Developing a Cognitive Behavioral Intervention for Gynecologic Cancer Survivors Undergoing Pelvic Exams

Abstract

Regular pelvic exams after completing cancer treatment are critical for detecting endometrial and cervical cancer recurrence. Patients report high levels of distress and pain during exams. We conducted in-depth individual interviews with patients (N = 13) and providers (N = 10) to explore patients’ pelvic exam experiences and intervention preferences. Findings suggested that most patients experience exam-related distress and pain, and a telemedicine cognitive behavioral intervention targeting anxiety and pain would be acceptable and feasible for most patients. Findings informed PEACE (Pelvic Examination and Anxiety Coping skills for Empowerment) intervention development. Formative work is described, including a conceptual model, qualitative data collection and analysis, and session content.

Keywords:

• Intervention development
• cognitive behavioral
• pelvic exam
• reproductive health
• anxiety

Acknowledgements

We acknowledge Michelle Huang, Shernice Martin, and Sophie Smith for their contributions to coding the provider interview transcripts. We acknowledge Drs. Eve Puffer, Francis Keefe, and Timothy Strauman for providing feedback on the study design. Thank you to Smrithi Divakarn and Michael Willis for their contributions to project management.

Data Availability Statement

The data that support the findings of this study are available on request from the corresponding author. The data are not publicly available due to restrictions (e.g., containing information that could compromise the privacy of research participants).

Disclosure Statement

The authors report that there are no competing interests to declare.

Additional information

Funding

This project was funded by a Duke University Bass Connections award and a Charles Lafitte Foundation Graduate Grant Award for Psychological Research related to Identity, Diversity, Inclusion, Equity, and Thriving. The funding sources were not involved in the study design, collection, analysis or interpretation of data, or the writing of the manuscript.