title: Distress after an abnormal Pap smear result: scale development and psychometric validation.
abstract: BACKGROUND
  Psychological distress is severe in women who receive a report of abnormal findings on Pap smear, and may be one reason 10-61% of such women fail to undergo follow-up testing.
  
  
  METHODS
  Using the 14-question Psychosocial Effects of Abnormal Pap Smears Questionnaire (PEAPS-Q) as a basis, we developed the 23-question Cervical Dysplasia Distress Questionnaire (CDDQ), testing its internal consistency and validity with 661 women undergoing colposcopy after an abnormal Pap smear finding in a three-phase analysis.
  
  
  RESULTS
  Items were divided into two sets and factor analyzed separately: one addressed distress during medical procedures, and the other concerned perceived consequences of an abnormal Pap smear. The medical procedures items yielded two factors: embarrassment regarding the procedures and discomfort/tension with the procedures. Factor analysis of the second set also resulted in two factors: concern about sexual and reproductive issues and concern about health consequences. Subscales created from items loading highly on each factor had high internal consistency (alpha ranged from 0.76 to 0.90) and demonstrated good concurrent validity with other psychometrically validated measures of distress.
  
  
  CONCLUSIONS
  The CDDQ is a reliable and valid questionnaire for measuring multiple domains of distress unique to women who test positive on a cervical cancer screening test.
authors.affiliation: Department of Behavioral Science, M.D. Anderson Cancer Center, The University of Texas, Houston, TX 77030, USA. eshinn@mdanderson.org
authors.forename: Eileen
authors.initials: E
authors.lastname: Shinn
authors.forename: Karen
authors.initials: K
authors.lastname: Basen-Engquist
authors.forename: Tao
authors.initials: T
authors.lastname: Le
authors.forename: Andrea
authors.initials: A
authors.lastname: Hansis-Diarte
authors.forename: De'Shaunda
authors.initials: D
authors.lastname: Bostic
authors.forename: Jodi
authors.initials: J
authors.lastname: Martinez-Cross
authors.forename: Annette
authors.initials: A
authors.lastname: Santos
authors.forename: Michele
authors.initials: M
authors.lastname: Follen
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004493:Education; D005007:Ethnology; D005260:Female; D006801:Humans; D017533:Marital Status; D008875:Middle Aged; D065006:Papanicolaou Test; D015203:Reproducibility of Results; D013315:Stress, Psychological; D011795:Surveys and Questionnaires / Q000592:standards; D002583:Uterine Cervical Neoplasms / Q000517:prevention & control / Q000523:psychology; D014626:Vaginal Smears / Q000523:psychology*