Self-management experiences of vaginal toxicities among patients undergoing radical radiotherapy for cervical cancer: a qualitative study

Cervical cancer is a common gynecologic malignancy, and radiotherapy often induces vaginal toxicities such as vaginitis and stenosis, affecting patients’ physical and psychological well-being. Current research focuses mainly on clinical parameters, with limited attention to patients’ self-management experiences. This study explores their self-management practices to inform targeted nursing strategies. To explore the self-management experiences and existing challenges related to vaginal toxicities among patients undergoing radical radiotherapy for cervical cancer, with the aim of informing the development of tailored management strategies for this population. A descriptive qualitative design was adopted. Using purposive sampling, 18 patients who had received radical radiotherapy for cervical cancer and returned for follow-up at a tertiary cancer hospital in Shanghai from December 2024 to January 2025 were recruited. Semi-structured individual interviews were conducted, and the data were analyzed using content analysis to extract themes. Three themes and ten subthemes were identified, including multifaceted challenges in vaginal self-management such as knowledge-related challenges in vaginal self-management, intimacy-related challenges in vaginal self-management, implementation-related challenges in vaginal self-management, environment- and caregiving-related challenges in vaginal self-management; individualized adjustment strategies to cope with self-management dilemmas, including personalized adjustments to vaginal cleansing, self-decision in vaginal dilation management, and self-adjustment in rebuilding intimacy; and internal and external support systems that empower self-management, characterized by the core role of family support, the safeguarding effect of financial support, and emotional connectedness provided by peer support. Patients undergoing radical radiotherapy for cervical cancer face multidimensional challenges—cognitive, psychological, and social—in vaginal rehabilitation management. Cognitive biases and poor adherence to vaginal self-management are closely associated with the lack of structured health education. Misconceptions about the disease contribute to sexual psychological distress, while existing nursing care lacks targeted psychological support. Furthermore, insufficient social support, particularly financial burden and limited caregiving capacity, further undermines treatment confidence. Therefore, healthcare providers should establish structured health education systems, strengthen psychological assessment and support, and build comprehensive support networks—including financial, caregiving, and peer support—to enhance patients’ self-management abilities and overall quality of life.