Effect of continuous intervention based on the knowledge-attitude-practice theory on the efficacy of 5-aminolevulinic acid photodynamic therapy for patients with high-risk human papillomavirus persistent infection complicated with cervical intraepithelial neoplasia grade Ⅰ

doi:10.3877/cma.j.issn.1674-1358.2025.03.007

Abstract

Abstract:

Objective

To investigate the effect of continuity care intervention based on the knowledge, attitude and practice (KAP) theory on the clinical outcomes of patients with high-risk human papillomavirus (HR-HPV) persistent infection complicated with cervical intraepithelial neoplasia grade Ⅰ (CIN Ⅰ) undergoing aminolevulinic acid photodynamic therapy (ALA-PDT).

Methods

Total of 120 patients with HR-HPV persistent infection and CIN Ⅰ diagnosed at the Dermatovenereology Outpatient Department of Beijing Ditan Hospital, Capital Medical University, from July 1st 2022 to June 30th 2023 were selected by convenience sampling method. Patients were randomly divided into control group (60 cases) and observation group (60 cases) by random number table method. Both groups received ALA-PDT treatment. Patients in control group received routine care, while observation group underwent additional continuity care intervention based on KAP theory. Indexes of generalized self-efficacy scale (GSES scores) and short form health survey (SF-36 scores) were compared between the two groups at baseline, after 6 times of ALA-PDT, 3-month and 6-month after ALA-PDT by independent samples t-test. HPV genotyping results and colposcopy reexamine findings were evaluated at 3 months and 6 months after ALA-PDT by Chi-square test.

Results

GSES and SF-36 scores between control group and observation group before treatment were not significantly different (t = 0.852, P = 0.398; t = 0.012,P = 0.991). After 6 times of ALA-PDT, 3-month and 6-month after ALA-PDT, the GSES scores of patients in observation group were (25.63 ± 4.34), (30.09 ± 4.34) and (34.21 ± 4.56), significantly higher than those of the control group [(22.23 ± 4.05), (25.78 ± 4.57) and (29.56 ± 5.13)], with significant differences (t = 3.137, 3.746, 3.711; P = 0.003, < 0.001, < 0.001); while the SF-36 scores of patients in observation group were (72.73 ± 3.58), (80.25 ± 4.20) and (89.34 ± 4.65), significantly higher than those of the control group [(64.59 ± 3.47), (72.78 ± 3.96) and (78.79 ± 4.11)], with significant differences (t = 8.547, 7.088, 9.311; all P < 0.001). At 3 and 6 months after ALA-PDT, the HPV-negative conversion rates of patients in observation group were 73.3% (44/60) and 70.4% (42/60), respectively, significantly higher than those of the control group [65% (39/60) and 61.7% (37/60)], with significant differences (χ² = 15.98, 13.76; both P < 0.001). At 6 months after ALA-PDT, the rate of lesion reversal in observation group was 80.0% (48/60), significantly higher than that of control group [68.3% (41/60)], with significant difference (χ² = 16.89, P < 0.001).

Conclusions

Continuity care intervention based on the KAP theory can significantly improve the self-efficacy and life quality of patients with HR-HPV persistent infection complicated with CIN Ⅰ, and optimize the clinical outcome of patients.

Key words: Knowledge-attitude-practice theory, Continuity intervention, Aminolevulinic acid photodynamic therapy, High-risk, Human papillomavirus, Persistent infection, Cervical intraepithelial neoplasia grade Ⅰ

Xin Wang, Dongling Wu, Guangxia Bai, Huiwen Yan, Jing Liu, Hong Li. Effect of continuous intervention based on the knowledge-attitude-practice theory on the efficacy of 5-aminolevulinic acid photodynamic therapy for patients with high-risk human papillomavirus persistent infection complicated with cervical intraepithelial neoplasia grade Ⅰ[J]. Chinese Journal of Experimental and Clinical Infectious Diseases(Electronic Edition), 2025, 19(03): 182-186.

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References 27

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时间点	观察组（60例）	对照组（60例）	χ²值	P值
术后3个月
HPV分型复查
HPV转阴	44（73.3）	39（65.0）	15.98	< 0.001^a
无效	16（26.7）	21（35.0）	4.59	< 0.001^a
术后6个月
HPV分型复查
HPV转阴	42（70.0）	37（61.7）	13.76	< 0.001^a
无效	18（30.0）	23（38.3）	6.75	< 0.001^a
阴道镜复查
病变逆转	48（80.0）	41（68.3）	16.89	< 0.001^a
病变持续	11（18.3）	17（28.3）	12.42	< 0.001^a
病变进展	1（1.7）	2（3.4）	7.24	< 0.001^b

时间点	观察组（60例）	对照组（60例）	χ²值	P值
术后3个月
HPV分型复查
HPV转阴	44（73.3）	39（65.0）	15.98	< 0.001^a
无效	16（26.7）	21（35.0）	4.59	< 0.001^a
术后6个月
HPV分型复查
HPV转阴	42（70.0）	37（61.7）	13.76	< 0.001^a
无效	18（30.0）	23（38.3）	6.75	< 0.001^a
阴道镜复查
病变逆转	48（80.0）	41（68.3）	16.89	< 0.001^a
病变持续	11（18.3）	17（28.3）	12.42	< 0.001^a
病变进展	1（1.7）	2（3.4）	7.24	< 0.001^b

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