Grant: Doctoral Award - Frederick Banting and Charles Best Canada Graduate Scholarships

For patients with colorectal cancer (CC), the third most diagnosed cancer in Canada (Canadian Cancer Society, 2015), sexual difficulties (e.g., erectile dysfunction, pain, low sex drive) are a common and distressing side-effect of treatment. CC patients who receive a colostomy, a surgically created opening in the body that allows for the excretion of waste, experience even greater sexual difficulties. Unfortunately, these sensitive issues are often not discussed because neither patient nor healthcare provider feels prepared to address or comfortable raising such issues. Further, many CC patients with colostomies do not feel comfortable traveling far from home for supportive resources due to a lack of control around waste elimination. In response to this gap in care, this study will evaluate a brief online intervention for the sexual/intimate adjustment of couples affected by CC. The intervention is based on a model of sex therapy that has been successfully used with cancer patients and includes an exercise where couples set aside a time to be physically intimate, without the expectation of intercourse. This helps couples feel emotionally closer and acts as a 'stepping stone' to reinitiating sex. The intervention will also include psychoeducation about sexual adjustment in CC. Couples, where one partner has been treated for CC and is living with a colostomy, will be randomly assigned to either: (1) receive the full intervention or (2) receive only the psychoeducational component of the intervention. Both groups will complete questionnaires about their sexual relationship before starting the intervention, upon completing the intervention, and 1-month and 3-months following. It is expected that the couples who receive the full intervention will report improved sexual adjustment when compare to couples who receive only the psychoeducation. This intervention addresses the intimacy issues that are typically neglected in CC rehabilitation, thus improving quality of care.