An Exploratory Study of the Psychological and Social Effects of the Human Papilloma Virus Test
Keywords:
Uterine cervical neoplasma, psicosocial aspects, DNA probes, HPVAbstract
Objective: To present the psychological and social effects of DNA and HPV exams among women resident in Bogotá; and, the means by which physicians communicate risks to patients. Ten, semi-structured interviews were carried out among women who underwent HPV-DNA examination. Simultaneously, two focus groups were set up: one with general practitioners and the other with gynecologists. Content analysis took place.
Methods: Qualitative study with a phenomenological perspective. Ten semi-structured interviews were conducted with women who underwent HPV testing. Two focus groups were carried out with gynecologists and medical practitioners. A content analysis was performed.
Results: Psychosocial impact has been classified into three categories: emotional; sex life and partner relationship; and, behavior. A model was designed to measure the magnitude of the effects of these determinants. This model is based upon the form and content of the information provided by physicians and by women´s biographical data. The effects encountered included: anxiety, rage, shame, guilt, panic at delayed results, fear of cancer, and fear of sexual relations.
Conclusions: The reasoning to undergo examination should not be based upon fear, but rather on knowledge of infection symptoms and the conviction that the examination is beneficial. Thinking about risk trajectories should play a relevant part in the communication process based on the concept of concerted decision-making.
Author Biographies
Carolina Wiesner Ceballos, Instituto Nacional de Cancerología
Instituto Nacional de Cancerología. Bogotá, Colombia.
Universidad Externado de Colombia. Bogotá, Colombia.
Jesús Acosta Peñaloza, Instituto Nacional de Cancerología
Instituto Nacional de Cancerología. Bogotá, Colombia.
Adriana Díaz del Castillo, Instituto Nacional de Cancerología
Instituto Nacional de Cancerología. Bogotá, Colombia.
Sandra Tovar Murillo, Instituto Nacional de Cancerología
Instituto Nacional de Cancerología. Bogotá, Colombia.
Hernando Salcedo Fidalgo, Universidad Externado de Colombia
Universidad Externado de Colombia. Bogotá, Colombia.
References
Baseman JG, Koutsky LA. The epidemiology of human papillomavirus infections. J Clin Virol. 2005;32 Suppl 1:S16-24.
https://doi.org/10.1016/j.jcv.2004.12.008
Klug SJ, Hukelman M, Blettner M. Knowledge about infection with human papillomavirus: a systematic review. Preventive Medicine 2008;46(2):87-98.
https://doi.org/10.1016/j.ypmed.2007.09.003
Zur Hausen H. Papillomaviruses and cancer: from basic studies to clinical application. Nat Rev Cancer. 2002;2(5):342-50.
https://doi.org/10.1038/nrc798
Muñoz N, Castellsague X, de González AB, Gissmann L. Chapter 1: HPV in the etiology of human cancer. Vaccine. 2006;24 Suppl 3:S3/1-10.
https://doi.org/10.1016/j.vaccine.2006.05.115
Franco EL. Chapter 13: Primary screening of cervical cancer with human papillomavirus tests. J Natl Cancer Inst Monogr. 2003;(31):89-96.
https://doi.org/10.1093/oxfordjournals.jncimonographs.a003488
Castle P. Invited commentary: Is monitoring of human papillomavirus infection for viral persistence ready for use in cervical cancer screening? Am J Epidemiol. 2008;168(2):138-44.
https://doi.org/10.1093/aje/kwn037
Webster A. Innovative Health technologies and the social: redefining health, medicine and the body. Curr Sociol. 2002;50(3):443-57.
https://doi.org/10.1177/0011392102050003009
Screening for Cervical Cancer. Agency for Healthcare research and Quality [Internet]. Rockville: Agency for Healthcare Research and Quality; 2002. [Citado: 2009 Ene 31]. Disponible en: http://www.preventiveservices.ahrq.gov.
Naylor B. The century for cytopathology. Acta Cytol. 2000;44(5):709-25.
https://doi.org/10.1159/000328553
Stoler MK, Schiffman M; Atypical Squamous Cells of Undetermined Significance-Low-grade Squamous Intraepithelial Lesion Triage Study (ALTS) Group. Interobserver reproducibility of cervical cytologic and histologic interpretations: realistic estimates from the ASCUS-L SIL Triage Study. JAMA. 2001; 285(11):1500-5.
https://doi.org/10.1001/jama.285.11.1500
Ronco G, Segnan N, Giorgi-Rossi P, Zappa M, Casadei GP, Carozzi F, et al. Human papillomavirus testing and liquid-based cytology: results at recruitment from the new technologies for cervical cancer randomized controlled trial. J Natl Cancer Inst. 2006;98(11):765-74.
https://doi.org/10.1093/jnci/djj209
Ronco G, Giorgi-Rossi P, Carozzi F, Dalla Palma P, Del Mistro A, De Marco L, et al. Human papillomavirus testing and liquid-based cytology in primary screening of women younger than 35 years: results at recruitment for a randomised controlled trial. Lancet Oncol. 2006;7(7):547-55.
https://doi.org/10.1016/S1470-2045(06)70731-8
Kotaniemi-Talonen L, Nieminen P, Anttila A, Hakama M. Routine cervical screening with primary HPV testing and cytology triage protocol in a randomised setting. Br J Cancer. 2005;93(8):862-7.
https://doi.org/10.1038/sj.bjc.6602799
Mayrand MH, Duarte-Franco E, Coutlee F, Rodrigues I, Walter SD, Ratnam S, et al. Randomized controlled trial of human papillomavirus testing versus Pap cytology in the primary screening for cervical cancer precursors: design, methods and preliminary accrual results of the Canadian cervical cancer screening trial (CCCaST). Int J Cancer. 2006;119(3):615-23.
https://doi.org/10.1002/ijc.21897
McCaffery K, Waller J, Nazroo J, Wardlw J. Social and psychological impact of HPV testing in cervical screening: a qualitative study. Sex Transm Infect. 2006;82(2):169-74.
https://doi.org/10.1136/sti.2005.016436
Da Silva Márquez Ferreira ML, Gimenez MT. Percepción de un grupo de mujeres acerca del hecho de ser portadoras del VPH. Ginecol Obstet Mex. 2005;73(10):531-6.
Kahn JA, Slap GB, Bernstein DI, Kollar LM, Tissot AM, Hillard PA, et al. Psychological, behavioral, and interpersonal impact of human papillomavirus and Pap test results. J Women's Health. 2005;14(7):650-9.
https://doi.org/10.1089/jwh.2005.14.650
Waller J, McCaffery K.J, Kitchener HC, Nazroo J, Wardle J. Women's experiences of repeated HPV testing in the context of cervical cancer screening: a qualitative study. Psychooncology. 2007;16(3):196-204.
https://doi.org/10.1002/pon.1053
Maissi E, Marteau TM, Hankins M, Moss S, Legood R, Gray A. Psychological impact of human papillomavirus testing in women with borderline or mildly dyskaryotic cervical smear test results: cross sectional questionnaire study. BMJ. 2004;328(7451):1293.
https://doi.org/10.1136/bmj.328.7451.1293
Waller J, Marlow LA, Wardle J. The association between knowledge of HPV and feelings of stigma, shame and anxiety. Sex Transm Infect. 2007;83(2):155-9.
https://doi.org/10.1136/sti.2006.023333
Jepson RG, Hewison J, Thompson AGH, Weller D. How should we measure informed choice? The case of cancer screening. J Med Ethics. 2005;31(4):192-6.
https://doi.org/10.1136/jme.2003.005793
Ministerio de la Protección Social; Instituto Nacional de Cancerología. Recomendaciones para la tamización de neoplasias del cuello uterino en mujeres sin antecedentes de patología cervical (preinvasora o invasora) en Colombia, Guía de práctica clínica número 3. Bogotá: Instituto Nacional de Cancerología; 2007.
De la Cuesta C. Estrategias cualitativas más usadas en el campo de la salud. Nure Investigación. 2006:25.
Kahn JA, Slap GB, Bernstein DI, Tissot AM, Kollar LM, Hillard PA, et al. Personal meaning of human papillomavirus and pap test results in adolescent and young adult women. Health Psychology. 2007;26 (2):192-200.
https://doi.org/10.1037/0278-6133.26.2.192
Sainz E, Sainz Sánchez FJ. La interacción comunicativa como representación: La forma del sujeto desde la Teoría de la Atribución. REIS. 1986;33:143-59.
https://doi.org/10.2307/40183193
Anhang R, Wright T, Smock L, Goldi S. Women's desired information about human papillomavirus. Cancer. 2004;100(2):315-20.
https://doi.org/10.1002/cncr.20007
Obregón D. Médicos, prostitución y enfermedades venéreas en Colombia (1986-1951). Historia, Ciências, Saúde. 2002;9 Supl:S161-86.
https://doi.org/10.1590/S0104-59702002000400008
Kitchener HC, Fletcher I, Roberts C, Wheeler P, Almonte M, Maguire P. The psychosocial impact of human papillomavirus testing in primary cervical screening-a study within a randomized trial. Int J Gynecol Cancer 2007;Oct 18 (Epub).
How to Cite
Downloads
Downloads
Issue
Section
License
Todos los derechos reservados.
Article metrics | |
---|---|
Abstract views | |
Galley vies | |
PDF Views | |
HTML views | |
Other views |