French D P, Maissi E, Marteau T M
Department of Psychology (at Guy's), Institute of Psychiatry, Kings College London, UK.
Br J Cancer. 2004 Nov 29;91(11):1887-92. doi: 10.1038/sj.bjc.6602224.
The purpose of the study is to investigate, for the first time, the psychological impact of an inadequate smear test result. A prospective questionnaire design was used, and the setting was a single English cervical screening laboratory. Two groups of women receiving either a normal test result (n=226) or either a first or nonconsecutive inadequate smear test result (n=180) participated. The main outcome measures included State anxiety (STAI) and concern about test result, assessed within 4 weeks of receipt of results, and attendance for a repeat cervical smear within 3 months. Compared to women with normal test results, women with inadequate smear test results had higher state anxiety (P=0.025), were more concerned about their results (P<0.001), perceived themselves to be at higher risk of cervical cancer (P=0.016), and felt less satisfied with the information they had received about their test results (P<0.001). The only predictor of attendance for a repeat smear test following an inadequate smear test result was state anxiety (P=0.011): nonattenders had higher levels of state anxiety in response to their initial test results. In conclusion, in this first study to assess the psychological impact of receiving an inadequate smear test result, we have shown that it raises state anxiety and concern to levels similar to those found in women with abnormal smear test results. Of particular concern is that anxious women are less likely to attend for a repeat smear test within the recommended time frame. Given the millions of women each year receiving this test result, research is now needed to ascertain how the anxiety associated with this result can be avoided.
本研究的目的是首次调查涂片检查结果不合格所产生的心理影响。采用前瞻性问卷调查设计，研究地点为英国一家单一的宫颈筛查实验室。两组女性参与了研究，一组为检查结果正常的女性（n = 226），另一组为首次或非连续涂片检查结果不合格的女性（n = 180）。主要测量指标包括状态焦虑（STAI）和对检查结果的担忧，在收到结果后的4周内进行评估，以及在3个月内进行重复宫颈涂片检查的出勤率。与检查结果正常的女性相比，涂片检查结果不合格的女性状态焦虑更高（P = 0.025），对自己的检查结果更担忧（P < 0.001），认为自己患宫颈癌的风险更高（P = 0.016），并且对所收到的关于检查结果的信息不太满意（P < 0.001）。涂片检查结果不合格后进行重复涂片检查出勤率的唯一预测因素是状态焦虑（P = 0.011）：未出勤者对其初始检查结果的状态焦虑水平更高。总之，在这项首次评估涂片检查结果不合格所产生心理影响的研究中，我们发现它会使状态焦虑和担忧程度升高，达到与涂片检查结果异常的女性相似的水平。特别令人担忧的是，焦虑的女性在推荐的时间范围内进行重复涂片检查的可能性较小。鉴于每年有数百万女性收到这样的检查结果，现在需要开展研究以确定如何避免与该结果相关的焦虑。
