Women's differing experiences of distress following colposcopy and related procedures: a qualitative interview study

Background: Women with abnormal cervical cytology may be referred for a colposcopy examination. Distress prior to and during colposcopy has been widely researched. Less is known about psychological wellbeing post-colposcopy and what influences this. This exploratory study aimed to identify factors associated with psychological distress post-colposcopy.

Aims: In-depth semi-structured interviews were undertaken with 23 women who had undergone colposcopies +/- related procedures. Interview transcripts were analysed thematically using the Framework Approach.

Results: Four groups emerged from analysis: (1) women with short-term distress; (2) women with long-term distress; (3) women with both short- and long-term distress; and (4) women without distress. Group 1 felt unprepared for how their colposcopy would feel and what it entailed. These women experienced distress during the investigation, found the physical experience particularly painful and had often attended the clinic alone. Group 2 had fertility worries, physical after-effects that impacted on their lives, and were still attending the clinic for follow-up. Group 3 had factors that overlapped with those of Groups 1 and 2. Group 4 felt reasonably prepared for the procedure, did not find it as bad as they had anticipated, and were accompanied to the clinic by a spouse/partner/friend.

Conclusions: Colposcopy/related procedures can lead to short-term and long-term post-procedural distress among some women. Our results suggest a lack of sensory and procedural preparation, lack of support while attending the clinic, fertility worries and on-going monitoring/follow-up may influence distress. There is an urgent need to develop targeted psycho-educational interventions to help alleviate this distress.