1. Exploring reasons for variations in anxiety after testing positive for human papillomavirus with normal cytology: a comparative qualitative study
- Author
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Jo Waller, Laura A.V. Marlow, Kirsty F Bennett, Emily McBride, and Selma Stearns
- Subjects
Adult ,Paper ,HPV ,cervical cancer ,media_common.quotation_subject ,Emotions ,Uterine Cervical Neoplasms ,Experimental and Cognitive Psychology ,Anxiety ,psychology ,03 medical and health sciences ,0302 clinical medicine ,Surveys and Questionnaires ,medicine ,Humans ,Mass Screening ,cancer ,cervical screening ,030212 general & internal medicine ,Papillomaviridae ,Early Detection of Cancer ,media_common ,Vaginal Smears ,Cervical cancer ,Cervical screening ,Papillomavirus Infections ,Middle Aged ,Uterine Cervical Dysplasia ,medicine.disease ,Mental health ,Psychiatry and Mental health ,Locus of control ,Oncology ,psycho‐oncology ,030220 oncology & carcinogenesis ,Papers ,cytology ,Female ,medicine.symptom ,Worry ,Attribution ,Psychology ,Stress, Psychological ,mental health ,Qualitative research ,Clinical psychology - Abstract
Objective To explore reasons for variations in anxiety in women testing positive for human papillomavirus (HPV) with normal cytology at routine HPV primary cervical cancer screening. Methods In‐depth interviews were conducted with 30 women who had tested HPV‐positive with normal cytology, including 15 with low‐to‐normal anxiety and 15 with high anxiety. Data were analysed using Framework Analysis to compare themes between low and high anxiety groups. Results Several HPV‐related themes were shared across anxiety groups, but only highly anxious women expressed fear and worry, fatalistic cognitions about cancer, fertility‐related cognitions, adverse physiological responses and changes in health behaviour(s). In comparison to those with low anxiety, women with high anxiety more strongly voiced cognitions about the 12‐month wait for follow‐up screening, relationship infidelity, a lower internal locus of control and HPV‐related symptom attributions. Conclusions Receiving an HPV‐positive with normal cytology result related to various emotional, cognitive, behavioural and physiological responses; some of which were specific to, or more pronounced in, women with high anxiety. If our observations are confirmed in hypothesis‐driven quantitative studies, the identification of distinct themes relevant to women experiencing high anxiety can inform targeted patient communications and HPV primary screening implementation policy., Highlights To our knowledge, this is the first qualitative study to explore anxiety in women testing human papillomavirus (HPV)‐positive with normal cytology at routine HPV primary screening.Our comparative qualitative design allowed thematic nuances to emerge between women who had experienced low versus high anxiety following their result.Only highly anxious women expressed fear and worry, fatalistic cognitions about cancer, fertility‐related cognitions, adverse physiological responses and changes in health behaviour(s).Highly anxious women also more strongly voiced cognitions about the 12‐month wait for follow‐up screen, reltionship infidelity, a lower internal locus of control and HPV‐related symptom attributions.These distinct themes can be used to minimise unnecessary anxiety through the development of evidence‐based patient communications at HPV primary screening.
- Published
- 2020