Is the provision of information leaflets before colposcopy beneficial? A prospective randomised study

Abstract

Objective To assess the usefulness of a leaflet distributed to women before colposcopy designed to Design Prospective randomised study.Setting Colposcopy clinic of a large district general hospital.Sample Two hundred consecutive women undergoing colposcopy for the first time for a cervical cytological abnormality of severity no greater than moderate dyskaryosis.Methods Women were randomised into one of two groups (leaflet or control). Those in the leaflet group were sent an information leaflet prior to attending the clinic. In the colposcopy clinic all the women completed a Statenrait Anxiety Inventory (StAVTrAI) and a modified psychosexual questionnaire before undergoing colposcopy. This was repeated at the six-month follow up visit. Women in the leaflet group also completed a further questionnaire on the leaflet.Main outcome measures Differences of anxiety and psychosexual scores between leaflet and control groups. ResultsThe leaflet was well received. There were no statistical differences in StAI and TrAI scores between the study group and the control group at either visit, although in the whole study population StAI and TrAI scores were reduced at the second visit. The leaflet group had significantly more psychosexual problems but by the second visit, the scores had improved and the two groups were similar. When the mean differences in anxiety and psychosexual scores at the initial and second visits were compared between the groups, the reduction in negative sexual feelings and deterioration of TrAI scores experienced by the leaflet group was significant. ConclusionsThis study suggests that the provision of sending an information leaflet prior to colposcopy is not beneficial in isolation. Other approaches need to be considered.reduce their anxiety and psychosexual morbidity by providing information.

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“…[4][5][6][7][8][9][10] However, the ideal way of providing this information is unclear. Although verbal information given by the clinician is the most common method, written material, 11 leaflets, 12 booklets, 13 audiotapes, 8 or video-based education have also been proposed. 4,6,11 Several studies have addressed the effect of video-based education on anxiety in patients undergoing different types of procedures.…”

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“…Moreover, they believe little or no information is provided by their primary care team and 43% had no knowledge at all about the colposcopy (4,12). This lack of information can result in high levels of anxiety and distress (4)(5)(6)(7)(8)24).…”

“…This lack of information can result in high levels of anxiety and distress (4)(5)(6)(7)(8)24). Various authors have advocated the provision of adequate information (4,8,12). Written information can improve compliance to follow-up after colposcopy (8).…”

“…To improve knowledge scores and satisfaction, pre-colposcopy discussion sessions in which detailed information is provided have proven to be effective. Pre-colposcopic counselling sessions were not associated with anxiety reduction (8,12).…”

“…Anxiety is also reduced when information videos are shown prior to colposcopy (8,10,11). Information leaflets increase knowledge levels, which is important for obtaining clinical consent to the colposcopy and for reducing psychosexual dysfunction (8,10,12). To improve knowledge scores and satisfaction, pre-colposcopy discussion sessions in which detailed information is provided have proven to be effective.…”