Patient acceptance and the psychological effects of women experiencing telecolposcopy and colposcopy.

BACKGROUND: The purpose of the study was to assess patient acceptance and psychological effects in women experiencing telecolposcopy compared with colposcopy. METHODS: Convenience samples of 150 and 263 women scheduled for colposcopy or telecolposcopy, respectively, completed questionnaires assessing anxiety (Prime MD), depression [Center for Epidemiologic Studies/Depressed Mood Scale (CES-D)], health beliefs and concerns, coping style (Miller Behavioral Style Score) and examination acceptance and satisfaction. Test scores and subject responses were compared using the t test and Wilcoxon rank sum test. RESULTS: Mean scores representing mild anxiety (1.3 and 1.2, P =.7) and mild depression (35.4 and 36.3, P =.4) were reported for the telecolposcopy and colposcopy groups, respectively. The telecolposcopy group indicated significantly greater mean scores for the examination, saving them time and money compared with the colposcopy group. Women in both groups were highly satisfied with their examinations and care. CONCLUSIONS: In general, women reported very high levels of satisfaction with telecolposcopy and colposcopy. Potential savings of time and money and improved health care were considered of particular value to women examined by telecolposcopy. Telecolposcopy seems to be well accepted by rural women.

Psychological effects women experience before and after a colposcopic examination and primary care appointment.

OBJECTIVE.: To estimate the psychological impact, health and behavior concerns, and coping styles of women awaiting colposcopic examination compared with women awaiting a scheduled primary care appointment. MATERIALS AND METHODS.: A convenience sample of 150 women presenting for a scheduled colposcopy examination and 201 women scheduled for a primary care appointment were assessed for demographic status, depression (Center for Epidemiologic Studies/Depressed Mood Scale), anxiety, health beliefs and concerns, and coping style (Miller Behavioral Style Score). Subjects also completed a postexamination questionnaire. Mean responses were compared using Wilcoxon rank sum test. RESULTS.: Mean anxiety scores were considered "mild" and equivalent for women in the two groups. Although the colposcopy group had a significantly greater mean depression score (36.3) compared with the noncolposcopy group (33.4, p = .03, Wilcoxon test), both mean scores indicated mild depression. Women undergoing colposcopy reported greater mean scores for concern about their disease, the procedure, and potential consequences (p < .01, Wilcoxon test). CONCLUSION.: Women scheduled for colposcopy have a similar level of mild anxiety and mild depression as women scheduled for a primary care appointment. Consequently, universal, instead of selective, use of anxiolytic agents before colposcopy appears unjustified. Avoidance of triage to colposcopy for atypical squamous cells of undetermined significance Pap smear results may be unwarranted based on concerns for causing excessive anxiety. In fact, colposcopy provides substantial reassurance.