Improving women's experience during speculum examinations at routine gynaecological visits: randomised clinical trial

doi:10.1136/bmj.38888.588519.55

BMJ, doi: 10.1136/bmj.38888.588519.55, (Published 27 June 2006)

RESEARCH

Improving women's experience during speculum examinations at routine gynaecological visits: randomised clinical trial

Dean A Seehusen ¹^*, Dawn R Johnson ¹, J Scott Earwood ¹, Sankar N Sethuraman ², Jamie Cornali ¹, Kelly Gillespie ¹, Maria Doria ¹, Edwin Farnell IV ¹, Jason Lanham ¹

¹ Department of Family and Community Medicine, Eisenhower Army Medical Center, Fort Gordon, GA 30905, USA
² Mathematics and Computer Science Department, Augusta State University, Augusta, GA 30904, USA

^* Correspondence to: dseehusen{at}msn.com.

Objectives To determine if a standardised method of leg positioningwithout stirrups reduces the physical discomfort and sense ofvulnerability and increases the sense of control among womenundergoing speculum examination as part of a routine gynaecologicalexamination.

Design Randomised clinical trial.

Setting Familymedicine outpatient clinic.

Patients 197 adult women undergoingroutine gynaecological examination and cervical smear.

InterventionExamination with or without stirrups.

Main outcome measures Women'sperceived levels of physical discomfort, sense of vulnerability,and sense of control during the examination, measured on 100mm visual analogue scales.

Results Women undergoing examinationwithout stirrups had a reduction in mean sense of vulnerabilityfrom 23.6 to 13.1 (95% confidence interval of the difference-16.6 to -4.4). Mean physical discomfort was reduced from 30.4to 17.2 (-19.7 to -6.8). There was no significant reductionin sense of loss of control.

Conclusion Women should be ableto have gynaecological examinations without using stirrups toreduce the stress associated with speculum examinations.

Trialregistration US Army Central Investigation Regulatory Office.Trial No DDEAMC 05-11.

(Accepted 22 May 2006)

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Seehusen, D. A., Richman, S. M., Kahwati, L. C., Edelman, A., Anderson, J., Tegtmeyer, K. (2007). Pelvic Examination. NEJM 357: 1778-1779 [Full text]
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