The effect of written information and counseling by an APN on resilience in women with vulvar neoplasia during six months after surgical treatment and the influence of social support, recurrence, and age: A secondary analysis of a multicenter randomized controlled trial, WOMAN-PRO-II

Abstract

Background Woman with vulvar neoplasia complain after surgical treatment often about physical and psychological distress. Lack of information and support can influence resilience. Whether an information-related intervention through an advanced practice nurse support resilience and which other factors have an influence on resilience in women with vulvar neoplasia has never been investigated.Methods The aim of this study were (a) to analyse whether counseling based on the WOMAN-PRO-II program compared to written information creates a significant improvement in resilience scores of women with vulvar neoplasia and (b) to identify potential predictors for resilience. A randomized controlled trial was carried out in women with vulvar neoplasia (N = 49) six months after a surgical treatment in four Swiss hospitals and one Austrian hospital. Analyses of resilience and its predictors were performed using a linear mixed model.Results The resilience score did not differ significantly between the two intervention three and six months after randomisation (p=0.759). As significant predictors of resilience, age (b=.04, p=0.001), social support (b=.28, p=0.009), counseling time (b=.03, p=0.018), and local recurrence (b=-.56, p=0.009) could be identified in linear mixed models analyses.Conclusion To promote resilience in women with vulvar neoplasia, the WOMAN-PRO II Program should be further developed. Particularly, social support should be extended, e.g. in form of more frequent consultations. The interrelation between recurrence and resilience needs to be further investigated to provide specific counseling for women with recurrence.