School of Psychology, National University of Ireland, Galway, Ireland.
Psychooncology. 2012 Mar;21(3):291-6. doi: 10.1002/pon.1895. Epub 2010 Dec 20.
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.
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.
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).
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.
患者对治疗建议的依从性是宫颈癌筛查计划有效性的一个重要因素。心理因素可能在患者对宫颈癌筛查的依从性中发挥作用。本研究旨在通过检查在阴道镜检查时测量的可能预测的生物心理社会变量以及从患者病历中获得的客观出勤率，来扩展女性对随访阴道镜检查依从性的认识。
在 141 名女性首次接受阴道镜检查之前（M 年龄=29.63，SD=8.39）收集了心理社会因素的基线数据（例如人口统计学变量、状态焦虑和疼痛）。随后评估了阴道镜检查的经验和随访（在两年内）的依从性。
依从性与人口统计学变量之间没有关联。患有重度发育不良的女性比患有其他组织学分级的女性更有可能遵循随访阴道镜检查。未接受随访的女性在阴道镜检查后报告的状态焦虑和疼痛不适明显高于接受随访的女性。多变量逻辑回归分析表明，阴道镜检查的心理体验并不能预测依从状态。然而，发育不良的严重程度对该模型有重要贡献。患有重度发育不良的患者接受阴道镜检查的依从率是正常组织学患者的 3.57 倍，是中度发育不良患者的 4.35 倍（p=0.005）。
阴道镜检查相关的经验似乎不是依从性的有力预测因素，但应针对非“严重”发育不良的女性进行随访建议和建议。
