title: Multidimensional associations of pain and anxiety before and after colposcopy.
abstract: OBJECTIVE
  To assess the effect of pre-procedural variables on post-procedural outcomes following colposcopy.
  
  
  METHODS
  A prospective study was conducted at Concord Women's Health Center in Israel between March 1, 2013, and March 31, 2014. Women waiting for colposcopy were approached and asked to complete questionnaires about anxiety, information-seeking patterns, fear associated with the examination, and demographics. After the procedure, participants answered questions about pain and state anxiety. The physician performing the procedure assessed the participant's levels of distress. A path analysis model was constructed.
  
  
  RESULTS
  Path analysis showed direct and indirect effects of both demographic and psychological variables on the main outcome measures. Physician's appraisal was related to fear, information seeking, state anxiety, and pain. Post-procedural state anxiety was related to fear, trait anxiety, pre-procedural state anxiety, past experience, pain, and information seeking. Pain was related to information seeking and age. Information seeking, pre-procedural state anxiety, and subjective pain served as mediators for some of these relationships.
  
  
  CONCLUSIONS
  The effect of various psychological and demographic variables on psychological outcome variables following colposcopy should not be measured independently but rather as inter-related variables.
authors.affiliation: School of Behavioral Sciences, The Academic College of Tel Aviv-Yaffo, Tel Aviv-Yaffo, Israel. Electronic address: jonathanh@013.net.
authors.forename: Jonathan E
authors.initials: JE
authors.lastname: Handelzalts
authors.affiliation: The Helen Schneider Hospital for Women, Rabin Medical Center, Petach-Tikva, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv-Yaffo, Israel.
authors.forename: Haim
authors.initials: H
authors.lastname: Krissi
authors.affiliation: School of Behavioral Sciences, The Academic College of Tel Aviv-Yaffo, Tel Aviv-Yaffo, Israel.
authors.forename: Sigal
authors.initials: S
authors.lastname: Levy
authors.affiliation: School of Behavioral Sciences, The Academic College of Tel Aviv-Yaffo, Tel Aviv-Yaffo, Israel.
authors.forename: Maayan
authors.initials: M
authors.lastname: Broitman
authors.affiliation: The Helen Schneider Hospital for Women, Rabin Medical Center, Petach-Tikva, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv-Yaffo, Israel.
authors.forename: Liat
authors.initials: L
authors.lastname: Binyamin
authors.affiliation: The Helen Schneider Hospital for Women, Rabin Medical Center, Petach-Tikva, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv-Yaffo, Israel.
authors.forename: Yoav
authors.initials: Y
authors.lastname: Peled
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D001007:Anxiety / Q000453:epidemiology* / Q000209:etiology; D003127:Colposcopy / Q000523:psychology*; D005239:Fear / Q000523:psychology; D005260:Female; D006801:Humans; D057226:Information Seeking Behavior; D007557:Israel; D008875:Middle Aged; D010146:Pain / Q000453:epidemiology* / Q000209:etiology; D011446:Prospective Studies; D013315:Stress, Psychological / Q000453:epidemiology* / Q000209:etiology; D011795:Surveys and Questionnaires; D055815:Young Adult
keywords: Anxiety; Cervical cancer; Colposcopy; Distress; Information seeking; Pain