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1.
BMC Womens Health ; 19(1): 112, 2019 09 02.
Artigo em Inglês | MEDLINE | ID: mdl-31477083

RESUMO

BACKGROUND: Internationally, women with cervical intraepithelial neoplasia (CIN) lack knowledge about their disease, which limits their ability to take responsibility for self-care and creates negative psychosocial effects, including marital problems. Normally, screening is performed in primary care, and in case of abnormal results, the patient is referred to specialized care for follow-up and treatment. Given the lack of international literature regarding patients' experiences in primary and specialized healthcare, our study aims to: (a) investigate how women with CIN perceive the communication and management of information by healthcare providers at different moments of their healthcare and (b) identify these women's informational needs. METHODS: A qualitative exploratory study was carried out in a gynecology unit of a public hospital of the Galician Health Care Service (Spain). Participants were selected through purposive sampling. The sample consisted of 21 women aged 21 to 52 years old with a confirmed diagnosis of CIN. Semistructured interviews were recorded and transcribed. A thematic analysis was carried out, including triangulation of researchers for analysis verification. RESULTS: Two analytical themes were identified. The first was communication gaps in the diagnosis and management of information in primary and specialized healthcare. These gaps occurred in the following moments of the healthcare process: (a) cervical cancer screening in primary care, (b) waiting time until referral to specialized care, (c) first consultation in specialized care, and (d) after consultation in specialized care. The second theme was participants' unmatched informational needs. The doubts and informational needs of women during their healthcare process related to the following subthemes: (a) HPV transmission, (b) HPV infection symptoms and consequences, and (c) CIN treatment and follow-up. CONCLUSIONS: This study shows that women who have a diagnosis of CIN experience important healthcare informational challenges when accessing primary and specialized care that have several implications for their wellbeing. The information given is limited, which makes it difficult for women to understand and participate in the decision making regarding the prevention and treatment of CIN. Service coordination among different levels of care and the availability of educational materials at any given time would improve the patients' healthcare experience.


Assuntos
Neoplasia Intraepitelial Cervical , Detecção Precoce de Câncer , Assistência ao Paciente , Navegação de Pacientes/organização & administração , Neoplasias do Colo do Útero , Adulto , Neoplasia Intraepitelial Cervical/patologia , Neoplasia Intraepitelial Cervical/psicologia , Detecção Precoce de Câncer/métodos , Detecção Precoce de Câncer/psicologia , Feminino , Humanos , Competência em Informação , Pessoa de Meia-Idade , Determinação de Necessidades de Cuidados de Saúde , Assistência ao Paciente/métodos , Assistência ao Paciente/normas , Pesquisa Qualitativa , Espanha , Neoplasias do Colo do Útero/patologia , Neoplasias do Colo do Útero/psicologia
2.
Eur J Cancer Prev ; 28(2): 96-101, 2019 03.
Artigo em Inglês | MEDLINE | ID: mdl-29406336

RESUMO

This study aims to assess (a) women's awareness of the human papillomavirus (HPV), (b) women's health-related quality of life (HRQoL) and levels of anxiety and depression symptoms, and (c) to compare the outcomes between women who are aware of the sexually transmitted nature of the HPV infection and women who are not. Swedish women who have been notified of an abnormal Pap smear result completed a questionnaire. This questionnaire consisted of sociodemographic characteristics, items on awareness of HPV, and how to cope with the Pap smear result and the instruments: the Functional Assessment of Chronic Illness Therapy - Cervical Dysplasia and the Hospital Anxiety and Depression Scale (HADS). Data were analyzed using descriptive statistics, Student's t-test, χ-tests, Fisher's exact test, the Mann-Whitney U-test, and Fisher-Freeman-Halton exact test. In total, 122 women participated. The women reported a median (quartile 1-quartile 3) score of 87.6 on the Functional Assessment of Chronic Illness Therapy - Cervical Dysplasia (81.8-107.0), compatible with a good HRQoL. The median (quartile 1-quartile 3) scores on HADS-anxiety and HADS-depression were 7.0 (4.0-10.0) and 3.0 (1.0-5.3), respectively; however, 48.4% of the women reported anxiety (compared with 20% in a normal population). There were no statistically significant differences in the median scores in any of the scales, including the prevalence of distress between the subgroups. Women with abnormal Pap smear results have a good HRQoL; they can become anxious, but not depressed. Awareness of HPV as a sexually transmitted infection is low, but being aware does not impact on women's HRQoL or on anxiety and depression.


Assuntos
Transtornos de Ansiedade/etiologia , Transtorno Depressivo/etiologia , Conhecimentos, Atitudes e Prática em Saúde , Infecções por Papillomavirus/complicações , Qualidade de Vida , Neoplasias do Colo do Útero/psicologia , Esfregaço Vaginal , Adulto , Idoso , Transtornos de Ansiedade/psicologia , Neoplasia Intraepitelial Cervical/diagnóstico , Neoplasia Intraepitelial Cervical/psicologia , Neoplasia Intraepitelial Cervical/virologia , Estudos Transversais , Transtorno Depressivo/psicologia , Feminino , Seguimentos , Humanos , Pessoa de Meia-Idade , Papillomaviridae/isolamento & purificação , Infecções por Papillomavirus/virologia , Prognóstico , Inquéritos e Questionários , Suécia , Displasia do Colo do Útero/diagnóstico , Displasia do Colo do Útero/psicologia , Displasia do Colo do Útero/virologia , Neoplasias do Colo do Útero/diagnóstico , Neoplasias do Colo do Útero/virologia , Adulto Jovem
3.
Eur J Cancer Care (Engl) ; 28(2): e12969, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30457186

RESUMO

This study aims to assess whether notification of an abnormal Pap smear result via a phone call, delivered by a trained healthcare provider, has an effect on women's HRQoL, coping and awareness of HPV. For this intervention study, women were consecutively recruited from a women's health clinic in Sweden. Women in the intervention group (n = 113) were notified of their Pap smear result via a phone call by a trained healthcare provider, while those in the comparison group (n = 122) were notified via a standard letter. A questionnaire was used to collect data. The results found no significant differences between the groups for HRQoL. However, 42.5% of women in the intervention group versus 48.3% in the comparison group reported anxiety. Women in the intervention group were more satisfied with the manner in which they were notified of their abnormal result than those in the comparison group (92.0% vs. 67.2%; p < 0.001), more aware of HPV (71% vs. 50%; p = 0.001), and called healthcare services less often (10.6% vs. 18.0%; p = 0.113), no significance. In conclusion, notification of an abnormal Pap smear result via a phone call does not increase women's HRQoL or reduce their anxiety.


Assuntos
Neoplasia Intraepitelial Cervical/psicologia , Revelação , Teste de Papanicolaou/psicologia , Infecções por Papillomavirus/psicologia , Neoplasias do Colo do Útero/psicologia , Adaptação Psicológica , Adulto , Idoso , Ansiedade/etiologia , Conscientização , Estudos de Casos e Controles , Neoplasia Intraepitelial Cervical/diagnóstico , Detecção Precoce de Câncer , Feminino , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Pessoa de Meia-Idade , Infecções por Papillomavirus/diagnóstico , Qualidade de Vida , Inquéritos e Questionários , Suécia , Telefone , Neoplasias do Colo do Útero/diagnóstico , Adulto Jovem
4.
BMC Womens Health ; 18(1): 200, 2018 12 12.
Artigo em Inglês | MEDLINE | ID: mdl-30541542

RESUMO

BACKGROUND: Previous studies have shown that woman attending their first cervical screening or colposcopy appointment experience negative emotions, primarily anxiety and fear. With the introduction of the Human Papillomavirus (HPV) vaccine, it is unknown whether these emotions will have altered or whether the information needs of vaccinated women will have changed. The objective of this study is to determine the knowledge, understanding and concerns that young women have about HPV when attending colposcopy and whether their information needs are met. METHODS: This is a qualitative study using semi-structured interviews which were audiotaped and transcribed. Data was analysed thematically, with recruitment until data saturation was reached. Women born after 01/09/1990 and attending colposcopy as a result of abnormal cytology were eligible to join the study. Recruitment took place in an out-patient regional colposcopy clinic, Aberdeen, Scotland. RESULTS: Fifteen women were interviewed. The majority of participants had some knowledge and understanding of HPV, cervical screening and colposcopy. Knowledge about the HPV vaccine was more limited; a third of participants misunderstood the effectiveness of the vaccine believing that is provided complete protection, and were left feeling that it had failed them. Some also felt that they were "test cases" for the vaccine. CONCLUSION: With the introduction of the HPV vaccine, the information and support needs of young women attending colposcopy are not fully met, leaving women with unanswered questions. With increasing numbers of vaccinated women entering the screening programme, it is timely to review the information available to these women.


Assuntos
Neoplasia Intraepitelial Cervical/psicologia , Colposcopia/psicologia , Necessidades e Demandas de Serviços de Saúde/estatística & dados numéricos , Vacinas contra Papillomavirus , Instituições de Assistência Ambulatorial , Ansiedade/prevenção & controle , Neoplasia Intraepitelial Cervical/prevenção & controle , Feminino , Humanos , Infecções por Papillomavirus/psicologia , Pesquisa Qualitativa , Adulto Jovem
5.
PLoS One ; 13(6): e0199038, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-29912903

RESUMO

OBJECTIVE: Self-sampling to test for high risk human papilloma virus (HPV) is becoming an increasingly important component of cervical cancer screening. The aim of this observational study is to examine how women treated for high-grade cervical intraepithelial neoplasia (CIN) view HPV self-sampling. METHODS: Invited to participate in the present study were patients who had undergone treatment of high-grade CIN (grade 2 or higher) and were followed-up at 6-months at the Karolinska University Hospital, Stockholm. The participants were instructed as to how to perform HPV self-sampling. Thereafter, the participants completed a questionnaire about HPV self-sampling and other cervical cancer screening methods, as well as about self-perceived risk of cervical cancer without regular gynecologic follow-up and about specific knowledge regarding HPV, CIN and cervical cancer. RESULTS: Altogether 479 women enrolled in this study. The participation rate was 96.6%. Nearly 75% of the participants stated they would consider performing the HPV self-sampling prior to their next gynecologic follow-up. Confidence in HPV self-sampling was a significant independent predictor of willingness to perform HPV self-sampling. However, confidence in HPV self-sampling was significantly lower than confidence in Papanicolaou smears and in HPV testing with samples collected by health professionals. Higher specific knowledge about HPV, CIN and cervical cancer was also a significant independent predictor of willingness to perform HPV self-sampling, as was having travelled longer distance to attend gynecologic follow-up. Participants with lower income and without completed university education expressed significantly higher confidence in HPV self-sampling and lower confidence in Papanicolaou smears than the other women. CONCLUSIONS: To the best of our knowledge, this is the first study to examine the views of women treated for high-grade CIN vis-à-vis HPV self-sampling. The latter is an acceptable option for the vast majority of this cohort of women.


Assuntos
Neoplasia Intraepitelial Cervical/virologia , Infecções por Papillomavirus/diagnóstico , Autocuidado/métodos , Adulto , Neoplasia Intraepitelial Cervical/diagnóstico , Neoplasia Intraepitelial Cervical/psicologia , Feminino , Humanos , Teste de Papanicolaou/métodos , Teste de Papanicolaou/psicologia , Infecções por Papillomavirus/psicologia , Aceitação pelo Paciente de Cuidados de Saúde/psicologia , Autocuidado/psicologia , Inquéritos e Questionários
6.
BMC Cancer ; 17(1): 686, 2017 Oct 16.
Artigo em Inglês | MEDLINE | ID: mdl-29037189

RESUMO

BACKGROUND: The occurrence of cervical intraepithelial neoplasia (CIN) is associated with changes in health-related quality of life, including psychological factors, such as fear and shame, and changes in sexuality and sexual satisfaction, such as decreased sexual desire and frequency of sexual intercourse. Personal relationships are the most affected because CIN is sexually transmitted and many women tend to blame their partner for disease transmission. The aim of this study was to evaluate the psychometric properties of the FACIT-CD questionnaire in Brazilian women diagnosed with CIN. METHODS: The properties of the FACIT-CD questionnaire were tested on a sample of 439 women seen at the Department of Prevention of Barretos Cancer Hospital, including 329 patients who were diagnosed with CIN and 110 women who were not diagnosed with the disease. The analysed parameters included internal consistency (Cronbach's alpha), reproducibility (intraclass correlation coefficient), structural validity, convergent validity (correlation with the SF-12 and EORTC QLQ-CX24 questionnaires), discriminant validity (according to disease status, and self-rating of health), sensitivity, and responsiveness. RESULTS: The Cronbach alpha values ​​of the FACIT-CD scales were higher than 0.70 with the exception of the relationship scale (0.66). The FACIT-CD reproducibility was satisfactory, with variation in the intraclass correlation coefficients ranging between 0.50 and 0.83, although the 95% confidence interval (CI) was lower than 0.40 (0.33-0.64) on the treatment satisfaction scale. Regarding structural validity, only one item on the physical well-being scale was not kept in the original domain. The expected correlations between the FACIT-CD and SF-12 were not confirmed, whereas the correlations between the FACIT-CD and EORTC QLQ-CX24 were confirmed. The questionnaire was able to discriminate the groups according to disease status and self-rating of health. The sensitivity was low for the relationship scale and moderate for the other scales. The responsiveness of the FACIT-CD questionnaire varied between the groups that denominate the self-perception of health as no change, improvement or worsening. CONCLUSION: Our results are encouraging and indicate that the FACIT-CD questionnaire is a promising tool for the analysis of the quality of life of women with CIN.


Assuntos
Neoplasia Intraepitelial Cervical/epidemiologia , Neoplasia Intraepitelial Cervical/psicologia , Infecções por Papillomavirus/epidemiologia , Psicometria , Adolescente , Adulto , Idoso , Brasil/epidemiologia , Neoplasia Intraepitelial Cervical/patologia , Criança , Feminino , Humanos , Pessoa de Meia-Idade , Papillomaviridae/patogenicidade , Infecções por Papillomavirus/patologia , Infecções por Papillomavirus/psicologia , Qualidade de Vida , Inquéritos e Questionários
7.
Sex Reprod Healthc ; 12: 3-8, 2017 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-28477928

RESUMO

OBJECTIVES: To describe women's experiences of abnormal Pap smear result. METHODS: Ten women were recruited from a women's health clinic. Qualitative interviews based on six open-ended questions were conducted, transcribed verbatim, and analyzed by content analysis. RESULTS: The women believed that their abnormal Pap smear result was indicative of having cancer. This created anxiety in the women, which resulted in the need for emotional support and information. Testing positive with human papillomavirus (HPV) also meant consequences for the relatives as well as concerns about the sexually transmitted nature of the virus. Finally, the women had a need to be treated with respect by the healthcare professionals in order to reduce feelings of being abused. CONCLUSIONS: In general, women have a low level of awareness of HPV and its relation to abnormal Pap smear results. Women who receive abnormal Pap smear results need oral information, based on the individual women's situation, and delivered at the time the women receive the test result. It is also essential that a good emotional contact be established between the women and the healthcare professionals.


Assuntos
Neoplasia Intraepitelial Cervical/psicologia , Detecção Precoce de Câncer/psicologia , Infecções por Papillomavirus/psicologia , Neoplasias do Colo do Útero/psicologia , Esfregaço Vaginal/psicologia , Adulto , Ansiedade/psicologia , Neoplasia Intraepitelial Cervical/diagnóstico , Feminino , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Entrevistas como Assunto , Pessoa de Meia-Idade , Teste de Papanicolaou/psicologia , Infecções por Papillomavirus/diagnóstico , Educação de Pacientes como Assunto , Relações Médico-Paciente , Pesquisa Qualitativa , Apoio Social , Neoplasias do Colo do Útero/diagnóstico
8.
Aust N Z J Obstet Gynaecol ; 57(4): 473-478, 2017 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-28508566

RESUMO

BACKGROUND: Although the patient perspective is implicit in the practice of medicine, research evaluating this remains scarce. In a climate where clinicians and policy-makers constantly strive to achieve more patient-centred models of care, this omission warrants attention. AIM: To assess health-related quality of life (HrQoL) in women under 25 years of age with cervical intra-epithelial neoplasia grade 2 (CIN2) receiving conservative management (colposcopy follow-up, with treatment if necessary) compared with those receiving immediate excisional treatment with large loop excision of the transformation zone (LLETZ). METHODS: An observational study evaluating HrQoL was conducted at Christchurch Women's Hospital, New Zealand. Women undergoing conservative management for CIN2 were compared with those undergoing immediate excisional treatment in an age-matched sample. The Short Form Health Survey 12 version 2 (SF-12v2) was used to evaluate HrQoL. Secondary outcomes of anxiety and sexual function were also assessed. RESULTS: One hundred and four women with CIN2 participated in the study. Of these, 63 (60%) received conservative management and 41 (40%) received immediate excisional treatment with LLETZ. We found no significant difference in HrQoL between the groups in a multivariate regression analysis adjusted for parity, smoking and socioeconomic status. There were also no significant differences in sexual function or anxiety. CONCLUSION: We found no difference in HrQoL by management strategy. Conservative management of CIN2 in women under 25 is unlikely to have an adverse impact on self-reported HrQoL, anxiety or sexual functioning compared with conventional management.


Assuntos
Ansiedade/etiologia , Neoplasia Intraepitelial Cervical/psicologia , Colposcopia , Tratamento Conservador/psicologia , Procedimentos Cirúrgicos em Ginecologia/psicologia , Qualidade de Vida , Neoplasias do Colo do Útero/psicologia , Adolescente , Biópsia , Neoplasia Intraepitelial Cervical/patologia , Neoplasia Intraepitelial Cervical/cirurgia , Feminino , Humanos , Nova Zelândia , Paridade , Análise de Regressão , Neoplasias do Colo do Útero/patologia , Neoplasias do Colo do Útero/cirurgia , Adulto Jovem
9.
J Behav Med ; 40(5): 814-820, 2017 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-28417294

RESUMO

Human papillomavirus (HPV), and the related, cervical intraepithelial neoplasia (CIN), are common yet poorly understood physical conditions. The diagnosis of HPV often elicits shame and guilt, which in turn may undermine psychological and physical health. The current study compared shame and guilt responses to diagnosis among two groups: women diagnosed with HPV/CIN and women diagnosed with Epstein-Barr Virus (EBV/IM). Eighty women recently diagnosed with HPV/CIN or EBV/IM completed measures of shame- and guilt-proneness, shame and guilt following diagnosis, and disease knowledge including prevalence estimates (HPV and EBV, respectively). HPV/CIN (vs. EBV/IM) predicted more diagnosis-related shame and guilt. Estimates of high prevalence interacted with diagnosis and shame-proneness to predict diagnosis-related shame. Simple slope analyses indicated that in women with HPV/CIN reporting low-to-average shame-proneness, high prevalence estimates reduced diagnosis-related shame; however, women high in shame-proneness experienced high diagnosis-related shame regardless of more accurate prevalence estimates. Women high in shame-proneness appear to be particularly vulnerable to HPV-related shame even when they are aware that it is very common.


Assuntos
Neoplasia Intraepitelial Cervical/diagnóstico , Neoplasia Intraepitelial Cervical/psicologia , Infecções por Vírus Epstein-Barr/psicologia , Culpa , Infecções por Papillomavirus/diagnóstico , Infecções por Papillomavirus/psicologia , Doenças Virais Sexualmente Transmissíveis/psicologia , Vergonha , Adolescente , Adulto , Infecções por Vírus Epstein-Barr/diagnóstico , Feminino , Humanos , Mononucleose Infecciosa/diagnóstico , Mononucleose Infecciosa/psicologia , Adulto Jovem
10.
Psychooncology ; 26(4): 476-483, 2017 04.
Artigo em Inglês | MEDLINE | ID: mdl-27297097

RESUMO

OBJECTIVE: To compare psychosocial outcomes (follow-up related worries and satisfaction with follow-up related information and support) over 30 months of two alternative management policies for women with low-grade abnormal cervical cytology. METHODS: Women aged 20-59 years with low-grade cytological abnormalities detected in the National Health Service Cervical Screening Programme were randomised to cytological surveillance or initial colposcopy. A total of 3399 women who completed psychosocial questionnaires at recruitment were invited to complete questionnaires at 12, 18, 24 and 30 months. Linear mixed models were used to investigate differences between arms in the two psychosocial outcomes. Each outcome had a maximum score of 100, and higher scores represented higher psychosocial morbidity. RESULTS: On average, over 30 months, women randomised to colposcopy scored 2.5 points (95%CI -3.6 to -1.3) lower for follow-up related worries than women randomised to cytological surveillance. Women in the colposcopy arm also scored significantly lower for follow-up related satisfaction with information and support (-2.4; -3.3 to -1.4) over 30 months. For both outcomes, the average difference between arms was greatest at 12th- and 18th-month time points. These differences remained when the analysis was stratified by post-school education. CONCLUSIONS: Women with low-grade cytology, irrespective of their management, have substantial initial psychosocial morbidity that reduces over time. Implementation of newer screening strategies, which include surveillance, such as primary HPV screening, need to consider the information and support provided to women. © 2016 The Authors. Psycho-Oncology published by John Wiley & Sons Ltd.


Assuntos
Ansiedade/psicologia , Neoplasia Intraepitelial Cervical/psicologia , Colposcopia/psicologia , Citodiagnóstico/psicologia , Neoplasias do Colo do Útero/psicologia , Adulto , Neoplasia Intraepitelial Cervical/patologia , Feminino , Humanos , Estudos Longitudinais , Pessoa de Meia-Idade , Morbidade , Inquéritos e Questionários , Neoplasias do Colo do Útero/patologia , Adulto Jovem
11.
Health Qual Life Outcomes ; 14(1): 163, 2016 Nov 28.
Artigo em Inglês | MEDLINE | ID: mdl-27894347

RESUMO

BACKGROUND: A cost-utility study of a human papilloma virus (HPV) vaccine requires that the utility weights for HPV-related health states (i.e., cervical intraepithelial neoplasia (CIN), cervical cancer, and condyloma) be evaluated. The aim of the present study was to determine the utility weights for HPV-related health states. METHODS: Hypothetical standardised health states related to HPV were developed based on patient education material and previous publications. To fully reflect disease progression from diagnosis to prognosis, each health state comprised four parts (diagnosis, symptoms, treatment, and progression and prognosis). Nine-hundred members from the Korean general population evaluated the HPV-related health states using a visual analogue scale (VAS) and a standard gamble (SG) approach, which were administered face-to-face via computer-assisted interview. The mean utility values were calculated for each HPV-related health state. RESULTS: According to the VAS, the highest utility (0.73) was HPV-positive status, followed by condyloma (0.66), and CIN grade I (0.61). The lowest utility (0.18) was cervical cancer requiring chemotherapy without surgery, followed by cervical cancer requiring chemoradiation therapy (0.42). SG revealed that the highest utility (0.83) was HPV-positive status, followed by condyloma (0.78), and CIN grade I (0.77). The lowest utility (0.43) was cervical cancer requiring chemotherapy without surgery, followed by cervical cancer requiring chemoradiation therapy (0.60). CONCLUSIONS: This study was based on a large sample derived from the general Korean population; therefore, the calculated utility weights might be useful for evaluating the economic benefit of cancer screening and HPV vaccination programs.


Assuntos
Neoplasia Intraepitelial Cervical/psicologia , Condiloma Acuminado/psicologia , Efeitos Psicossociais da Doença , Infecções por Papillomavirus/psicologia , Aceitação pelo Paciente de Cuidados de Saúde/psicologia , Qualidade de Vida , Neoplasias do Colo do Útero/psicologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Neoplasia Intraepitelial Cervical/diagnóstico , Neoplasia Intraepitelial Cervical/terapia , Condiloma Acuminado/diagnóstico , Condiloma Acuminado/terapia , Detecção Precoce de Câncer , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Infecções por Papillomavirus/diagnóstico , Infecções por Papillomavirus/terapia , Prognóstico , República da Coreia , Índice de Gravidade de Doença , Neoplasias do Colo do Útero/diagnóstico , Neoplasias do Colo do Útero/terapia , Escala Visual Analógica
12.
Rev. Pesqui. (Univ. Fed. Estado Rio J., Online) ; 8(1): 3667-3678, jan.-mar. 2016. tab
Artigo em Inglês, Português | LILACS, BDENF - Enfermagem | ID: lil-776193

RESUMO

Objective: understanding the social representation of women about cervical cancer and its implications for care of themselves. Method: this is a qualitative study of a descriptive approach that used as a theoretical role the social representations, taking the interview as a technique for data collection of information. We worked with 35 outpatient women of a referral public hospital in oncology. Results: within the dialogs it was observed that the concept of cervical cancer was closely related to the feeling factor, leading fear and sadness. The evidences also showed that women focused on sexuality and treatment as a life change along the disease. Conclusion: cancer of the cervix produces a great change of life in women who passed through the problem, not just by the physical factors, but quite by the subjective side in fighting the disease.


Objetivo: compreender a representação social de mulheres com câncer de colo de útero e suas implicações para o cuidado de si. Método: um estudo de natureza qualitativa e abordagem descritiva que utilizou como aporte teórico as representações sociais, tendo a entrevista como técnica de coleta de dados das informações. Trabalhamos com 35 mulheres do ambulatório de um hospital público de referência em oncologia. Resultados: dentre os discursos observou-se que o conceito de câncer de colo de útero foi muito relacionado com o fator sentimental, imperando o medo e a tristeza. Os depoimentos mostraram também que as mulheres focaram a sexualidade e o tratamento como mudança de vida no decorrer da doença.Conclusão: o câncer de colo de útero gera uma grande mudança de vida nas mulheres que passam pelo problema, não apenas pelo fator físico, mas muito pelo lado subjetivo no enfrentamento da doença.


Objetivo: comprender la representación social de las mujeres acerca del cáncer cervical y sus implicaciones para el cuidado de sí mismas. Método: este estudio cualitativo de enfoque descriptivo utilizó como aporte teórico las representaciones sociales, tomando la entrevista como técnica de recolección de datos de la información. Trabajamos con 35 mujeres del ambulatorio de un hospital público de referencia en oncología. Resultados: entre los discursos se observó que el concepto de cáncer cervical de útero estaba realmente relacionado con el factor sentimental, que reina el miedo y la tristeza. Los testimonios también mostraron que las mujeres se centraron en la sexualidad y el tratamiento como un cambio de vida ya que la enfermedad avanzaba. Conclusión: el cáncer del cuello del útero produce un gran cambio de vida en las mujeres que pasan por el problema, no sólo por factores físicos, sino todo el aspecto subjetivo en la lucha contra la enfermedad.


Assuntos
Humanos , Feminino , Conhecimentos, Atitudes e Prática em Saúde , Neoplasia Intraepitelial Cervical/psicologia , Neoplasias do Colo do Útero/psicologia , Brasil
13.
J Sex Med ; 13(2): 253-9, 2016 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-26782607

RESUMO

INTRODUCTION: Genital human papillomavirus (HPV) infections are very common in women 18 to 30 years old and substantially affect women's sexual health. AIM: To examine sexual activity, psychosexual distress, and fear of progression in women diagnosed with HPV-related precancerous genital lesions. METHODS: In this observational study, women diagnosed with premalignant lesions of the cervix, vagina, or vulva were recruited from a university hospital-based colposcopy clinic. MAIN OUTCOME MEASURES: Quantitative data from three validated patient-administered questionnaires (Sexual Activity Questionnaire, German version of the Cervical Dysplasia Distress Questionnaire, and Fear of Progression Questionnaire) were compared within the study population, according to the location of the genital lesion, and with relevant reference populations. Qualitative data from two written open-ended questions about women's thoughts regarding diagnosis and information were analyzed. RESULTS: Two-hundred nine women completed the questionnaires. Seventy-eight percent of women (n = 162) were referred for evaluation of suspect lesions of the cervix, 8% (n = 17) of the vagina, and 14% (n = 30) of the vulva. There were no significant differences in questionnaire results among the three patient groups, except for sexual consequences (Cervical Dysplasia Distress Questionnaire) and recent sexual activity (Sexual Activity Questionnaire). Women with vulvar lesions were most likely to worry about sexual consequences (ie, being unable to have children, being sexually less attractive, or infecting a sexual partner; P = .04). The Sexual Activity Questionnaire subscales sexual pleasure (P = .15) and sexual habits (P = 1.00) were similar to those in a healthy control population, whereas sexual discomfort (P = .51) was comparable to that in a reference population of women who survived cervical cancer. The subscale partner-specific concerns (Fear of Progression Questionnaire) was similar to that in a reference population of patients with cancer (P = .28). CONCLUSION: HPV-related precancerous genital lesions, especially of the vulva, are likely to cause concerns about sexual health. Effective information and communication are important to lessen negative sexual consequences and anxiety.


Assuntos
Ansiedade/diagnóstico , Neoplasia Intraepitelial Cervical/psicologia , Papillomaviridae/isolamento & purificação , Infecções por Papillomavirus/psicologia , Lesões Pré-Cancerosas/psicologia , Disfunções Sexuais Psicogênicas/diagnóstico , Adulto , Ansiedade/etiologia , Ansiedade/psicologia , Neoplasia Intraepitelial Cervical/diagnóstico , Neoplasia Intraepitelial Cervical/fisiopatologia , Medo , Feminino , Humanos , Pessoa de Meia-Idade , Infecções por Papillomavirus/diagnóstico , Infecções por Papillomavirus/fisiopatologia , Educação de Pacientes como Assunto , Disfunções Sexuais Psicogênicas/epidemiologia , Disfunções Sexuais Psicogênicas/psicologia , Parceiros Sexuais , Doenças Sexualmente Transmissíveis , Inquéritos e Questionários , Neoplasias do Colo do Útero/epidemiologia , Saúde da Mulher
14.
Rev. pesqui. cuid. fundam. (Online) ; 8(1): 3667-3678, jan.-mar. 2016. tab
Artigo em Inglês, Português | BDENF - Enfermagem | ID: bde-27353

RESUMO

Objective: understanding the social representation of women about cervical cancer and its implications for care of themselves. Method: this is a qualitative study of a descriptive approach that used as a theoretical role the social representations, taking the interview as a technique for data collection of information. We worked with 35 outpatient women of a referral public hospital in oncology. Results: within the dialogs it was observed that the concept of cervical cancer was closely related to the feeling factor, leading fear and sadness. The evidences also showed that women focused on sexuality and treatment as a life change along the disease. Conclusion: cancer of the cervix produces a great change of life in women who passed through the problem, not just by the physical factors, but quite by the subjective side in fighting the disease.(AU)


Objetivo: compreender a representação social de mulheres com câncer de colo de útero e suas implicações para o cuidado de si. Método: um estudo de natureza qualitativa e abordagem descritiva que utilizou como aporte teórico as representações sociais, tendo a entrevista como técnica de coleta de dados das informações. Trabalhamos com 35 mulheres do ambulatório de um hospital público de referência em oncologia. Resultados: dentre os discursos observou-se que o conceito de câncer de colo de útero foi muito relacionado com o fator sentimental, imperando o medo e a tristeza. Os depoimentos mostraram também que as mulheres focaram a sexualidade e o tratamento como mudança de vida no decorrer da doença.Conclusão: o câncer de colo de útero gera uma grande mudança de vida nas mulheres que passam pelo problema, não apenas pelo fator físico, mas muito pelo lado subjetivo no enfrentamento da doença.(AU)


Objetivo: comprender la representación social de las mujeres acerca del cáncer cervical y sus implicaciones para el cuidado de sí mismas. Método: este estudio cualitativo de enfoque descriptivo utilizó como aporte teórico las representaciones sociales, tomando la entrevista como técnica de recolección de datos de la información. Trabajamos con 35 mujeres del ambulatorio de un hospital público de referencia en oncología. Resultados: entre los discursos se observó que el concepto de cáncer cervical de útero estaba realmente relacionado con el factor sentimental, que reina el miedo y la tristeza. Los testimonios también mostraron que las mujeres se centraron en la sexualidad y el tratamiento como un cambio de vida ya que la enfermedad avanzaba. Conclusión: el cáncer del cuello del útero produce un gran cambio de vida en las mujeres que pasan por el problema, no sólo por factores físicos, sino todo el aspecto subjetivo en la lucha contra la enfermedad.(AU)


Assuntos
Humanos , Feminino , Neoplasia Intraepitelial Cervical/psicologia , Neoplasias do Colo do Útero/psicologia , Conhecimentos, Atitudes e Prática em Saúde , Brasil
15.
BJOG ; 123(1): 24-38, 2016 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-26099164

RESUMO

BACKGROUND: Although colposcopy is the leading follow-up option for women with abnormal cervical cytology, little is known about its psychological consequences. OBJECTIVES: We performed a systematic review to examine: (1) what, if any, are the adverse psychological outcomes following colposcopy and related procedures; (2) what are the predictors of adverse psychological outcomes post-colposcopy; and (3) what happens to these outcomes over time. SEARCH STRATEGY: Five electronic databases (PubMed, PsychINFO, CINAHL, Web of Science, Scopus) were searched for studies published in English between January 1986 and February 2014. SELECTION CRITERIA: Eligible studies assessed psychological wellbeing at one or more time-points post-colposcopy. DATA COLLECTION AND ANALYSIS: Two reviewers independently screened titles and abstracts. Full texts of potentially eligible papers were reviewed. Data were abstracted from, and a quality appraisal performed of, eligible papers. MAIN RESULTS: Twenty-three papers reporting 16 studies were eligible. Colposcopy and related procedures can lead to adverse psychological outcomes, particularly anxiety. Ten studies investigated predictors of adverse psychological outcomes; management type and treatment had no impact on this. Seven studies investigated temporal trends in psychological outcomes post-colposcopy; findings were mixed, especially in relation to anxiety and distress. Studies were methodologically heterogeneous. CONCLUSIONS: Follow-up investigations and procedures for abnormal cervical cytology can cause adverse psychological outcomes among women. However, little is known about the predictors of these outcomes or how long they persist. There is a need for a more standardised approach to the examination of the psychological impact of colposcopy, especially longer-term outcomes. TWEETABLE ABSTRACT: Follow-up investigations for abnormal cervical cytology can cause adverse psychological outcome among women.


Assuntos
Ansiedade/etiologia , Neoplasia Intraepitelial Cervical/psicologia , Colposcopia/psicologia , Detecção Precoce de Câncer/psicologia , Estresse Psicológico/etiologia , Neoplasias do Colo do Útero/psicologia , Neoplasia Intraepitelial Cervical/patologia , Detecção Precoce de Câncer/instrumentação , Feminino , Humanos , Neoplasias do Colo do Útero/patologia
17.
Arch Gynecol Obstet ; 293(2): 391-8, 2016 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-26202136

RESUMO

PURPOSE: Invasive cervical cancer is today the fourth most common cancer of women in western civilization. Screening programs have led to a continuously decrease. Nevertheless, both screening and a positive test result are known to be associated with a negative psychological impact. Screening programs in European countries differ and thus psychological impact might as well. The aim of this study was to evaluate the psychological impact of women with an abnormal Pap smear in a German cohort. METHODS: Between July 2013 and May 2014, a self-assessment questionnaire was distributed to 595 patients that were referred to a special clinic for cervical dysplasia for further evaluation of an abnormal Pap smear. Patients were recruited in five different centers. RESULTS: Most patients (45.9 %) were informed about the test result via phone call by their doctor. 68.8 % of the patients felt anxious and 26.3 % even felt panic. After having talked to their physician, 51.4 % of our cohort still felt worried and only 24.4 % felt reassured. Concerning disease management, 48.4 % underwent a control Pap smear in 6 months. The preferred information source was the physician (63.9 %). Compared to the results in other European countries, our study cohort showed differences concerning age distribution, patients living in a partnership, number of children and especially disease management. CONCLUSION: Cancer screening itself and abnormal test results have an impact on patient's feelings. To reduce the psychological impact, patients need to be better informed about the risks and benefits of cancer screening programs and in case of cervical cancer screening about the meaning of an abnormal test result. Our results underline the importance of a trustful physician-patient relationship in that matter.


Assuntos
Ansiedade/psicologia , Detecção Precoce de Câncer/métodos , Teste de Papanicolaou/psicologia , Displasia do Colo do Útero/diagnóstico , Neoplasias do Colo do Útero/diagnóstico , Esfregaço Vaginal/psicologia , Adulto , Idoso , Ansiedade/etiologia , Neoplasia Intraepitelial Cervical/diagnóstico , Neoplasia Intraepitelial Cervical/psicologia , Europa (Continente) , Feminino , Humanos , Pessoa de Meia-Idade , Relações Médico-Paciente , Qualidade de Vida , Autoavaliação , Inquéritos e Questionários , Displasia do Colo do Útero/psicologia , Neoplasias do Colo do Útero/patologia , Neoplasias do Colo do Útero/psicologia , Adulto Jovem
18.
J Clin Virol ; 76 Suppl 1: S81-S87, 2016 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-26651602

RESUMO

BACKGROUND: Australian guidelines for cervical cancer screening are being revised under the "renewal program". Physicians' willingness to accept these changes will play a pivotal role in its success. OBJECTIVE: To understand the willingness and acceptance of, as well as barriers and facilitators for Royal Australian and New Zealand College of Obstetricians and Gynaecologists (RANZCOG) affiliates to screening using human papillomavirus (HPV) testing, starting at 25 years of age, every 5 years. STUDY DESIGN: An electronic survey of RANZCOG affiliates was undertaken April-June 2014, while renew was announced April 28th 2014. Responses used a 7 point Likert scale, which was dichotomized as ≤4, indicating 'unwilling' and >4, indicating 'willing' to adopt revised practices. RESULTS: Response rate was 22% (n=956): 60% were obstetricians and gynaecologists (OG); 27% general practitioner diplomates; 13% OG trainees. Overall, 60% (n=526/874) were willing to revise their screening practice. This correlated with awareness of new guidelines (p=<0.001). Fifty percent (n=438/869) of respondents were concerned about delaying to 25 years, and 48% (n=421/869) concerned cervical cancers would be missed. Reasons respondents gave for wishing to continue screening from 18 years contrary to guidelines included: women not being vaccinated (65.6%), immunosuppressed women (92.2%) and women who had been victims of childhood sexual assault (73.9%). CONCLUSIONS: The majority of RANZCOG affiliates were willing to change screening practice however, a number of barriers to delaying onset of screening age to age 25 years were reported. Effective change management strategies will need to be implemented to address the concerns raised to ensure best practice for cervical screening.


Assuntos
Neoplasia Intraepitelial Cervical/psicologia , Conhecimentos, Atitudes e Prática em Saúde , Programas de Rastreamento/psicologia , Infecções por Papillomavirus/psicologia , Médicos/psicologia , Neoplasias do Colo do Útero/psicologia , Fatores Etários , Austrália , Neoplasia Intraepitelial Cervical/complicações , Neoplasia Intraepitelial Cervical/diagnóstico , Neoplasia Intraepitelial Cervical/prevenção & controle , Detecção Precoce de Câncer/métodos , Feminino , Testes de DNA para Papilomavírus Humano , Humanos , Programas de Rastreamento/legislação & jurisprudência , Papillomaviridae/classificação , Papillomaviridae/genética , Infecções por Papillomavirus/complicações , Infecções por Papillomavirus/diagnóstico , Infecções por Papillomavirus/prevenção & controle , Vacinas contra Papillomavirus/administração & dosagem , Guias de Prática Clínica como Assunto , Inquéritos e Questionários , Neoplasias do Colo do Útero/complicações , Neoplasias do Colo do Útero/diagnóstico , Neoplasias do Colo do Útero/prevenção & controle , Vacinação/psicologia
19.
J Fam Plann Reprod Health Care ; 42(1): 43-51, 2016 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-26376822

RESUMO

BACKGROUND: Effective cervical screening reduces cancer incidence and mortality. However, these benefits may be accompanied by some harms, potentially including, adverse psychological impacts. Studies suggest women may have concerns about various specific issues, such as cervical cancer. AIM: To compare worries about cervical cancer, future fertility, having sex, and general health between women managed by alternative policies at colposcopy. DESIGN: Multicentre individually-randomised controlled trial, nested within the National Health Service Cervical Screening Programmes. SETTING: UK. METHODS: 1515 women, aged 20-59 years, with low-grade cytology who attended colposcopy during February 2001-October 2002, were randomised to immediate loop excision or punch biopsies with recall for treatment if cervical intraepithelial neoplasia (CIN)2/3 was confirmed. Women completed questionnaires at recruitment and after 12, 18, 24 and 30 months. Outcomes were prevalence of worries at each time-point (point prevalence) and at any time-point during follow-up (12-30 months; cumulative prevalence). Primary analysis was by intention-to-treat (ITT); secondary per-protocol analysis compared groups according to management received among women with an abnormal transformation zone. RESULTS: Cumulative prevalence of worries was: cervical cancer 40%; having sex 26%, future fertility 24%, and general health 60%. In ITT analyses, there were no statistically significant differences between management arms in cumulative or point prevalence of any of the worries. In per-protocol analyses, between-group differences were significant only for future fertility; cumulative prevalence was highest in women who underwent punch biopsies and treatment. CONCLUSIONS: There is no difference in the prevalence of specific worries in women randomised to alternative post-colposcopy management policies. ISRCTN: 34841617.


Assuntos
Neoplasia Intraepitelial Cervical/patologia , Neoplasia Intraepitelial Cervical/psicologia , Colo do Útero/patologia , Colposcopia/psicologia , Detecção Precoce de Câncer/psicologia , Adulto , Biópsia por Agulha , Neoplasia Intraepitelial Cervical/cirurgia , Detecção Precoce de Câncer/métodos , Feminino , Seguimentos , Humanos , Pessoa de Meia-Idade , Reino Unido , Adulto Jovem
20.
J Clin Virol ; 76 Suppl 1: S74-S80, 2016 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-26589584

RESUMO

BACKGROUND: Revised Australian guidelines have been announced under the Renew(®) program to commence screening at 25 years of age with HPV testing in 5-yearly intervals, in 2017. We conducted a study of young Victorian women to assess attitudes towards a change in cervical screening practice. METHODS: An online survey was conducted of young women aged 16-28 years enrolled in the Young Female Health Initiative (YFHI) study at the Royal Women's Hospital, Melbourne, to assess attitudes towards delaying the age of cervical screening, widening screening intervals and screening with HPV DNA testing, prior to the announcement of the renewal. RESULTS: Of 149 respondents (response rate 75%), mean age was 23.2 (range 16-27) years. Most (85/131, 65%) were concerned about delaying the age of cervical screening until 25 years. The majority (79% (106/135) were willing to undertake primary screening with HPV testing, whilst 66% (88/133) were willing to undertake HPV testing from 25 years, only 34% (45/132) were willing to undertake such screening every five years. Those willing to change screening practice were more likely to perceive that people important to them would expect them to do so; to have been vaccinated; and to value the importance of national guidelines (p≤0.05). While 69% (95/136) of participants indicated that a positive HPV test would be a source of worry, 76% (103/136) reported they would not feel ashamed about it. CONCLUSION: Targeted health campaigns are needed to address the concerns of young women prior to the introduction of new cervical screening guidelines in 2017.


Assuntos
Neoplasia Intraepitelial Cervical/psicologia , Programas de Rastreamento/psicologia , Papillomaviridae/isolamento & purificação , Infecções por Papillomavirus/psicologia , Neoplasias do Colo do Útero/psicologia , Adolescente , Adulto , Austrália , Neoplasia Intraepitelial Cervical/complicações , Neoplasia Intraepitelial Cervical/diagnóstico , Neoplasia Intraepitelial Cervical/prevenção & controle , Colposcopia/psicologia , Colposcopia/estatística & dados numéricos , Detecção Precoce de Câncer/métodos , Feminino , Testes de DNA para Papilomavírus Humano , Humanos , Programas de Rastreamento/legislação & jurisprudência , Teste de Papanicolaou/psicologia , Teste de Papanicolaou/estatística & dados numéricos , Papillomaviridae/classificação , Papillomaviridae/genética , Infecções por Papillomavirus/complicações , Infecções por Papillomavirus/diagnóstico , Infecções por Papillomavirus/prevenção & controle , Vacinas contra Papillomavirus/administração & dosagem , Guias de Prática Clínica como Assunto , Inquéritos e Questionários , Fatores de Tempo , Neoplasias do Colo do Útero/complicações , Neoplasias do Colo do Útero/diagnóstico , Neoplasias do Colo do Útero/prevenção & controle , Vacinação/psicologia , Esfregaço Vaginal/psicologia , Esfregaço Vaginal/estatística & dados numéricos
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