Gynäkologisch-psychosomatische Beratung bei HPV-Infektionen

Zusammenfassung

Das Spektrum der HPV-Infektionen reicht von der passageren subklinischen Infektion über Kondylome bis zu Dysplasien und Karzinomen. Die hierdurch erforderlichen Kontrollen und Therapien sowie das Infektionspotenzial stellen für die betroffene Patientin eine starke emotionale und psychosoziale Belastung dar, zumal es oft an Kenntnissen über die Infektion und deren Folgen fehlt. Zur Verringerung dieser Belastung empfiehlt sich daher ein abgestuftes Beratungskonzept, das neben der medizinischen Information und Versorgung psychosoziale Aspekte berücksichtigt mit dem Ziel, individuelle Anpassungsstrategien zu entwickeln und zu optimieren. Hierbei ist nach Diagnosestellung eine Krisenintervention nützlich, die die Reaktion der Patientin auf die Diagnose einfühlsam erfasst und kommentiert, die wichtigsten Informationen zur HPV-Infektion mitteilt, positive Formulierungen bei der Beantwortung von Fragen verwendet und schriftliches Informationsmaterial zum Nachlesen zu Hause anbietet. Im Rahmen der nachfolgenden Betreuung ist eine supportive Beratung von Bedeutung, die das Angebot von Paargesprächen und im Fall von Kondylomen die Anleitung zu Selbstkontrollen sowie klare Absprachen über Folgemaßnahmen umfasst. Im weiteren Verlauf sind Informationen zu gesundheitsfördernden und das Immunsystem stärkenden Maßnahmen ebenso wie präventive Aspekte zum Schutz vor weiteren Infektionen wichtig.

Abstract

The spectrum of HPV infections ranges from subclinical infection and genital warts to intraepithelial neoplasia and cancer. The infectious potential as well as the necessary check-ups and therapies place a heavy emotional and psychosocial burden on the patient. Moreover, knowledge about the infection and its sequelae is limited. A stepwise concept of counselling including medical information and psychosocial counselling is advisable to improve individual adaptive strategies. After diagnosis a crisis intervention is useful which sensitively recognizes and comments the patient's reaction to the HPV diagnosis and offers key information on the infection. When answering questions, positive statements should be made and written information should be provided for the patient to read through at home. Supportive counselling during subsequent check-ups is important and should include the offer of partner interventions and, in the case of genital warts, education about self monitoring together with specific information regarding further measures. Additional outpatient care needs to include information on measures conducive to good health and the strengthening of the patient’s immune system as well as preventive measures to be taken against further infections.

Schlüsselwörter

HPV‐Infektion - psychosoziale Belastung - supportive Beratung

Key words

HPV infection - psychosocial burden - supportive counselling

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