Providing high quality information about human papillomavirus for women after treatment for high-grade cervical dysplasia
Suzanne Dyson A C , Marian Pitts A , Anthony Lyons A and Robyn Mullins BA Australian Research Centre in Sex, Health and Society, La Trobe University, Melbourne, Vic. 3000, Australia.
B Centre for Behavioural Research in Cancer, Cancer Council Victoria, Carlton, Vic. 3053, Australia.
C Corresponding author. Email: s.dyson@latrobe.edu.au
Sexual Health 7(1) 49-54 https://doi.org/10.1071/SH09059
Submitted: 29 May 2009 Accepted: 10 November 2009 Published: 15 February 2010
Abstract
Background: The present study aimed to inform the production of a resource for women who have had a high-grade cervical abnormality and are scheduled to undergo testing for human papillomavirus (HPV) at their 12-month follow-up. Methods: Two rounds of semi-structured, qualitative interviews were held with women who were attending a gynaecological oncology clinic at a major teaching hospital for women in Melbourne, Australia, 6 months after treatment for cervical intraepithelial neoplasia (CIN) to receive a follow-up Pap test and colposcopy. In an initial round of interviews, we gauged the reactions of 16 women to an existing information brochure containing general information about HPV. Based on the findings from the interviews, a second brochure aimed specifically for women scheduled to undergo HPV testing as part of their post treatment follow-up was drafted. Feedback was then gathered from a further 12 women. Results: While all participants had received some information and counselling about HPV and HPV testing as part of their treatment, many still experienced high levels of stress and anxiety about cancer and the sexually transmissible nature of HPV. Many also still had unanswered questions about HPV, their treatment regime and future prognosis. Conclusion: For a brochure to provide an effective adjunct to counselling, it is essential that it is carefully developed and pilot tested to ensure that it is easily understood and meets the information needs of the target audience. Such materials need to provide both medical and psychosocial information about HPV and be presented in accessible, easy to understand language.
Additional keywords: abnormal Pap test, cervical cancer, high-grade cervical abnormality, high quality information.
Acknowledgements
The authors thank the Professor Michael Quinn and Ms Barbara McBride at Royal Women’s Hospital, Melbourne, and for providing the location for the study, and access to patients attending the dysplasia clinic. Research was carried out by Suzanne Dyson with assistance from PapScreen Victoria recruiter, Bronwyn Nixon. Professor Marian Pitts and Ms Robyn Mullins were also members of the research team. We also thank the women who gave their time to the project and their feedback on the brochures.
[1] Cuzick J, Sasieni P, Davies P, Adams J, Normand C, Frater A, et al. A systematic review of the role of human papillomavirus testing (HPV) in the cervical screening programme. Health Technol Assess 1999; 3 1095–101.
[2]
[3] Hall B, Howard K, McCaffery K. Do cervical cancer screening patient information leaflets meet the HPV information needs of women? Patient Educ Couns 2008; 72 78–87.
| Crossref | GoogleScholarGoogle Scholar | PubMed |
[4] Dehn D, Torroko K, Shroyer K. Human papillomavirus testing and molecular markers of cervical dysplasia and carcinoma. Cancer 2007; 111 1–14.
| Crossref | GoogleScholarGoogle Scholar | CAS | PubMed |
[5] Cuschieri K, Cubie H. The role of human papillomavirus testing in cervical screening. J Clin Virol 2005; 32(suppl. 1): 34–42.
| Crossref | GoogleScholarGoogle Scholar |
[6] Hernadi Z, Szoke K, Sapy T, Krasznai Z, Soos G, Veress G, et al. Role of human papillomavirus (HPV) testing in the follow-up of patients after treatment for cervical precancerous lesions. Eur J Obstet Gyn 2005; 118 229–34.
| Crossref | GoogleScholarGoogle Scholar |
[7] Nobbenhuis M, Meijer C, van den Brule A, Rozendaal L, Voorhorst F, Risse E, et al. Addition of high-risk HPV testing improves the current guidelines on follow-up after treatment for cervical intraepithelial neoplasia. Br J Cancer 2001; 84 796–801.
| Crossref | GoogleScholarGoogle Scholar | CAS | PubMed |
[8] Philips Z, Johnson S, Avis M, Whynes DK. Human papillomavirus and the value of screening: young women’s knowledge of cervical cancer. Health Education Research 2003; 18 318.
| Crossref | GoogleScholarGoogle Scholar | PubMed |
[9] Baer H, Allen S, Braun L. Knowledge of human papillomavirus infection among young adult men and women: implications for health education and research. J Community Health 2000; 25 67–78.
| Crossref | GoogleScholarGoogle Scholar | CAS | PubMed |
[10] Hoover D, Carfioli B, Moench E. Attitudes of adolescent/young adult women toward human papillomavirus vaccination and clinical trials. Health Care Women Int 2000; 21 375–91.
| Crossref | GoogleScholarGoogle Scholar | CAS | PubMed |
[11]
[12] Holcomb B, Bailey JM, Crawford K, Ruffin MT. Adults’ knowledge and behaviors related to human papillomavirus infection. J Am Board Fam Pract 2004; 17 26–31.
| Crossref | GoogleScholarGoogle Scholar | PubMed |
[13] Mays RM, Zimet GD, Winston Y, Kee R, Dickes J, Su L. Human papillomavirus, genital warts, Pap smears, and cervical cancer: knowledge and beliefs of adolescent and adult women. Health Care Women Int 2000; 21 361–74.
| Crossref | GoogleScholarGoogle Scholar | CAS | PubMed |
[14] Waller J, McCaffery K, Forrest S, Szarewski A. Awareness of human papillomavirus among women attending a well woman clinic. Sex Transm Infect 2003; 79 320.
| Crossref | GoogleScholarGoogle Scholar | CAS | PubMed |
[15] Pitts M, Dyson S, Rosenthal D, Garland S. Knowledge and awareness of human papillomavirus (HPV): attitudes towards HPV vaccination among a representative sample of women in Victoria, Australia. Sex Health 2006; 3 4.
[16] Goldsmith MR, Bankhead CR, Kehoe ST, Marsh G, Austoker J. Information and cervical screening: a qualitative study of women’s awareness, understanding and information needs about HPV. J Med Screen 2007; 14 29–33.
| Crossref | GoogleScholarGoogle Scholar | PubMed |
[17] McCaffery K, Forrest S, Waller J, Desai M, Szarewski A, Wardle J. Attitudes towards HPV testing: a qualitative study of beliefs among Indian, Pakistani, African-Caribbean and white British women in the UK. Br J Cancer 2003; 88 42–6.
| Crossref | GoogleScholarGoogle Scholar | CAS | PubMed |
[18] McCaffery K, Wardle JJW. Knowledge, attitudes, and behavioural intentions in relation to the early detection of colorectal cancer in the United Kingdom. Prev Med 2003; 36 525–35.
| Crossref | GoogleScholarGoogle Scholar | PubMed |
[19] McCaffery K, Waller J, Nazroo J, Wardle J. Social and psychological impact of HPV testing in cervical screening: a qualitative study. Sex Transm Infect 2006; 82 169–74.
| Crossref | GoogleScholarGoogle Scholar | CAS | PubMed |
[20] McCaffery K, Waller J, Forrest S, Cadman L, Szarewski A, Wardle J. Testing positive for human papillomavirus in routine cervical screening: examination of psychosocial impact. Br J Obstet Gynaecol 2004; 111 1437–43.
[21] Conaglen H, Hughes R, Conaglen J, Morgan J. A prospective study of the psychological impact on patients of first diagnosis of human papillomavirus. Int J STD AIDS 2001; 12 651–8.
| Crossref | GoogleScholarGoogle Scholar | CAS | PubMed |
[22] Waller J, McCaffery K, Forrest S, Wardle J. Human papillomavirus and cervical cancer: issues for biobehavioural and psychosocial research. Ann Behav Med 2004; 27 68–79.
| Crossref | GoogleScholarGoogle Scholar | PubMed |
[23] Anhang R, Wright T, Smock L, Goldie S. Women’s desired information about human papillomavirus. Cancer 2004; 100 315–20.
| Crossref | GoogleScholarGoogle Scholar | PubMed |
[24] Kools M, Ruiter R, van de Wiel M, Kok G. Testing the usability of access structures in a health education brochure. Br J Health Psychol 2007; 12 525–41.
| Crossref | GoogleScholarGoogle Scholar | PubMed |
[25] Whittingham J, Ruiter R, Castermans D, Huiberts A, Kok G. Designing effective health education materials: experimental pre-testing of a theory-based brochure to increase knowledge. Health Educ Res 2008; 23 414–26.
| Crossref | GoogleScholarGoogle Scholar | PubMed |
