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Reychav I, Parush A, McHaney R, Hazan M, Moshonov R. The use of mobile technology in waiting rooms to leverage women's empowerment: A conceptual context. Health Informatics J 2016; 24:277-292. [PMID: 27738260 DOI: 10.1177/1460458216671561] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
This article focuses on a conceptual framework that can be applied to the use of mobile technology in the waiting room with the goal of empowering women recently diagnosed with abnormal Pap test results. It further describes trends which indicate a need for improved and timely information dissemination. Genecology practice outpatients report a predominant feeling of worry on receipt of abnormal medical test results, along with a clearly expressed wish for additional information. This research suggests that there is room for improvement in existing processes through use of mobile technology with carefully vetted materials which indicate a doctor is interested in the patient's well-being.
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Affiliation(s)
| | - Avi Parush
- The Israel Institute of Technology, Israel
| | | | - Maya Hazan
- The Israel Institute of Technology, Israel
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Kola-Palmer S, Walsh J, Rogers M. Patients’ perceptions of colposcopy pain. Eur J Cancer Care (Engl) 2015; 25:49-56. [DOI: 10.1111/ecc.12343] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/20/2015] [Indexed: 11/29/2022]
Affiliation(s)
- S. Kola-Palmer
- Department of Behavioural and Social Sciences; University of Huddersfield; Queensgate Huddersfield UK
| | - J.C. Walsh
- School of Psychology; National University of Ireland, Galway; Galway Ireland
| | - M. Rogers
- Department of Health Sciences; University of Huddersfield; Queensgate Huddersfield UK
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Kola-Palmer S, Walsh JC. Correlates of psychological distress immediately following colposcopy. Psychooncology 2015; 24:819-24. [DOI: 10.1002/pon.3738] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2014] [Revised: 11/17/2014] [Accepted: 11/20/2014] [Indexed: 11/11/2022]
Affiliation(s)
- Susanna Kola-Palmer
- Department of Behavioural and Social Sciences; University of Huddersfield; UK
| | - Jane C. Walsh
- School of Psychology; National University of Ireland; Galway Ireland
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Bosgraaf RP, de Jager WCC, Servaes P, Prins JB, Massuger LFAG, Bekkers RLM. Qualitative insights into the psychological stress before and during colposcopy: a focus group study. J Psychosom Obstet Gynaecol 2013; 34:150-6. [PMID: 24188786 DOI: 10.3109/0167482x.2013.849688] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE To determine the reasons for women's anxiety and psychological stress before and during colposcopy, in order to define strategies to decrease their stress. METHODS Qualitative study with 15 women participating in four focus groups between April 2011 and April 2012. All participants were diagnosed with a cervical cytological abnormality and attended a gynecologist's clinic to undergo colposcopy. The focus group interview was audio-taped and transcribed verbatim. The data were analyzed using qualitative content analysis to identify themes. RESULTS Psychological stress before colposcopy was seen as being caused by unsatisfactory explanation of abnormal cervical smears and the colposcopy procedure itself. Additionally, a fear of cancer, pain and discomfort, embarrassment, waiting time in the hospital, and a longer interval between referral and the actual colposcopy appointment increased psychological stress and anxiety. Women indicated that more detailed and practical information about the cervical smear result and the colposcopy procedure may reduce stress and anxiety. CONCLUSION In order to minimize the adverse psychological consequences of an abnormal cervical smear and colposcopy, timely, practical and detailed information needs to be provided to the women, and waiting and access times need to be as short as possible. These measures may reduce the psychological stress and anxiety, however some stress and anxiety will always remain, and may even be desirable in order to ensure proper follow-up of abnormal cervical smears.
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Sharp L, Cotton S, Thornton A, Gray N, Cruickshank M, Whynes D, Duncan I, Hammond R, Smart L, Little J. Who defaults from colposcopy? A multi-centre, population-based, prospective cohort study of predictors of non-attendance for follow-up among women with low-grade abnormal cervical cytology. Eur J Obstet Gynecol Reprod Biol 2012; 165:318-25. [DOI: 10.1016/j.ejogrb.2012.08.001] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2011] [Revised: 07/19/2012] [Accepted: 08/01/2012] [Indexed: 10/28/2022]
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Monsonego J, Cortés J, Pereira da Silva D, Jorge AF, Klein P. [Perception and psychological impact of an abnormal Pap smear. Results of a comparative European survey]. GYNECOLOGIE, OBSTETRIQUE & FERTILITE 2012; 40:213-218. [PMID: 22153154 DOI: 10.1016/j.gyobfe.2011.10.016] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/21/2011] [Accepted: 04/14/2011] [Indexed: 05/31/2023]
Abstract
OBJECTIVES The availability of information on HPV and Pap tests has increased dramatically with the introduction of national HPV vaccination programs. But data on the effectiveness of this information is limited. However, our desire is to reduce patient anxiety and promote better delivery of information. PATIENTS AND METHODS Therefore a questionnaire-based cohort study was conducted to investigate women's experience with the announcement of an abnormal Pap smear result, then the ensuing events, as well as their practitioner's management. This article focuses on the French experience, underpinned by comparative data with Spain and Portugal. RESULTS It shows that, face with stress reactions and patient's anxiety, the level of information from the medical profession is still seen as inadequate, while the Internet as an information source has its limitations and dangers. The close entourage is most relied on, which supports the need for better public information. DISCUSSION AND CONCLUSION Uniformity and standardization of information strategies is not yet on European time.
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Affiliation(s)
- J Monsonego
- Institute of the Cervix, 174, rue de Courcelles, 75017 Paris, France.
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KOLA S, WALSH J. Determinants of pre-procedural state anxiety and negative affect in first-time colposcopy patients: implications for intervention. Eur J Cancer Care (Engl) 2011; 21:469-76. [DOI: 10.1111/j.1365-2354.2011.01317.x] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Monsonego J, Cortes J, da Silva DP, Jorge AF, Klein P. Psychological impact, support and information needs for women with an abnormal Pap smear: comparative results of a questionnaire in three European countries. BMC WOMENS HEALTH 2011; 11:18. [PMID: 21612599 PMCID: PMC3123641 DOI: 10.1186/1472-6874-11-18] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/12/2010] [Accepted: 05/25/2011] [Indexed: 11/17/2022]
Abstract
Background Extensive information on cervical cancer is currently available. Its effectiveness in reducing anxiety in women receiving abnormal Pap tests is not clear. We investigated current practices of communicating abnormal Pap results to evaluate women's reactions and determine the sources of information they use subsequently. Methods A self-administered questionnaire-based study was performed in 1475 women in France, Spain and Portugal who had received an abnormal Pap smear result in the 12 months prior to completing the questionnaire. Questions covered methods of communication of the result, emotional reactions, support received (from the physician and entourage), and information sources, using pre-specified check box options and rating scales. Data were analyzed by country. Results Pap test results were mostly communicated by phone to Spanish women (76%), while physician letters were common in France (59%) and Portugal (36%). Frequent reactions were anxiety, panic and stress, which were less common in Spanish women than their French and Portuguese counterparts. After discussing with their physician, half of the participants were worried, despite rating highly the psychological support received. Over 90% of women in each country discussed their results with family or friends. Partners provided a high level of support. Overall, the abnormal diagnosis and consequences had a low to medium impact on daily, professional and family life and their relationships with their partner. Impact was higher in Spanish women than the French or Portuguese. Information on the diagnosis and its treatment was rated average, and nearly 80% of participants wanted more information, notably French women. Preferred sources were the physician and the Internet. Conclusions Women expressed a strong wish for more information about cervical cancer and other HPV-related diseases, and that their physician play a major role in its provision and in support. There was a heavy reliance on the close entourage and the Internet for information, highlighting the need for dissemination of accurate material. Differences between countries suggest information management strategies may need to be tailored to different geographical regions.
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Affiliation(s)
- Joseph Monsonego
- Institut of the Cervix, 174 rue de Courcelles, 75017 Paris, France.
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Rao D, Gela N, Daley EM, Kattezham R, Rodriguez G, Cella D. Developing a measure of health-related quality of life for women with cervical dysplasia resulting from human papillomavirus infection. Int J STD AIDS 2010; 21:697-701. [PMID: 21139148 DOI: 10.1258/ijsa.2010.010069] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Human papillomavirus (HPV) infection is the most common sexually transmitted infection in the USA, and has major physical and psychological consequences including fear, anxiety and stigma. To date, there is no measure of health-related quality of life specifically designed to assess symptoms and functioning for people with cervical dysplasia resulting from HPV infection. In the present study, we set out to develop a disease-specific measure of health-related quality of life among women with low-grade cervical dysplasia. We conducted literature reviews, open-ended interviews with patients, clinician surveys and cognitive interviews which guided item development. The result is a preliminary 36-item measure, the Functional Assessment of Chronic Illness Therapy-Cervical Dysplasia (FACIT-CD), which sets out to assess the physical and psychological health-related quality-of-life aspects of cervical dysplasia and will be validated in an upcoming study.
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Affiliation(s)
- D Rao
- Department of Global Health, University of Washington, Seattle, WA 98104, USA.
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Lee Mortensen G, Adeler AL. Qualitative study of women's anxiety and information needs after a diagnosis of cervical dysplasia. ZEITSCHRIFT FUR GESUNDHEITSWISSENSCHAFTEN = JOURNAL OF PUBLIC HEALTH 2010; 18:473-482. [PMID: 21151479 PMCID: PMC2967227 DOI: 10.1007/s10389-010-0330-1] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/17/2009] [Accepted: 03/18/2010] [Indexed: 10/28/2022]
Abstract
AIM: Each year almost 15,000 Danish women are diagnosed with cervical dysplasia, a precursor to cervical cancer. The period of medical follow-up, or 'watchful waiting', to monitor for regression or progression of the lesion before deciding if treatment by conisation is necessary can be long. The aim of this study was to examine the experiences of women with different stages of cervical dysplasia and to examine whether their knowledge of human papillomavirus (HPV) as the cause of cervical dysplasia influenced their perception of their disease. SUBJECT AND METHODS: We used focus group and individual interviews with 12 women diagnosed with different stages of cervical dysplasia-women who had and had not been conised. Interview guides were prepared on the basis of a literature review that identified important issues and questions for the participants. RESULTS: The participants considered cervical dysplasia to be a highly distressing condition and experienced monitoring as a worrying delay before regression of the lesions or treatment could be initiated. Women expressed a fear of cancer that was not proportional to the stage of their dysplasia, but was determined by their degree of knowledge about their condition. Unlike other sexually transmitted diseases, information about HPV did not result in stigmatisation as the perception of this disease was dominated by cancer. CONCLUSION: This study showed that it is extremely important to address women's fears, their need for information and to ensure better communication with medical practitioners about cervical dysplasia immediately after diagnosis, irrespective of the disease stage.
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Mortensen GL, Larsen HK. The quality of life of patients with genital warts: a qualitative study. BMC Public Health 2010; 10:113. [PMID: 20205944 PMCID: PMC2848198 DOI: 10.1186/1471-2458-10-113] [Citation(s) in RCA: 71] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2009] [Accepted: 03/07/2010] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND Genital warts, which are caused by infection with human papillomavirus (HPV), are one of the most common sexually transmitted diseases in Europe. Although genital warts are commonly perceived as a non-serious condition, treatment is often long, of varying effectiveness and the recurrence rate is high. Very few studies have been performed on the personal consequences of genital warts. The aim of this qualitative study, set in Denmark, was to examine the ways in which genital warts may affect patients' quality of life. METHODS To obtain an in-depth understanding of patients' perceptions of genital warts, we used qualitative focus-group interviews with five men and five women aged between 18 and 30 years who had genital warts. The interview guide was based on a literature review that identified important issues and questions. The data were analysed using a medical anthropological approach. RESULTS Patients' experiences were related to cultural conceptions of venereal diseases and the respective identities and sexuality of the sexes. The disease had negative psychological and social effects both for men and for women and it affected their sex and love lives, in particular. The psychological burden of the disease was increased by the uncertain timeline and the varying effectiveness of treatment. We identified a need for more patient information about the disease and its psycho-sexual aspects. CONCLUSIONS The men and women participating in this study considered their quality of life to be significantly lowered because of genital warts. The experiences described by the participants give insights that may be valuable in treatment and counselling.The quadrivalent HPV vaccine that has now been added to the childhood vaccination programme for girls in Denmark for the prevention of cervical cancer can also prevent 90% of cases of genital warts. Our results suggest that HPV vaccination could considerably reduce the largely unacknowledged psychological and social burden associated with genital warts, in men as well as women.
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Affiliation(s)
| | - Helle K Larsen
- Venereal Diseases Clinic, Bispebjerg Hospital, Bispebjerg Bakke 23, 4 Tvaervej, 1 sal, 2400 Copenhagen NV, Denmark
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Ahmed AS, Goumalatsos G, Akbar N, Lawton FG, Savvas M. Outcome analysis of 4 years' follow-up of patients referred for colposcopy with one smear showing mild dyskaryosis. Cytopathology 2007; 19:94-105. [PMID: 17937774 DOI: 10.1111/j.1365-2303.2007.00478.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To assess the 4-year outcome of patients after one smear showing mild dyskaryosis with respect to smear regression rate, prevalence of cervical intraepithelial neoplasia (CIN) and the effect of age. METHODS Retrospective analysis of patients diagnosed with initial mildly dyskaryotic smear during the year 2000 with a follow-up period of 48 months. These women had not had any previous abnormal smears. SETTINGS Cytopathology Department and Colposcopy Unit, King's College Hospital, London, UK. RESULTS We identified 524 patients of whom 375 patients with complete follow-up data are included. The age range was 19-67 years with a median of 29 years. There were 207 patients aged 35 years or less (55%). At 6 months, 258 smears were performed and 47.8% of them were negative (95% CI: 41.6-54.0%). The total number of negative follow-up smears in the first year was 198 out of a total of 397 smears performed (50%). This proportion has significantly increased between 1 and 4 years' follow-up to 67.5% (RR: 1.24; 95% CI: 1.14-1.35). Over the 4-year period, 791 smears were performed and 477 were negative (60.3%; 95% CI: 56.9-63.7%). Of the 477 negative smears there were only 61 smears (12.8%; 95% CI: 10-16%), in 54 patients (14%; 95% CI: 11-18%) that reverted back to low-grade cytological abnormality. In only one case the repeat smear showed high-grade abnormality after initial negative follow-up; however, on biopsy, histology showed CIN I. Out of the 375 patients, 70 required treatment with excisional biopsy (19%; 95% CI: 15.0-22.9%). Histology confirmed high-grade CIN in only 41 cases giving a prevalence of 11% (95% CI: 8.1-14.5%). There were no cases of microinvasive or invasive cancer detected. Age (< or =35 years versus >35 years) did not significantly affect either cytological or histological outcome. CONCLUSION Sixty per cent of follow-up smears after initial mild dyskaryosis subsequently became negative; of them 87.2% remained negative over the 4 year follow-up. Treatment was only required in 19% of patients, with 11% prevalence of high-grade CIN. Age did not affect the outcome. These results are reassuring and indicate that colposcopic referral may not be necessary after only one mildly dyskaryotic smear.
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Affiliation(s)
- A S Ahmed
- Gynaecology Dept, King's College Hospital, London, UK.
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Goldsmith MR, Bankhead CR, Austoker J. Synthesising quantitative and qualitative research in evidence-based patient information. J Epidemiol Community Health 2007; 61:262-70. [PMID: 17325406 PMCID: PMC2652927 DOI: 10.1136/jech.2006.046110] [Citation(s) in RCA: 77] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BACKGROUND Systematic reviews have, in the past, focused on quantitative studies and clinical effectiveness, while excluding qualitative evidence. Qualitative research can inform evidence-based practice independently of other research methodologies but methods for the synthesis of such data are currently evolving. Synthesising quantitative and qualitative research in a single review is an important methodological challenge. AIMS This paper describes the review methods developed and the difficulties encountered during the process of updating a systematic review of evidence to inform guidelines for the content of patient information related to cervical screening. METHODS Systematic searches of 12 electronic databases (January 1996 to July 2004) were conducted. Studies that evaluated the content of information provided to women about cervical screening or that addressed women's information needs were assessed for inclusion. A data extraction form and quality assessment criteria were developed from published resources. A non-quantitative synthesis was conducted and a tabular evidence profile for each important outcome (eg "explain what the test involves") was prepared. The overall quality of evidence for each outcome was then assessed using an approach published by the GRADE working group, which was adapted to suit the review questions and modified to include qualitative research evidence. Quantitative and qualitative studies were considered separately for every outcome. RESULTS 32 papers were included in the systematic review following data extraction and assessment of methodological quality. The review questions were best answered by evidence from a range of data sources. The inclusion of qualitative research, which was often highly relevant and specific to many components of the screening information materials, enabled the production of a set of recommendations that will directly affect policy within the NHS Cervical Screening Programme. CONCLUSIONS A practical example is provided of how quantitative and qualitative data sources might successfully be brought together and considered in one review.
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Affiliation(s)
- Megan R Goldsmith
- Cancer Research UK Primary Care Education Research Group, Department of Primary Health Care, University of Oxford, Old Road Campus, Headington, Oxford OX3 7LF, UK.
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Fleurence RL, Dixon JM, Milanova TF, Beusterien KM. Review of the economic and quality-of-life burden of cervical human papillomavirus disease. Am J Obstet Gynecol 2007; 196:206-12. [PMID: 17346523 DOI: 10.1016/j.ajog.2007.01.028] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2006] [Revised: 05/08/2006] [Accepted: 06/17/2006] [Indexed: 10/23/2022]
Abstract
OBJECTIVE The purpose of this study was to conduct a systematic literature review on the economic burden and health-related quality-of-life impact of cervical human papillomavirus disease. STUDY DESIGN A systematic review of cost-of-illness studies and health-related quality-of-life studies was conducted. PubMed, Embase, and PsycINFO databases were searched with the use of predefined terms. RESULTS Nine economic and 24 quality-of-life studies were identified. The annual health care costs of human papillomavirus-related conditions in the United States range from 2.25-4.6 billion dollars (2005 US dollars). The burden of human papillomavirus is second only to human immunodeficiency virus among sexually transmitted diseases. Health-related quality-of-life areas that are impacted substantially by human papillomavirus include emotional, social, and sexual functioning. CONCLUSION The economic and quality-of-life burden of cervical human papillomavirus disease is significant and highlights the need for treatment and prevention options for this condition.
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Affiliation(s)
- Rachael L Fleurence
- Health Care Analytics Group, United BioSource Corporation, Bethesda, MD, USA.
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Pruitt SL, Parker PA, Peterson SK, Le T, Follen M, Basen-Engquist K. Knowledge of cervical dysplasia and human papillomavirus among women seen in a colposcopy clinic. Gynecol Oncol 2005; 99:S236-44. [PMID: 16150483 DOI: 10.1016/j.ygyno.2005.07.095] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE This study was undertaken to evaluate knowledge of cervical dysplasia and human papillomavirus (HPV) among women seen in a colposcopy clinic. STUDY DESIGN Demographics, knowledge, and psychological distress were assessed in structured interviews with 175 women before, during, and after colposcopy. RESULTS Respondents had low knowledge scores before and after colposcopy; however, their overall knowledge improved slightly (P = 0.013) following the exam. When responses were examined by question, respondents demonstrated a significant increase of correct answers to only one question: Does dysplasia, or precancerous cells on the cervix, always go away without treatment? Pre-exam knowledge was positively associated with educational level and was lower among Hispanics and patients recruited at the clinic. Post-exam knowledge was positively associated with pre-exam knowledge and educational level. CONCLUSION Routine clinical education during colposcopy can improve patients' understanding of cervical cancer; however, the low level of knowledge that persisted after colposcopy is a cause for concern.
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Affiliation(s)
- Sandi L Pruitt
- The Center for Health Promotion and Prevention Research at The University of Texas, Houston School of Public Health, Houston, TX 77030, USA
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