eISSN: 2081-2841
ISSN: 1689-832X
Journal of Contemporary Brachytherapy
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vol. 11
Original paper

HAPPY – Humanity Assurance Protocol in interventional radiotheraPY (brachytherapy) – an AIRO Interventional Radiotherapy Study Group project

Valentina Lancellotta
Vitaliana De Sanctis
Patrizia Cornacchione
Fernando Barbera
Vincenzo Fusco
Cristiana Vidali
Sara Scalise
Giulia Panza
Angela Tenore
Giuseppe Ferdinando Colloca
Renzo Corvò
Maria Antonietta Gambacorta
Stefano Maria Magrini
Luca Tagliaferri

J Contemp Brachytherapy 2019; 11, 6: 510–515
Online publish date: 2019/12/25
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Interventional procedures may produce emotional distress, particularly in interventional radiotherapy (IRT, brachytherapy – BT). This work would like to propose a series of recommendations/interventions to guarantee a human approach in order to favor the psychological well-being of the patient during interventional radiotherapy.

Material and methods
Thirty patients affected by gynecological cancer and treated with endovaginal high-dose-rate IRT (HDR-IRT) were selected from January to March 2019. A specific Multiprofessional Task Group (MTG) was defined in order to analyze the needs of patients. Each component of the task group spoke with the patients to examine their needs and to investigate their fears and perception. The results of the MTG were subjected to evaluation by an Expert Team (ET) of 4 physicians from 4 different institutions for a final evaluation. Both teams discussed the patient’s needs to generate a list of necessary interventions to fulfill every single need in order to obtain their inner well-being. Another team (Master Team – MT) performed an independent check.

All patients suggest that the main issue is the “lack of information and fear of the unknown”. The fear of feeling pain was a significant source of concern, sadness, and vulnerability for the majority of the patients (76.6%). All patients do not appreciate the use of the word “bunker” to describe the treatment place. In 33.3% of patients the word “brachytherapy” (often unknown) determines insecurity while the term “interventional radiotherapy” reassures. Ninety percent of patients preferred to perform the external genital depilation at home and 80% of them would like the bladder catheter to be placed immediately before the procedure. MTG and ET defined nine “HAPPY recommendations”. The MT approved the protocol without changes.

The aim of the present paper was to produce a protocol consisting in intervention that could improve the internal serendipity and emotional state of patients who underwent HDR-IRT.


emotional distress, human approach, endovaginal high-dose-rate IRT, patient perspective

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