Oral Presentation 2025 Joint Meeting of the COSA ASM and IPOS Congress

The Bare Truth: Uncovering Modesty Concerns to Optimise Radiotherapy Patient Care (126020)

Kylie L Dundas 1 2 3 , Felicity Hudson 1 2 3 , Rachael Beldham-Collins 4 5 , Joseph Descallar 2 3 , Kathy Andrew 1 , Triet Dang 4 5 , Elizabeth Coles 1 3 6 7 , Liam O'Brien 4 5 , Michelle Roach 1 , Yolanda Surjan 6 7 , Shalini K Vinod 1 2 3
  1. Liverpool and Macarthur Cancer Therapy Centres, Liverpool and Campbelltown Hospitals, SWSLHD, Liverpool, New South Wales, Australia
  2. South Western Sydney Clinical School, Faculty of Medicine, University of New South Wales, Sydney, New South Wales, Australia
  3. Ingham Institute for Applied Medical Research, Liverpool, NSW, Australia
  4. Crown Princess Mary Cancer Centre, Westmead Hospital, Westmead, New South Wales, Australia
  5. Blacktown Cancer and Haematology Centre, Blacktown Hospital, , Blacktown, New South Wales, Australia
  6. College of Health, Medicine and Wellbeing, School of Health Sciences, The University of Newcastle, Callaghan, New South Wales, Australia
  7. Global Centre for Research and Training in Radiation Oncology, The University of Newcastle, Callaghan, New South Wales, Australia

Objectives

Modesty affects patient experience of healthcare and health outcomes. Patients undergoing radiotherapy are often required to undress. Little is known about patient unease and modesty during radiotherapy, particularly across multi-cultural populations. This study examined current practice and patient perceptions regarding modesty and associated unease in radiotherapy waiting and treatment rooms.

 

Sample and setting

A 38-question survey (English and 4 other languages) was distributed to patients undergoing thoracic or pelvic radiotherapy across four centres in Western and South-Western Sydney. A minimum sample size of 200 was sought to conduct item response theory (IRT) analysis. 

 

Procedures

IRT was used to analyse the psychometric properties of unease. A structural equation model identified factors associated with unease. Summative content analysis of free text responses was conducted.

 

Results

312 participants responded, 76% female, 69% received thoracic radiotherapy, 43% born overseas, 65% spoke a language other than English. 10% indicated they were never informed about the need to undress, 26% received information regarding the need to undress in written format. This survey was reliable for patients with average or above levels of waiting room and treatment unease (IRT theta values > -0.3). 67.5% of reported unease in the treatment room was related to unease in the waiting room, gender of treating staff and baseline levels of modesty unease (p < 0.001). Functionality of treatment garments and waiting spaces were connected to patient ease (f=41% and 46% respectively).

 

Conclusion and clinical implications

Patient modesty can affect unease during radiotherapy. This is the first study to demonstrate this in both a multicultural population, and across different anatomical treatment sites. Unease during treatment is strongly associated with waiting room unease. Personalised treatment garments and waiting space options are recommended. Patient education materials can be improved by clearly outlining the requirement of patients to undress whilst treatment is delivered.