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Item Vaginal dilation after pelvic radiotherapy(Montana State University - Bozeman, College of Nursing, 2021) Besel, Alecia Marie; Chairperson, Graduate Committee: Amanda LucasThis quality improvement project addressed the inequity between assessment of female versus male sexual health in patients undergoing pelvic radiotherapy. Women undergoing pelvic radiotherapy suffer from the long-term side effect of vaginal stenosis which has been cited to decrease sexual satisfaction, result in pain with penetration, and decrease overall quality of life. Vaginal dilation has shown to decrease the degree of vaginal stenosis, and increase overall sexual satisfaction in this population. While national guidelines exist for the assessment of sexual health in men undergoing pelvic radiotherapy, no such guidelines exist for women. The setting of interest was a radiation oncology clinic in Montana, and the following procedures took place: phone calls to women who underwent pelvic radiotherapy between January 1, 2020 and September 9, 2020 to assess sexual health utilizing a validated screening form, the FSFI-6. At the initial phone call, adherence to twice per week vaginal dilation was asked, the woman was re-educated on vaginal dilation to prevent stenosis, and offered a vibrating dilator utilized at other radiation sites with increased adherence rates. Eight weeks later a follow-up call was placed, the FSFI-6 was reviewed and adherence to twice per week vaginal dilation was asked. Initial FSFI-6 and adherence scores were then compared to follow-up scores. The project sample consisted of 55 women meeting inclusion criteria, 13 women were lost to death or recurrence (23%); thus, phone calls took place to 42 women. Seven of these 42 (17%) women answered their phones and provided consent, five consented to the mailing of a vibrating dilator (one of these women was lost to recurrence). A mere two of the seven women (29%) were adherent to twice per week vaginal dilation at initial phone call. At eight-week follow-up phone call to those consenting to vibrating dilator, three of four women (75%) were adherent to at least twice per week dilation, and pain with penetration score on the FSFI-6 decreased by an average of three points, illustrating that issuing a vibrating dilator at completion of pelvic radiotherapy has the potential to increase adherence and decrease pain when a validated screening tool is utilized.Item Considerations for rural residents undergoing radiation therapy for cancer treatment(Montana State University - Bozeman, College of Nursing, 2012) Barber, Alana Carlisle; Chairperson, Graduate Committee: Charlene WintersCancer is a disease that will affect roughly one in three Americans in their lifetime. Of those who choose to undergo cancer treatment, approximately 60% will be treated with radiation therapy (XRT). In order to contain health care delivery costs, specialty medical centers that offer XRT are often centralized, making access to necessary treatment difficult for rural residents. Researchers have identified accessibility to services, required travel, being away from family and friends, locating accommodations during treatment, financial burdens, emotional stress, quality of life, and treatment options as burdens to this population. Research has been conducted in other areas of the world to identify commonalities amongst rural residents undergoing XRT but no such studies have been conducted within the United States. The purpose of this study was to identify considerations for rural residents who have been diagnosed with cancer and are undergoing external beam radiation therapy for treatment. A convenience sample of rural residents who were currently or had in the last year received external beam XRT for cancer treatment at a regional cancer treatment center in south central Montana were asked to participate in this study. Surveys were mailed anonymously to 49 persons meeting study criteria. Twenty one surveys containing demographic, multiple choice, and Likert scale questions focusing on travel, lifestyle changes and accommodation during XRT, the financial implications and psychosocial significance of XRT, and treatment decisions were completed and returned. Responses to the survey were entered into a database where descriptive statistics were used to summarize the data. The results suggest that travel and distance to services continues to be a challenge for most rural residents, that rural residents often alter lifestyles and believe costs are greater for them during XRT. Data also showed that participants did not base treatment decisions on cost or distance nor did they feel they were overly stressed or anxious during XRT. Implications for nursing include identification of variables associated with a rural lifestyle, increasing education for rural persons, and being aware of available resources to assist persons undergoing XRT for cancer treatment.