2869 - Development of a Multidisciplinary Sexual Health Program (MSHP): A Supportive Care Needs Assessment for Gynecological Cancer Survivors at a Community Hospital
J. Ogunmuyiwa1, O. D. Balogun2, A. Heller1, and H. Ashamalla1; 1New York Presbyterian Brooklyn Methodist Hospital, Brooklyn, NY, 2New York Presbyterian-Cornell, New York, NY
Purpose/Objective(s): Vaginal toxicity and sexual dysfunction are some of the most distressing and long-lasting survivorship concerns of patients with gynecological cancer. Despite its prevalence, it remains an underrecognized and undertreated morbidity of cancer treatment. This morbidity is disproportionate across subpopulations with race/ethnicity, income, health insurance, and access to health care contributing to these disparities. This pilot study aimed to assess the knowledge, attitudes, and needs of gynecological cancer patients treated at a community hospital and assess contextual barriers that interfere with the delivery of survivorship care.Materials/
Methods: A mixed-methods, qualitative and quantitative needs assessment of patients with gynecological cancer treated with both external beam radiation therapy and brachytherapy between November 2023 to March 2024 at a community hospital was performed. Investigators conducted a semi-structured survey and in-depth qualitative interview via telephone. Quantitative data was analyzed using descriptive statistics and qualitative data was analyzed using content and thematic analysis. Results: The response rate of 72.7%, with a total of 24 participants. The average age was 67.6 (SD=11.6). Of the participants, 62.5% were African American (n=15) and 33.3% were White (n=8). Cancer types included endometrial cancer (62.5%, n=15), cervical cancer (29.2%, n=7), and other (8.3%, n=2). Most participants were not sexually active (75%, n=18). Vaginal toxicity after treatment included vaginal dryness (45.8%, n=11) and pain with penetration/speculum exam (41.6%, n=10).Thematic analysis demonstrated six major themes under three domains (Patient, Provider, System) including: psychosocial distress, vaginal toxicity, sexual difficulty, changes to relationship satisfaction, communication gaps with healthcare providers , and financial barriers.Knowledge and skills to manage vaginal toxicity associated with radiation therapy emerged as a key challenge. While all patients received educational material on vaginal dilation prior to treatment, 45.8% (n=11) stated they were unsure of or did not understand the contents of the educational material. Conclusion: This pilot study underscores the urgent need to address the vaginal and sexual health concerns among gynecological cancer patients. Though the majority of patients were not sexually active, a large percentage endorsed vaginal toxicity negatively affecting their quality of life. By identifying the gaps in patient knowledge and provider communication regarding vaginal toxicity and sexual dysfunction and the supportive services needed by this population, these findings will inform the development of a comprehensive, multidisciplinary sexual health program to improve survivorship care in this population.
