title: Physical after-effects of colposcopy and related procedures, and their inter-relationship with psychological distress: a longitudinal survey.
abstract: OBJECTIVE
  To estimate prevalence of post-colposcopy physical after-effects and investigate associations between these and subsequent psychological distress.
  
  
  METHODS
  Longitudinal survey.
  
  
  METHODS
  Two hospital-based colposcopy clinics.
  
  
  METHODS
  Women with abnormal cytology who underwent colposcopy (±related procedures).
  
  
  METHODS
  Questionnaires were mailed to women 4, 8 and 12 months post-colposcopy. Details of physical after-effects (pain, bleeding and discharge) experienced post-colposcopy were collected at 4 months. Colposcopy-specific distress was measured using the Process Outcome-Specific Measure at all time-points. Linear mixed-effects regression was used to identify associations between physical after-effects and distress over 12 months, adjusting for socio-demographic and clinical variables.
  
  
  METHODS
  Prevalence of post-colposcopy physical after-effects. Associations between the presence of any physical after-effects, awareness of after-effects, and number of after-effects and distress.
  
  
  RESULTS
  Five-hundred and eighty-four women were recruited (response rate = 73, 59 and 52% at 4, 8 and 12 months, respectively). Eighty-two percent of women reported one or more physical after-effect(s). Multiple physical after-effects were common (two after-effects = 25%; three after-effects = 25%). Psychological distress scores declined significantly over time. In adjusted analyses, women who experienced all three physical after-effects had on average a 4.58 (95% CI: 1.10-8.05) higher distress scored than those who experienced no after-effects. Women who were unaware of the possibility of experiencing after-effects scored significantly higher for distress during follow-up.
  
  
  CONCLUSIONS
  The prevalence of physical after-effects of colposcopy and related procedures is high. The novel findings of inter-relationships between awareness of the possibility of after-effects and experiencing multiple after-effects, and post-colposcopy distress may be relevant to the development of interventions to alleviate post-colposcopy distress.
  
  
  CONCLUSIONS
  Experiencing multiple physical after-effects of colposcopy is associated with psychological distress.
authors.affiliation: National Cancer Registry Ireland, Cork, Ireland.
authors.forename: M
authors.initials: M
authors.lastname: O'Connor
authors.affiliation: National Cancer Registry Ireland, Cork, Ireland.
authors.forename: K
authors.initials: K
authors.lastname: O'Brien
authors.affiliation: Department of Behavioural Science and Health, University College London, London, UK.
authors.forename: J
authors.initials: J
authors.lastname: Waller
authors.affiliation: School of Nursing and Human Sciences, Dublin City University, Dublin, Ireland.
authors.forename: P
authors.initials: P
authors.lastname: Gallagher
authors.affiliation: Coombe Women and Infants University Hospital, Dublin 8, Ireland.
authors.forename: T
authors.initials: T
authors.lastname: D'Arcy
authors.affiliation: National Maternity Hospital, Dublin 2, Ireland.
authors.forename: G
authors.initials: G
authors.lastname: Flannelly
authors.affiliation: Coombe Women and Infants University Hospital, Dublin 8, Ireland.
authors.forename: C M
authors.initials: CM
authors.lastname: Martin
authors.affiliation: National Cancer Registry Ireland, Cork, Ireland.
authors.forename: J
authors.initials: J
authors.lastname: McRae
authors.affiliation: Coombe Women and Infants University Hospital, Dublin 8, Ireland.
authors.forename: W
authors.initials: W
authors.lastname: Prendiville
authors.affiliation: Coombe Women and Infants University Hospital, Dublin 8, Ireland.
authors.forename: C
authors.initials: C
authors.lastname: Ruttle
authors.affiliation: Trinity College Dublin, Dublin 2, Ireland.
authors.forename: C
authors.initials: C
authors.lastname: White
authors.affiliation: Coombe Women and Infants University Hospital, Dublin 8, Ireland.
authors.forename: L
authors.initials: L
authors.lastname: Pilkington
authors.affiliation: Coombe Women and Infants University Hospital, Dublin 8, Ireland.
authors.forename: J J
authors.initials: JJ
authors.lastname: O'Leary
authors.affiliation: Institute of Health & Society, Newcastle University, Newcastle upon Tyne, UK.
authors.forename: L
authors.initials: L
authors.lastname: Sharp
mesh_terms: D000328:Adult; D003127:Colposcopy / Q000009:adverse effects* / Q000523:psychology; D005260:Female; D006470:Hemorrhage / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology* / Q000523:psychology; D006801:Humans; D016014:Linear Models; D008137:Longitudinal Studies; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D000073818:Procedural Pain / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology* / Q000523:psychology; D015995:Prevalence; D013315:Stress, Psychological / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology*; D014623:Vaginal Diseases / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology* / Q000523:psychology
keywords: Colposcopy; longitudinal survey; physical after-effects; post-colposcopy distress