DOI QR코드

DOI QR Code

Effect of Pre-Procedural State-Trait Anxiety on Pain Perception and Discomfort in Women Undergoing Colposcopy for Cervical Cytological Abnormalities

  • Baser, Eralp (Department of Gynecologic Oncology, Zekai Tahir Burak Women's Health Education and Research Hospital) ;
  • Togrul, Cihan (Department of Gynecologic Oncology, Zekai Tahir Burak Women's Health Education and Research Hospital) ;
  • Ozgu, Emre (Department of Gynecologic Oncology, Zekai Tahir Burak Women's Health Education and Research Hospital) ;
  • Esercan, Alev (Department of Gynecologic Oncology, Zekai Tahir Burak Women's Health Education and Research Hospital) ;
  • Caglar, Mete (Department of Gynecologic Oncology, Zekai Tahir Burak Women's Health Education and Research Hospital) ;
  • Gungor, Tayfun (Department of Gynecologic Oncology, Zekai Tahir Burak Women's Health Education and Research Hospital)
  • 발행 : 2013.07.30

초록

Background: Colposcopy is the gold standard procedure for evaluating cervical cytological abnormalities. Although it is essentially a minimally invasive intervention, referral for colposcopy may cause significant distress on patients. In this study, we aimed to determine if pre-procedural anxiety levels have a significant association with procedure related pain and discomfort in women undergoing colposcopy for evaluation of abnormal cervical cytology. We also assessed the impact of various clinical factors on anxiety, pain and discomfort in these patients. Materials and Methods: This prospective study was performed at the gynecologic oncology department of Zekai Tahir Burak Women's Health Education and Research Hospital in Ankara, Turkey between January and June 2013. After taking informed consent, State-Trait Anxiety Inventory (STAI) form and a 14-item questionnaire were filled for women who were admitted to our outpatient colposcopy unit for evaluation of abnormal cervical cytology. STAI scores were calculated for each participant. Immediately after the procedure, visual analog scale (VAS) scores for procedure-related pain and discomfort were obtained. Associations between STAI and VAS scores were investigated using correlation analyses. The effect of various contributing factors on anxiety, pain and discomfort were evaluated with linear regression analysis. The p values less than 0.05 were considered statistically significant. Results: A total of 222 women met the inclusion criteria within the study period. Mean patient age was $38.5{\pm}9.6$. Median state and trait anxiety scores were 47 and 46, respectively. Median VAS scores for pain and discomfort were 4 for both variables. State anxiety had a significant correlation with procedure related discomfort (p=0.02). Colposcopy related pain VAS scores were significantly affected by state anxiety level, marital status and prior gynecological examination (p<0.05). Colposcopy related discomfort VAS scores were significantly affected by state anxiety level, marital status, prior gynecological examination and educational status. Conclusions: Additional measures should be implemented in women that carry higher risk for experiencing pain and discomfort. Social, cultural and lifestyle issues may also affect women's experiences during colposcopy, therefore further studies are needed to define specific determining factors in various populations.

키워드

참고문헌

  1. Bolukbas N, Erbil N, Kahraman AN (2010). Determination of the anxiety level of women who present for mammography. Asian Pac J Cancer Prev, 11, 495-8.
  2. Chan YM, Lee PW, Ng TY, Ngan HY (2004). Could precolposcopy information and counseling reduce women's anxiety and improve knowledge and compliance to follow-up? Gynecol Oncol, 95, 341-6. https://doi.org/10.1016/j.ygyno.2004.07.002
  3. Chan YM, Lee PW, Ng TY, et al (2003). The use of music to reduce anxiety for patients undergoing colposcopy: a randomized trial. Gynecol Oncol, 91, 213-7. https://doi.org/10.1016/S0090-8258(03)00412-8
  4. Danhauer SC, Marler B, Rutherford CA, et al (2007). Music or guided imagery for women undergoing colposcopy: a randomized controlled study of effects on anxiety, perceived pain, and patient satisfaction. J Low Genit Tract Dis, 11, 39-45. https://doi.org/10.1097/01.lgt.0000230206.50495.4c
  5. De Bie RP, Massuger LF, Lenselink CH, et al (2011). The role of individually targeted information to reduce anxiety before colposcopy: a randomised controlled trial. BJOG, 118, 945-50. https://doi.org/10.1111/j.1471-0528.2011.02996.x
  6. Freeman-Wang T, Walker P, Linehan J, et al (2001). Anxiety levels in women attending colposcopy clinics for treatment for cervical intraepithelial neoplasia: a randomised trial of written and video information. BJOG, 108, 482-4.
  7. Galaal K, Bryant A, Deane KH, et al (2011). Interventions for reducing anxiety in women undergoing colposcopy. Cochrane Database Syst Rev, CD006013.
  8. Heinonen A, Tapper AM, Leminen A, et al (2013). Health-related quality of life and perception of anxiety in women with abnormal cervical cytology referred for colposcopy: an observational study. Eur J Obstet Gynecol Reprod Biol, 169, 387-91. https://doi.org/10.1016/j.ejogrb.2013.03.033
  9. Kola S, Walsh JC (2012). Determinants of pre-procedural state anxiety and negative affect in first-time colposcopy patients: implications for intervention. Eur J Cancer Care (Engl), 21, 469-76. https://doi.org/10.1111/j.1365-2354.2011.01317.x
  10. Kola S, Walsh JC, Hughes BM, Howard S (2012). Attention focus, trait anxiety and pain perception in patients undergoing colposcopy. Eur J Pain, 16, 890-900. https://doi.org/10.1002/j.1532-2149.2011.00068.x
  11. Kola S, Walsh JC, Hughes BM, Howard S (2013). Matching intra-procedural information with coping style reduces psychophysiological arousal in women undergoing colposcopy. J Behav Med, 36, 401-12. https://doi.org/10.1007/s10865-012-9435-z
  12. Ludwick-Rosenthal R, Neufeld RW (1988). Stress management during noxious medical procedures: an evaluative review of outcome studies. Psychol Bull, 104, 326-42. https://doi.org/10.1037/0033-2909.104.3.326
  13. Mao C (2002). Teaching residents humanistic skills in a colposcopy clinic. Acad Med, 77, 742.
  14. Marteau TM, Walker P, Giles J, Smail M (1990). Anxieties in women undergoing colposcopy. Br J Obstet Gynaecol, 97, 859-61. https://doi.org/10.1111/j.1471-0528.1990.tb02586.x
  15. Rogstad KE (2002). The psychological impact of abnormal cytology and colposcopy. BJOG, 109, 364-8. https://doi.org/10.1111/j.1471-0528.2002.99023.x
  16. Spielberger CD, Gorsuch RC, Lushene RE (1970). Manual for the state-trait anxiety inventory, Palo Alto: Consulting Psychologists Press.
  17. Swancutt DR, Greenfield SM, Wilson S (2008). Women's colposcopy experience and preferences: a mixed methods study. BMC Womens Health, 8, 2. https://doi.org/10.1186/1472-6874-8-2
  18. Van Leeuwen AW, De Nooijer P, Hop WC (2005). Screening for cervical carcinoma. Cancer, 105, 270-6. https://doi.org/10.1002/cncr.21153
  19. Walsh JC, Curtis R, Mylotte M (2004). Anxiety levels in women attending a colposcopy clinic: a randomised trial of an educational intervention using video colposcopy. Patient Educ Couns, 55, 247-51. https://doi.org/10.1016/j.pec.2003.09.012
  20. Williams GL, Clarke P, Vellacott KD (2006). Anxieties should not be forgotten when screening relatives of colorectal cancer patients by colonoscopy. Colorectal Dis, 8, 781-4. https://doi.org/10.1111/j.1463-1318.2006.01092.x

피인용 문헌

  1. Prevalence and Predicting Factors for Anxiety in Thai Women with Abnormal Cervical Cytology Undergoing Colposcopy vol.16, pp.4, 2015, https://doi.org/10.7314/APJCP.2015.16.4.1427
  2. Exploring women’s sensory experiences of undergoing colposcopy and related procedures: implications for preparatory sensory information provision vol.37, pp.4, 2016, https://doi.org/10.1080/0167482X.2016.1197905
  3. Analgosedation for interventional procedures in patients with acute and chronic pain vol.17, pp.4, 2017, https://doi.org/10.1111/papr.12553