O'Connor M, O'Brien K, Waller J, Gallagher P, D'Arcy T, Flannelly G, Martin CM, McRae J, Prendiville W, Ruttle C, White C, Pilkington L, O'Leary JJ, Sharp L. Physical after-effects of colposcopy and related procedures, and their inter-relationship with psychological distress: a longitudinal survey.
BJOG 2017;
124:1402-1410. [PMID:
28374937 DOI:
10.1111/1471-0528.14671]
[Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/29/2017] [Indexed: 11/29/2022]
Abstract
OBJECTIVE
To estimate prevalence of post-colposcopy physical after-effects and investigate associations between these and subsequent psychological distress.
DESIGN
Longitudinal survey.
SETTING
Two hospital-based colposcopy clinics.
POPULATION
Women with abnormal cytology who underwent colposcopy (±related procedures).
METHODS
Questionnaires were mailed to women 4, 8 and 12 months post-colposcopy. Details of physical after-effects (pain, bleeding and discharge) experienced post-colposcopy were collected at 4 months. Colposcopy-specific distress was measured using the Process Outcome-Specific Measure at all time-points. Linear mixed-effects regression was used to identify associations between physical after-effects and distress over 12 months, adjusting for socio-demographic and clinical variables.
MAIN OUTCOME MEASURES
Prevalence of post-colposcopy physical after-effects. Associations between the presence of any physical after-effects, awareness of after-effects, and number of after-effects and distress.
RESULTS
Five-hundred and eighty-four women were recruited (response rate = 73, 59 and 52% at 4, 8 and 12 months, respectively). Eighty-two percent of women reported one or more physical after-effect(s). Multiple physical after-effects were common (two after-effects = 25%; three after-effects = 25%). Psychological distress scores declined significantly over time. In adjusted analyses, women who experienced all three physical after-effects had on average a 4.58 (95% CI: 1.10-8.05) higher distress scored than those who experienced no after-effects. Women who were unaware of the possibility of experiencing after-effects scored significantly higher for distress during follow-up.
CONCLUSIONS
The prevalence of physical after-effects of colposcopy and related procedures is high. The novel findings of inter-relationships between awareness of the possibility of after-effects and experiencing multiple after-effects, and post-colposcopy distress may be relevant to the development of interventions to alleviate post-colposcopy distress.
TWEETABLE ABSTRACT
Experiencing multiple physical after-effects of colposcopy is associated with psychological distress.
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