The Bare Essentials: Exploring Modesty Concerns to Enhance Radiation Therapy Practice and Patient Care.

Area of Science:

• Oncology
• Patient Experience
• Healthcare Quality

Background:

• Modesty is a key factor influencing patient experience and health outcomes in healthcare.
• Radiotherapy frequently necessitates patient undress, raising concerns about modesty and unease.
• Limited research exists on modesty and patient unease during radiotherapy across diverse populations and treatment sites.

Purpose of the Study:

• To examine current practices and patient perceptions of modesty and associated unease during thoracic and pelvic radiotherapy.
• To identify factors contributing to patient unease in the context of radiotherapy.

Main Methods:

• A 38-question survey was administered to patients undergoing thoracic or pelvic radiotherapy across four centers.
• Item response theory (IRT) was used to analyze the psychometric properties of unease.
• A structural equation model identified factors associated with unease, complemented by content analysis of free-text responses.

Main Results:

• 312 patients responded; 76% female, 69% thoracic radiotherapy, 43% foreign-born, 65% non-English speakers.
• 10% were never informed about undressing; 26% received written information.
• Unease in the waiting room, staff gender, and baseline modesty explained 67.5% of variance in treatment room unease (p < 0.001).
• Staff kindness, professionalism, treatment garment functionality, and waiting space design positively impacted patient ease.

Conclusions:

• Patient modesty significantly influences unease in radiotherapy waiting and treatment rooms, particularly in multicultural populations and across different anatomical sites.
• Simple questionnaires effectively identify patients with higher than average unease.
• Recommendations include personalized treatment garments, improved waiting spaces, and enhanced patient education materials detailing undressing requirements.