3744 - Knowledge and Opinions on Trauma-Informed Care in Radiation Oncologists and Trainees Involved in Gynecologic Brachytherapy in Canada
Presenter(s)
T. Derashodian1, T. Newaz2, F. Huang2, J. F. Cuartero3, J. N. Maina4, and E. M. Wiebe5; 1Cross Cancer Instutite, University of Alberta, Edmonton, AB, Canada, 2University of Alberta, Edmonton, AB, Canada, 3Central Alberta Cancer Centre, Edmonton, Canada, 4Cross Cancer Institute, University of Alberta, Edmonton, Canada, 5Department of Oncology, Cross Cancer Institute and University of Alberta, Edmonton, AB, Canada
Purpose/Objective(s):
Invasive cancer treatments such as gynecologic brachytherapy contribute to trauma-related distress faced by patients, particularly those from vulnerable populations. This study aimed to review the knowledge, perspectives, and current practices of Canadian radiation oncologists (ROs) and radiation oncology trainees regarding trauma-informed care (TIC) in gynecologic cancer treatment, and to identify perceived barriers and suggestions for the implementation of TIC-practices into routine care.Materials/Methods:
An anonymous 23-question survey was distributed to Canadian ROs treating gynecologic cancers, as well as trainees, through direct outreach to program directors and radiation oncologists. The survey assessed prior formal training in TIC, familiarity with and confidence applying TIC principles, current brachytherapy-related practices, perceived barriers and proposed suggestions for integrating TIC into clinical practice.Results:
A total of 22 responses were obtained, of which 68% were staff ROs and 32% were trainees. Most participants (62%) reported no formal training in TIC and indicated that they were either unfamiliar with or somewhat uncomfortable with the concept. Only 5% felt confident in recognizing trauma-related distress in their patients, and 41% were comfortable asking about prior trauma. Despite this, 82% agreed that TIC is relevant to gynecologic brachytherapy practice. When patients disclosed prior trauma, 55% of respondents reported that they often or always adapted their brachytherapy approach accordingly.
While 91% of respondents were comfortable referring patients to psychosocial services and 86% believed that radiation oncologists should address brachytherapy-related trauma, only 46% felt comfortable doing so themselves. Additionally, 62% identified current anesthesia protocols as insufficient for providing adequate emotional and physical support during brachytherapy.
The primary barriers to implementing TIC included a lack of training, time constraints, concerns about re-traumatization when inquiring about trauma history, and broader institutional or systemic challenges. The most commonly reported strategy to reduce patient distress was providing multiple preparatory information sessions prior to brachytherapy.
Conclusion:
This national survey demonstrates that TIC represents an important, yet heavily under-explored aspect of gynecologic brachytherapy practice in Canada. While most respondents recognize the potential for brachytherapy to re-traumatize vulnerable patients and believe that addressing trauma falls within their professional responsibilities, access to formal training, availability of TIC resources, and overall confidence in managing trauma-related distress remain limited. These findings provide a foundation for developing future educational initiatives, clinical guidelines, and implementation strategies for trauma-informed practices within gynecologic cancer care.