a small randomized controlled trial to assess the efficacy of a telephone-based, four-session Cancer Survivorship Intervention-Sexual Health (CSI-SH).Participants (N?=?70) were stratified by chemotherapy, stoma, and menopause statuses before randomization to CSI-SH or assessment only (AO). Participants were assessed at baseline, 4 months (follow-up 1), and 8 months (follow-up 2).The intervention had medium effect sizes from baseline to follow-up 1, which decreased by follow-up 2. Effect sizes were larger among the 41 sexually active women. Unadjusted means at the follow-ups were not significantly different between the treatment arms. Adjusting for baseline scores, demographics, and medical variables, the intervention arm had significantly better emotional functioning at follow-ups 1 and 2 and less cancer-specific stress at follow-up 1 compared to the AO arm.The data supported the hypothesized effects on improved sexual and psychological functioning and quality of life in CSI-SH female rectal/anal cancer survivors compared to the AO condition. This pilot study (N?=?70) of CSI-SH supported the impact of this intervention on sexual and psychological functioning and quality of life on rectal and anal cancer survivors compared with an AO condition. However, intervention effects were stronger at follow-up 1 as compared to follow-up 2 and were stronger for sexually active women.Women may benefit from a brief, four-session, sexual health intervention after treatment from rectal and anal cancer.

SUBMITTER: DuHamel K

PROVIDER: S-EPMC4864056 | biostudies-literature | 2016 Jun

REPOSITORIES: biostudies-literature

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The sexual health of female rectal and anal cancer survivors: results of a pilot randomized psycho-educational intervention trial.

DuHamel Katherine K Schuler Tammy T Nelson Christian C Philip Errol E Temple Larissa L Schover Leslie L Baser Raymond E RE Starr Tatiana D TD Cannon Kathleen K Jennings Sabrina S Jandorf Lina L Carter Jeanne J

Journal of cancer survivorship : research and practice 20151214 3

<h4>Background</h4>Sexual dysfunction is a frequently reported consequence of rectal/anal cancer treatment for female patients.<h4>Purpose</h4>The purpose of this study was to conduct a small randomized controlled trial to assess the efficacy of a telephone-based, four-session Cancer Survivorship Intervention-Sexual Health (CSI-SH).<h4>Methods</h4>Participants (N = 70) were stratified by chemotherapy, stoma, and menopause statuses before randomization to CSI-SH or assessment only (AO). Participa ...[more]

PMID: 26667358

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Project description:BackgroundLittle evidence exists regarding efficacious HIV and sexually transmitted infections (STI) prevention interventions with internally displaced populations. Internally displaced women are at elevated risk for HIV/STI due to limited access to health services, heightened poverty and social network breakdown. The FASY (Famn an Aksyon Pou Sante' Yo) (Women Taking Action For Their Health) study examined the effectiveness of a peer health worker (PHW) delivered psycho-educational HIV/STI pilot study with internally displaced women in Leogane, Haiti.MethodThis was a non-randomized cohort pilot study. Participants completed a computer-assisted pre-test programmed on Android tablet PCs followed by an HIV/STI educational video-based session and a 6-week psycho-educational group program of weekly meetings. Participants completed a post-test upon completion of group sessions. The primary outcome was HIV knowledge; our pre-specified index of clinically significant change was an effect size of 0.30. Secondary outcomes included: STI knowledge, condom use, social support, resilient coping, depression and relationship control. We used mixed-effects regression to calculate mean outcome pre-post score change. This study was registered (clinicaltrials.gov, NCT01492829).ResultsBetween January 1-April 30, 2012 we assigned 200 participants to the study. The majority of participants (n = 176, 88%) completed the study and were followed up at 8 weeks, finishing April 30, 2012. Adjusted for socio-demographic characteristics, HIV knowledge (β = 4.81; 95% CI 4.36-5.26), STI knowledge (β = 0.84; 95% CI 0.70-0.99), condom use (AOR = 4.05, 95% CI 1.86-8.83), and depression (β = -0.63, 95% CI -0.88--0.39) scores showed statistically significant change post-intervention (p<0.05).ConclusionsThis pilot study evaluated a PHW psycho-educational HIV/STI prevention intervention among internally displaced women in post-earthquake Haiti. Pilot studies are an important approach to understand feasibility and scientific impacts of HIV prevention strategies in disaster contexts. Study results may inform HIV prevention interventions among internally displaced women in Haiti and can be tested for applicability with internally displaced women globally. ClinicalTrials.gov: Identifier NCT01492829, URL: http://clinicaltrials.gov/ct2/show/NCT01492829?term=logie&rank=1.

Project description:IntroductionSexual and reproductive health are significant aspects of quality of life. Healthcare often fails to provide adequate support for young cancer survivors in this area, hence the need to develop more effective interventions. The present study aimed to describe experiences of participating in a web-based psycho-educational intervention focusing on sexual dysfunction and fertility distress after cancer, and to explore these experiences within the theoretical frame of the basic psychological needs for competence, relatedness and autonomy according to self-determination theory.MethodsIndividual semi-structured interviews with 24 women and 4 men, age 19-40, were abductively analyzed using the Framework approach for qualitative content analysis.ResultsParticipant experiences corresponded well with the three main deductive themes competence, relatedness and autonomy, divided into a total of nine subthemes illustrating varying degrees of basic need satisfaction with considerable nuance but not without ambiguity. While satisfaction of the need for competence could be linked to the amount of information in relation to participants' cognitive capacity, satisfaction of the need for relatedness seemed to be of special importance for these young adults with cancer experience. Invitation to the program meant a chance at alleviating loneliness and normalizing problems, symptoms and concerns. Participants' descriptions of perceived autonomy support were more challenging and ambiguous, because of the many contradictions in participants' responses to their variable situations.ConclusionBasic psychological needs were confirmed as flexible positions along a continuum rather than discrete and mutually exclusive qualities. Understanding the variety of basic need satisfaction may enhance the design of future web-based interventions to be even more inclusive, tailorable and autonomy-supportive. Further research is warranted to determine the role of basic need satisfaction as a possible mediator for web-based psychoeducational interventions in cancer survivorship care.

Project description:Interventions: The intervention is a face-to-face educational psychoanalysis program.Intervention group:Intervention method: Training groups will be 4 to 6 people and the training is done in a classroom formed at the infirmary, the training class includes:A: Educational pamphlet provided to the learner at the beginning of the classB: PowerPoint using a computer and monitorThe training time will be 60 minutes. At the beginning of the session and before the training, the researcher gives the questionnaires to patients and asks them to complete those questionnaires, then the training begins by the researcher. According to the educational pamphlet, the researcher first outlines the importance of conducting these examinations and notes the dangers of non-timely examinations and its non-adherence. Then explains the examination method with the help of images that represent how the examination will be performed. These images are available on Pamphlet and PowerPoint; Images and explanations will be based on how to make such examinations scientifically as well as the special procedure of the surgeon. Through these images and descriptions, we help the patients to learn how to prepare themselves for examinations. We explain to patients the cause of each question doctor asks and they will be asked to answer the questions correctly and tell the doctor real signs and symptoms in order to help the doctor identify the actual diagnosis. The duration of this training phase is estimated 30 minutes. After the training stage, the psychological preparation of patients begins. Fellow psychologist who is already coordinated with the research project, talks with patients and makes them mentally prepared to accept such examinations. The duration of this psychological counseling will be 30 minutes. During this psychologica Primary outcome(s): Anexiety_ embarrassment_ concern about judgment. Timepoint: Before intervention and after intervention. Method of measurement: Measurement of Beck’s Anxiety Scale and measurement of embarrassment and concern are judgments of the medical embarrassment questionnaire. Study Design: Randomization: Randomized, Blinding: Single blinded, Placebo: Not used, Assignment: Single, Purpose: Prevention, Randomization description: Sample selection: the method of selecting admission days of this surgeon for the intervention and control group will be randomly and by using random number table in block method. Visitation days for the mentioned surgeon will be done by randomized block design, and weekdays will be allocated to two groups through block method. First, the researcher constitutes different permutations of A (indicating the visitation date of intervention group) and B (indicating the visitation date of control group) which consist of 6 different modes: for example (1-AABB, 2-ABAB… 6-ABAB). Then to select specific days for control group and intervention group from the table, randomly moves his finger from a point in the random number table in a row or column direction. If a number between one and six is observed, its permutation will be noted. For example, if

Project description:BACKGROUND:Although sexual dysfunction is common after hematopoietic stem cell transplantation (HCT), interventions to address sexual function are lacking. METHODS:We conducted a pilot study to assess the feasibility and preliminary efficacy of a multimodal intervention to address sexual dysfunction in allogeneic HCT survivors. Transplant clinicians screened HCT survivors ≥3 months post-HCT for sexual dysfunction causing distress. Those who screened positive attended monthly visits with a trained transplant clinician who: 1) performed an assessment of the causes of sexual dysfunction; 2) educated and empowered the patient to address his or her sexual concerns; and 3) implemented therapeutic interventions targeting the patient's needs. Feasibility was defined as having approximately 75% of patients who screened positive agreeing to participate and 80% attending at least 2 intervention visits. We administered the Patient-Reported Outcomes Measurement Information System (PROMIS) sexual function and satisfaction measure, the Functional Assessment of Cancer Therapy-Bone Marrow Transplant (FACT-BMT), and the Hospital Anxiety and Depression Scale (HADS) to evaluate sexual function, quality of life (QOL), and mood, respectively, at baseline and 6 months postintervention. RESULTS:Approximately 33.1% of patients (50 of 151 patients) screened positive for sexual dysfunction causing distress and 94.0% (47 of 50 patients) agreed to participate, with 100% attending 2 intervention visits. Participants reported improvements in satisfaction (P<.0001) and interest in sex (P<.0001), as well as orgasm (P<.0001), erectile function (P<.0001), vaginal lubrication (P = .0001), and vaginal discomfort (P = .0005). At baseline, approximately 32.6% of participants were not sexually active, compared with 6.5% after the intervention (P = .0005). Participants reported improvement in their QOL (P<.0001), depression (P = .0002), and anxiety (P = .0019). CONCLUSIONS:A multimodal intervention to address sexual dysfunction integrated within the transplant clinic is feasible with encouraging preliminary efficacy for improving sexual function, QOL, and mood in HCT survivors. Cancer 2018;124:2438-46. © 2018 American Cancer Society.

Project description:Latinas are less likely to participate in genetic counseling (GC) and genetic testing (GT) than non-Hispanic Whites. A multisite, randomized pilot study tested a culturally targeted educational intervention to increase uptake of GC/GT among Latina breast cancer (BC) survivors (N = 52). Participants were recruited in Tampa, FL and Ponce, PR and randomized to: (a) fact sheet about BC survivorship (control) or (b) a culturally targeted educational booklet about GC/GT (intervention). Participants in the intervention condition were also offered no-cost telephone GC followed by free GT with mail-based saliva sample collection. Participants self-reported hereditary breast and ovarian cancer (HBOC) knowledge and emotional distress at baseline and 1- and 3-month follow-ups. We used logistic regression to examine differences in GC/GT uptake by study arm (primary outcome) and repeated measures ANOVA to examine the effects of study arm and time on HBOC knowledge and emotional distress (secondary outcomes). Compared to the control arm, intervention participants were more likely to complete GC (ORIntervention = 13.92, 95% CI = 3.06-63.25, p < .01) and GT (ORIntervention = 12.93, 95% CI = 2.82-59.20, p < .01). Study site did not predict uptake of GC (p = .08) but Ponce participants were more likely to complete GT (ORPonce = 4.53, 95% CI = 1.04-19.72, p = .04). ANOVAs demonstrated an increase in HBOC knowledge over time across both groups (F(2,88) = 12.24, p < .01, ηp 2 = 0.22). We also found a significant interaction of study arm and time, such that intervention participants demonstrated a greater and sustained (to the 3-month follow-up) increase in knowledge than control participants (F(2,88) = 3.66, p = .03, ηp 2 = 0.08). No other main or interaction effects were significant (all p's> .15). Study findings demonstrate the potential of our culturally targeted print intervention. Lessons learned from this multisite pilot study for enhancing GC/GT in Latinas include the need to attend to both access to GC/GT and individual factors such as attitudes and knowledge.

Dataset Information

The sexual health of female rectal and anal cancer survivors: results of a pilot randomized psycho-educational intervention trial.

Publications

The sexual health of female rectal and anal cancer survivors: results of a pilot randomized psycho-educational intervention trial.

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