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  • 1
    Language: English
    In: Archives of Gynecology and Obstetrics, 2016, Vol.293(2), pp.391-398
    Description: Byline: Fabinshy Thangarajah (1), Thomas Einzmann (1), Florian Bergauer (2), Jan Patzke (3), Silke Schmidt-Petruschkat (3), Monika Theune (4), Katja Engel (3), Julian Puppe (1), Lisa Richters (1), Peter Mallmann (1), Verena Kirn (1) Keywords: Pap smear; Psychological impact; Cervical cancer screening Abstract: Purpose Invasive cervical cancer is today the fourth most common cancer of women in western civilization. Screening programs have led to a continuously decrease. Nevertheless, both screening and a positive test result are known to be associated with a negative psychological impact. Screening programs in European countries differ and thus psychological impact might as well. The aim of this study was to evaluate the psychological impact of women with an abnormal Pap smear in a German cohort. Methods Between July 2013 and May 2014, a self-assessment questionnaire was distributed to 595 patients that were referred to a special clinic for cervical dysplasia for further evaluation of an abnormal Pap smear. Patients were recruited in five different centers. Results Most patients (45.9 %) were informed about the test result via phone call by their doctor. 68.8 % of the patients felt anxious and 26.3 % even felt panic. After having talked to their physician, 51.4 % of our cohort still felt worried and only 24.4 % felt reassured. Concerning disease management, 48.4 % underwent a control Pap smear in 6 months. The preferred information source was the physician (63.9 %). Compared to the results in other European countries, our study cohort showed differences concerning age distribution, patients living in a partnership, number of children and especially disease management. Conclusion Cancer screening itself and abnormal test results have an impact on patient's feelings. To reduce the psychological impact, patients need to be better informed about the risks and benefits of cancer screening programs and in case of cervical cancer screening about the meaning of an abnormal test result. Our results underline the importance of a trustful physician--patient relationship in that matter. Author Affiliation: (1) Department of Obstetrics and Gynecology, University of Cologne, Kerpener Stra[sz]e 34, 50931, Cologne, Germany (2) Amedes MVZ for Gynecology and Pathology Munich GmbH, Maximillianstra[sz]e 38, 80539, Munich, Germany (3) MVZ Institute for Clinical Genetics, Pathology and Cytology Nordrhein GmbH in the Protestant Hospital of Oberhausen, Virchowstra[sz]e 20, 46047, Oberhausen, Germany (4) Amedes MVZ Wagnerstibbe for Gynecology, Reproductive Medicine, Cytology, Pathology and Internal Medicine, Hannoversche Str. 24, 31848, Bad Muenster, Germany Article History: Registration Date: 13/07/2015 Received Date: 14/04/2015 Accepted Date: 13/07/2015 Online Date: 23/07/2015 Article note: Electronic supplementary material The online version of this article (doi: 10.1007/s00404-015-3821-z) contains supplementary material, which is available to authorized users.
    Keywords: Pap smear ; Psychological impact ; Cervical cancer screening
    ISSN: 0932-0067
    E-ISSN: 1432-0711
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  • 2
    Language: English
    In: Archives of gynecology and obstetrics, February 2016, Vol.293(2), pp.391-8
    Description: Invasive cervical cancer is today the fourth most common cancer of women in western civilization. Screening programs have led to a continuously decrease. Nevertheless, both screening and a positive test result are known to be associated with a negative psychological impact. Screening programs in European countries differ and thus psychological impact might as well. The aim of this study was to evaluate the psychological impact of women with an abnormal Pap smear in a German cohort. Between July 2013 and May 2014, a self-assessment questionnaire was distributed to 595 patients that were referred to a special clinic for cervical dysplasia for further evaluation of an abnormal Pap smear. Patients were recruited in five different centers. Most patients (45.9 %) were informed about the test result via phone call by their doctor. 68.8 % of the patients felt anxious and 26.3 % even felt panic. After having talked to their physician, 51.4 % of our cohort still felt worried and only 24.4 % felt reassured. Concerning disease management, 48.4 % underwent a control Pap smear in 6 months. The preferred information source was the physician (63.9 %). Compared to the results in other European countries, our study cohort showed differences concerning age distribution, patients living in a partnership, number of children and especially disease management. Cancer screening itself and abnormal test results have an impact on patient's feelings. To reduce the psychological impact, patients need to be better informed about the risks and benefits of cancer screening programs and in case of cervical cancer screening about the meaning of an abnormal test result. Our results underline the importance of a trustful physician-patient relationship in that matter.
    Keywords: Cervical Cancer Screening ; Pap Smear ; Psychological Impact ; Anxiety -- Psychology ; Early Detection of Cancer -- Methods ; Papanicolaou Test -- Psychology ; Uterine Cervical Dysplasia -- Diagnosis ; Uterine Cervical Neoplasms -- Diagnosis ; Vaginal Smears -- Psychology
    ISSN: 09320067
    E-ISSN: 1432-0711
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  • 3
    Language: English
    In: Archives of Gynecology and Obstetrics, 2014, Vol.289(4), pp.755-763
    Description: Purpose Depression during and after pregnancy can have a negative impact on women’s quality of life and on the development of the newborn child. Interventions have been shown to have a positive influence on both mothers and children. Predictive factors for depressive symptoms might possibly be able to identify groups that are at high risk. The aim of this study was to investigate the value of socioeconomic factors in predicting depressive symptoms during and after pregnancy. Methods Depressiveness was measured using the German version of the 10-item Edinburgh Postnatal Depression Scale (EPDS) at three time-points, in a prospective cohort study (n = 1,100). Visit 1 (Q1) was at study entry in the third trimester of the pregnancy, visit 2 (Q2) was shortly after birth, and visit 3 (Q3) was 6–8 months after birth. Depression scores were associated with socioeconomic factors and time in linear mixed models. Results Parity status, education status, monthly income, residential property status, and partnership status, as well as interactions between them, were found to be predictive factors for EPDS scores. The strongest factor influencing depressive symptoms was partnership status. Women who did not have an intact partnership had EPDS scores that were on average four points higher than in women with a partner at all three study visits (P 〈 0.000001). Conclusions Socioeconomic factors define subgroups that have different depression scores during and after pregnancy. Partnership status appears to be one of the most important influencing factors and could be useful for identifying women who should be offered an intervention to prevent possible negative effects on the mother or child.
    Keywords: Pregnancy ; Depression ; Socioeconomic factors ; Prediction
    ISSN: 0932-0067
    E-ISSN: 1432-0711
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  • 4
    Language: English
    In: Archives of Gynecology and Obstetrics, 2014, Vol.289(4), p.755(9)
    Description: Byline: Alexander Hein (1), Claudia Rauh (1), Anne Engel (1), Lothar Haberle (1), Ulf Dammer (1), Franziska Voigt (1,2), Peter A. Fasching (1), Florian Faschingbauer (1), Pascal Burger (3), Matthias W. Beckmann (1), Johannes Kornhuber (3), Tamme W. Goecke (1,2) Keywords: Pregnancy; Depression; Socioeconomic factors; Prediction Abstract: Purpose Depression during and after pregnancy can have a negative impact on women's quality of life and on the development of the newborn child. Interventions have been shown to have a positive influence on both mothers and children. Predictive factors for depressive symptoms might possibly be able to identify groups that are at high risk. The aim of this study was to investigate the value of socioeconomic factors in predicting depressive symptoms during and after pregnancy. Methods Depressiveness was measured using the German version of the 10-item Edinburgh Postnatal Depression Scale (EPDS) at three time-points, in a prospective cohort study (n = 1,100). Visit 1 (Q1) was at study entry in the third trimester of the pregnancy, visit 2 (Q2) was shortly after birth, and visit 3 (Q3) was 6--8 months after birth. Depression scores were associated with socioeconomic factors and time in linear mixed models. Results Parity status, education status, monthly income, residential property status, and partnership status, as well as interactions between them, were found to be predictive factors for EPDS scores. The strongest factor influencing depressive symptoms was partnership status. Women who did not have an intact partnership had EPDS scores that were on average four points higher than in women with a partner at all three study visits (P 〈 0.000001). Conclusions Socioeconomic factors define subgroups that have different depression scores during and after pregnancy. Partnership status appears to be one of the most important influencing factors and could be useful for identifying women who should be offered an intervention to prevent possible negative effects on the mother or child. Author Affiliation: (1) Department of Gynecology and Obstetrics, Erlangen University Hospital, Friedrich-Alexander University of Erlangen-Nuremberg, Universitaetsstrasse 21--23, 91054, Erlangen, Germany (2) Department of Gynecology and Obstetrics, Medical Faculty, University of Technology Aachen, Pauwelsstrasse 30, 52074, Aachen, Germany (3) Department of Psychiatry and Psychotherapy, Erlangen University Hospital, Friedrich-Alexander University of Erlangen-Nuremberg, Schwabachanlage 6, 91054, Erlangen, Germany Article History: Registration Date: 27/09/2013 Received Date: 14/01/2013 Accepted Date: 27/09/2013 Online Date: 12/10/2013
    Keywords: Pregnant Women – Analysis ; Pregnancy – Analysis ; Depression (Mood Disorder) – Analysis ; Real Estate Industry – Analysis
    ISSN: 0932-0067
    E-ISSN: 14320711
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  • 5
    Language: English
    In: Archives of Gynecology and Obstetrics, 2012, Vol.286(6), pp.1407-1412
    Description: To compare depressiveness scores, both during and after pregnancy, with the delivery mode (DM).In a longitudinal, prospective study, standardized questionnaires for the Edinburgh Postnatal Depression Scale were presented to 1,100 women and used to assess the presence and severity of depressiveness at three time points: prenatal, from the 30th gestational week (Q1); 48–72 h postnatal (Q2); and 6–8 months postnatal (Q3). The patients were divided into four groups relative to DM: spontaneous delivery, primary cesarean section (CS), secondary CS, and assisted vaginal delivery. The final number of participating women with both delivery mode and depression information for all three time points was 753.There was a significant difference of the mean EPDS values between the spontaneous delivery and primary CS groups (P = 0.04) at Q1 (5.1 vs. 6.3). None of the other comparisons was significant. Significant differences relative to DM were seen at Q2 (P 〈 0.0001), but there were no significant differences between the patient groups at Q3 (P = 0.54).DM only showed coherence with the extent of depression briefly during the peripartal period. A relationship was found between depressiveness during pregnancy and DM, with higher depressiveness scores in the group of patients undergoing primary CS. This should be taken into account when patients requesting an elective cesarean section are being counseled.
    Keywords: Depression ; Delivery mode ; Cesarean section ; Assisted vaginal delivery
    ISSN: 0932-0067
    E-ISSN: 1432-0711
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