Accepted for/Published in: JMIR Cancer
Date Submitted: Jan 8, 2018
Open Peer Review Period: Jan 10, 2018 - Jul 11, 2018
Date Accepted: Feb 18, 2019
(closed for review but you can still tweet)
Benefit of watching live visual inspection with acetic acid and Lugol on women's anxiety: a randomized controlled trial of an educational intervention conducted in a low-resource setting.
ABSTRACT
Background:
Women undergoing pelvic examination for cervical cancer screening can experience periprocedural anxiety.
Objective:
Our aim was to assess the anxiety level experienced by women undergoing visual inspection with acetic acid and lugol iodine (VIA/VILI) examination, with or without watching the procedure on a digital screen.
Methods:
This prospective study took place at the Dschang District Hospital, Cameroon. HPV-positive women, aged 30-49 years old, were recruited in a cervical cancer screening campaign and invited to participate to the study during the 12-months follow-up control visit, including VIA/VILI examination. Before the procedure, participants were randomized with a 1:1 ratio in a control group (CG) who underwent a pelvic examination in the usual practice and were verbally informed and an intervention group (IG), where participants were verbally informed and watched the procedure live on a digital screen. Women’s anxiety was assessed before and immediately after the exam, using Spielberg’s State Anxiety Inventory (STAI). A two-sided Student t-test and Mann-Whitney Wilcoxon test were used to compare the mean STAI score for each question before and after VIA/VILI.
Results:
A total of 118 women were included in the study (CG: 60, IG: 58). The mean age was 39.1 (±5.2) years. The mean STAI baseline scores before the exam were similar between the two groups (CG: 33.6±10.9, IG: 36.4±11.8, P = .17). The STAI score after pelvic examination was significantly reduced for both groups (CG: 29.3±11.2, IG: 28.5±12.0). Overall, the difference of the STAI score between before and after the pelvic examination was similar for the two groups (IG: 7.9±14.3, CG: 4.2±9.0, P=.1). However, women’s emotional state, such as “I feel secure” and “I feel strained”, were improved in IG as compared to CG (P=.01).
Conclusions:
Watching live VIA/VILI procedure improved the emotional state but did not reduce the periprocedural anxiety. Further larger studies should assess women's satisfaction with watching their pelvic examination in real time to determine if this procedure should be include in VIA/VILI routine practice. Clinical Trial: clinicaltrials.gov, NCT02945111.
Citation
Per the author's request the PDF is not available.
Copyright
© The authors. All rights reserved. This is a privileged document currently under peer-review/community review (or an accepted/rejected manuscript). Authors have provided JMIR Publications with an exclusive license to publish this preprint on it's website for review and ahead-of-print citation purposes only. While the final peer-reviewed paper may be licensed under a cc-by license on publication, at this stage authors and publisher expressively prohibit redistribution of this draft paper other than for review purposes.