Impact of different educational interventions on psychosocial well-being of women with a positive high-risk human papillomavirus and normal cervical cytology: a randomised trial

Abstract

Introduction: The aim of this study was to compare the effect of two educational interventions on the psychosocial well-being of Hong Kong Chinese women who have a positive high-risk human papillomavirus (HPV) test and normal cervical cytology.

Methods: Participants were randomised into either leaflet group, in which a written HPV factsheet was provided; or counselling group, in which a didactic HPV presentation in person in addition to the factsheet was provided. Women’s psychological conditions were assessed by self-administered questionnaires at pre, post (within one week) and 6 months after the educational interventions. Main outcome measures were psychosocial well-being (cervical cancer worry, anxiety and depression, screening-related anxieties, HPV-related shame) and knowledge of cervical screening and HPV.

Results: Data from 121 women (52 in leaflet group; 69 in counselling group) were analysed. There was no significant difference in the psychosocial well-being between the two groups at alltime points. Irrespective of the two educational interventions, cervical cancer worry and anxiety decreased over time. The counselling group had a significantly higher score in knowledge of cervical screening and HPV compared with leaflet group (mean score 4.65 ± 0.19 versus 3.71 ± 0.23, p = 0.002) at post-educational intervention, but there was no significant difference (mean score 4.14 ± 0.22 versus 3.58 ± 0.24, p = 0.084) at 6 months.

Discussion: Both educational interventions were comparable in relieving adverse HPV-related psychosocial effects. Combination of counselling and leaflet were more effective than leaflet only in improving women’s knowledge on cervical screening and HPV soon after educational interventions but the benefit was not apparent after 6 months.

Keywords:

• Cervical screening
• education
• general gynaecology
• human papillomavirus
• psychological well-being

Disclosure statement

This study was funded by the Research Fund of the Department of Obstetrics & Gynaecology, the University of Hong Kong. The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the article.

Current knowledge of this subject

• A positive HPV result raises anxiety and fear of cancer in women.

• Sexually transmitted nature of HPV commonly leads to concerns about sexual and reproductive function, worries about impact on intimate relationship and fear of stigma.

• Women’s perceptions and reactions towards a positive HPV result may be positively modulated when their information needs are met.

What this study adds

• Combination of counselling and leaflet were better than leaflet only in improving women’s knowledge on cervical screening and HPV soon after educational interventions, but the difference was not apparent after 6 months.

• Cervical cancer worry and women’s anxiety decreased over time in both leaflet and counselling groups.

• Both educational approaches may generate similar results in relieving adverse HPV-related psychosocial effects.

Additional information

Funding

This study was funded by the Research Fund of the Department of Obstetrics & Gynaecology, the University of Hong Kong.