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.

Conclusion: 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.

Keywords: Anxiety; Cervical cancer; Colposcopy; Distress; Information seeking; Pain.