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Objective: Women are at risk for prolonged psychological distress following attendance at colposcopy for cervical abnormalities, with potentially negative consequences. Little is presently known about the correlates of post-colposcopy distress. The present study aimed to extend knowledge of correlates of post-colposcopy anxiety and negative affect, and identify women at risk for elevated psychological distress., Methods: Psychosocial data (demographic variables, anxiety, negative affect, and pain) were collected using validated questionnaires from 164 women attending colposcopy for the first time immediately prior to their colposcopy examination and immediately following it. Two separate logistic regressions were conducted to identify key factors that may be useful targets for preventing post-colposcopy distress and to determine which factors exert the biggest influence and therefore may be targeted in future intervention studies., Results: Pre-colposcopy state anxiety, pain experienced during colposcopy, and trait anxiety emerged as independent predictors of post-colposcopy state anxiety, accounting for 36% of the variance. Pre-colposcopy negative affect, pain experienced during colposcopy, trait anxiety, and referral smear grade were independent predictors of post-colposcopy negative affect, explaining 32% of variance., Conclusions: Whether or not women underwent punch biopsy or treatment did not influence post-colposcopy distress levels; however, pain experienced during colposcopy remains a risk for continued psychological distress. Trait anxiety may be an important variable to consider in future studies, as women high in trait anxiety may represent a particularly vulnerable subgroup of women referred for colposcopy, at greater risk for negative psychosocial consequences associated with colposcopy, and to be targeted for interventions to reduce psychological distress., (Copyright © 2015 John Wiley & Sons, Ltd.)

This study assessed the combined effects of coping style and intra-procedural information on indices of distress (physiological measures, observed distress, self-report measures of anxiety and affect) among a group of patients undergoing colposcopy. High and low monitors were exposed to one of three interventions: high information (live video feed of colposcopy); low information (complete audiovisual distraction); and control. Results revealed a 2 (monitoring style) × 3 (information level) × 2 (time) interaction for systolic blood pressure (SBP), F(2, 111) = 3.55, p = .032. Among low monitors, patients in the low-information group exhibited significant SBP reductions during colposcopy, while those in the high-information group exhibited SBP increases. Among high monitors, patients in the high-information and control groups exhibited SBP reductions. Further, significant differences in observed signs of distress were found between groups with high monitors in the low-information group faring best overall, F(2, 111) = 4.41, p = .014. These findings indicate that tailoring information to suit individual coping style may maximize the apparent efficacy of interventions aimed at reducing stress during medical examinations.

Objective: Patient adherence with treatment recommendations is an essential factor for the effectiveness of cervical cancer screening programs. Psychological factors may play a role in patient adherence to cervical cancer screening. The present study aimed to extend knowledge of women's adherence to follow-up colposcopy, by examining possible predictive biopsychosocial variables measured at colposcopy and objective attendance rates from patients' medical files., Methods: Baseline data on psychosocial factors (e.g. demographic variables, state anxiety, and pain) were collected from 141 women prior to undergoing colposcopy for the first time (M age = 29.63, SD = 8.39). Experiences of colposcopy and adherence to follow-up (within two years) were assessed subsequently., Results: There were no associations between adherence and demographic variables. Women with severe dysplasia were more likely to adhere to follow-up colposcopy than women with other histology grades. Women who did not attend for follow-up reported significantly greater state anxiety and pain unpleasantness following colposcopy than women who did attend. A multivariate logistic regression analysis revealed that the psychological experiences of colposcopy did not predict adherence status. However, dysplasia severity made a significant contribution to the model. The odds of adhering to colposcopy for patients with severe dysplasia were 3.57 times higher than for patients with normal histology, and 4.35 times higher than for patients with moderate dysplasia (p = 0.005)., Conclusions: Colposcopy-related experiences do not appear to be strong predictors of adherence, but women with dysplasia grades other than 'severe' should be targeted for follow-up recommendations and advice., (Copyright © 2010 John Wiley & Sons, Ltd.)

Objectives: To compare intra-procedural distress between colposcopy and see-and-treat LLETZ patients, and to assess patients' perceptions of possible non-pharmacological interventions to reduce distress., Study Design: Retrospective postal questionnaire survey. A total of 151 women aged 20-60 with high-grade cervical intraepithelial neoplasia (CIN), of which 86 had undergone colposcopy, and 65 had undergone LLETZ treatment, recruited from the Department of Obstetrics and Gynaecology, University Hospital Galway, Ireland. Colposcopy- and LLETZ-related distress and pain, and patient perceptions of helpfulness of suggested interventions., Results: Respondents reported high levels of colposcopy-related anxiety and worry. Those who reported fear of cancer, and concerns about fertility, colposcopy procedure itself and embarrassment had higher anxiety levels than those not reporting these concerns. LLETZ treatment was perceived as distressing, and as more painful than colposcopy. Women's perceptions of certain interventions were associated, and distinct coping profiles were identified., Conclusions: Colposcopy elicits high levels of anxiety, and see-and-treat LLETZ patients experience greater negative psychological consequences than colposcopy patients. Finding suitable interventions to reduce anxiety levels is recommended.

A video colposcopy allows the real-time images viewed by the doctor performing the examination to be viewed by patients on a television monitor during the consultation. Eighty-one women (requiring either laser treatment or a normal recheck) were randomly assigned to either the video intervention group or the control group. A significant decrease in state anxiety was observed from one visit to the next in all patients (P = 0.000). This decrease in anxiety was significantly greater in the laser patients in the video colposcopy condition than patients in the control group for both groups of patients. Patients in the experimental groups also reported less pain than patients in the control conditions (P < 0.05). This benefit associated with video colposcopy was not observed on the second (treatment) visit. In conclusion, video colposcopy is a useful and time-efficient method that reduces patient anxiety and pain during examination visits, but not necessarily during visits where laser treatment is required.