The psychological impact of illness among women experiencing human papillomavirus-related illness or screening interventions

Abstract

The present study describes the psychological impact of human papillomavirus (HPV)-related conditions or preventive interventions on Taiwanese women. Women with an HPV-related diagnosis or intervention within the past 3 months were invited to participate in a cross-sectional survey before the receipt of HPV-related diagnostic results. Participants completed a 29-item HPV impact profile (HIP), which was a questionnaire designed to represent the full spectrum of potential HPV-related impacts. The HIP assesses worries and concerns; emotional impact; sexual impact; self-image; partner issues and transmission; interactions with doctors; and control/life impact. The final sample size was 249 women from three hospitals. The mean HIP score (0-100) was normal Pap: 28.2; abnormal Pap: 44.3; CIN: 47.5; genital warts: 62.5; abnormal Pap with high-risk HPV positive: 48.8. This study indicates that significant psychological impact is found in women diagnosed with abnormal Pap, CIN, high-risk HPV test positive and genital wart compared to women with a normal Pap. Women with genital warts had the highest psychological impact scores. This is the first quantitative data that can lay the ground work for future studies that enable the comparison of the effectiveness of different interventions in alleviating the psychological burden of HPV-associated infection and preventive interventions in Taiwan.

Impact of human papillomavirus-related genital diseases on quality of life and psychosocial wellbeing: results of an observational, health-related quality of life study in the UK

“…The mean total HIP score for women with normal cervical cytology was 22.3, which was similar to mean total scores reported in the studies of Pirotta et al (25.8) [40] and Wang et al (28.2) [41], and about 8 points higher than that observed in the initial validation study for this instrument (14.4) [32]. The apparently elevated HIP scores for women with normal cervical cytology may indicate a negative impact of the cervical screening procedure itself, as observed in studies showing that women undergoing routine gynaecological examinations may experience pain or discomfort, embarrassment, fear, worry, nervousness and inconvenience [42,43].…”

Psychological effects of diagnosis and treatment of cervical intraepithelial neoplasia: a systematic review

“…The opposite was seen in women whose abnormal cytology samples were followed with an HPV-positive test. Also in the Taiwanese study by Wang et al ,29 receipt of a positive HPV test after abnormal cytology had a similar psychological impact as a histologically confirmed CIN diagnosis. In contrast, the large Chinese study by Wang et al 31 reported that a histological CIN diagnosis had a significantly worse psychosocial impact compared to a diagnosis of an abnormal smear.…”

“…Of these, 15 were consistent with the inclusion criteria; two were from the same study 15 17–27 30–32. Examination of reference lists identified two additional manuscripts published since 1990 28 29. In total, therefore, 17 English-language articles describing 16 studies and published between 1993 and 2011, satisfied our inclusion criteria (see online supplementary figure S1).…”

“…This was the case for distress and state anger in a study by Palmer et al ,17 anxiety about cervical cancer in a study by Salz et al ,30 and ‘psychosocial impact’ (combining, for example, worry about future health and fertility, depression, anxiety, sexual and partnership problems, deterioration of self-image, effect on sleep) in studies by Mast et al 28 in the USA, Pirotta et al 27 in Australia, Wang et al 31 in China and Wang et al 29 in Taiwan. Measured with the latter instrument, the psychosocial impact of a CIN diagnosis was less negative than that of EGW in the two studies undertaken in Chinese-speaking populations and in the US study 28 29 31. In the Australian study, no differences were found for psychosocial impact and quality of life between women with CIN2/3 and women with EGW 27…”

Impact of Human Papillomavirus-Related Lesions on Quality of Life: A Multicenter Hospital-Based Study of Women in Mainland China

“…When the mean total HIP score was less than 40, it indicated no or little impact; when between 40 and 70, it indicated moderate impact; and above 70, it indicated heavy psychosocial impact. 12 The Chinese version of the HIP questionnaire was generated through a standard linguistic validation process, which included translation, back translation, comparison, review, consolidation, and pilot field testing. 12,13 Quality control was performed throughout the project; we trained the local interviewers before the project started, provided all participants with a letter of introduction describing selfadministration to obtain a more uniform standard for ques-tionnaires, and performed regular daily quality control to ensure the completion of the questionnaires and accuracy of data entry.…”