HPV testing versus repeat Pap testing for the management of a minor abnormal Pap smear: Evaluation of a decision aid to support informed choice
| Autor: | Judith Clarke, Petra Macaskill, Les Irwig, Kirsten McCaffery, Alexandra Barratt, Siew F Chan, Edith Weisberg, Mary Lewicka |
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| Rok vydání: | 2008 |
| Předmět: |
Adult
medicine.medical_specialty Adolescent Minor (academic) Decisional conflict Choice Behavior Decision Support Techniques Young Adult Abnormal PAP Smear Patient Education as Topic Surveys and Questionnaires Humans Mass Screening Medicine Pap test Vaginal Smears Gynecology Colposcopy Analysis of Variance Informed Consent Cervical screening medicine.diagnostic_test business.industry Papillomavirus Infections Australia General Medicine Middle Aged Uterine Cervical Dysplasia Triage female genital diseases and pregnancy complications Preference Family medicine Regression Analysis Female Patient Participation business Follow-Up Studies Papanicolaou Test |
| Zdroj: | Patient Education and Counseling. 73:473-481 |
| ISSN: | 0738-3991 |
| DOI: | 10.1016/j.pec.2008.07.021 |
| Popis: | Objective To examine women's informed preference for the management of a mildly abnormal Pap smear and the impact of a decision aid. Methods Women ( n =106) were given a choice of management supported by a decision aid and surveyed before, and after decision making to evaluate predictors of choice and decision aid impact. Results HPV triage was preferred by most women (65%) although a substantial minority selected repeat Pap testing (35%). Women who chose HPV triage were more likely to have had children, have had a previous abnormal Pap smear and were more distressed than women who chose a repeat Pap test. In total, 68% of women made an informed choice. Rapid timing of follow-up was important for women choosing HPV testing. The lower chance of colposcopy and greater opportunity for regression, were rated as important by women choosing Pap testing. Decisional conflict was lower among women who chose HPV triage. No other differences in short-term psychological outcomes were found. Conclusion The decision aid supported informed choice among the majority of women. Women tailored their choice to their practical, health and psychological needs. Practice implications Offering women an informed choice for a mildly abnormal Pap smear may enable women to select the management that best suits their circumstances. |
| Databáze: | OpenAIRE |
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