Literature DB >> 16803941

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

Dean A Seehusen1, Dawn R Johnson, J Scott Earwood, Sankar N Sethuraman, Jamie Cornali, Kelly Gillespie, Maria Doria, Edwin Farnell, Jason Lanham.   

Abstract

OBJECTIVES: To determine if a standardised method of leg positioning without stirrups reduces the physical discomfort and sense of vulnerability and increases the sense of control among women undergoing speculum examination as part of a routine gynaecological examination.
DESIGN: Randomised clinical trial.
SETTING: Family medicine outpatient clinic. PATIENTS: 197 adult women undergoing routine gynaecological examination and cervical smear. INTERVENTION: Examination with or without stirrups. MAIN OUTCOME MEASURES: Women's perceived levels of physical discomfort, sense of vulnerability, and sense of control during the examination, measured on 100 mm visual analogue scales.
RESULTS: Women undergoing examination without stirrups had a reduction in mean sense of vulnerability from 23.6 to 13.1 (95% confidence interval of the difference - 16.6 to - 4.4). Mean physical discomfort was reduced from 30.4 to 17.2 (- 19.7 to - 6.8). There was no significant reduction in sense of loss of control.
CONCLUSION: Women should be able to have gynaecological examinations without using stirrups to reduce the stress associated with speculum examinations. TRIAL REGISTRATION: US Army Central Investigation Regulatory Office. Trial No DDEAMC 05-11.

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Mesh:

Year:  2006        PMID: 16803941      PMCID: PMC1513491          DOI: 10.1136/bmj.38888.588519.55

Source DB:  PubMed          Journal:  BMJ        ISSN: 0959-8138


  15 in total

1.  Practice tips. No stirrups?

Authors:  M Greiver
Journal:  Can Fam Physician       Date:  2001-10       Impact factor: 3.275

2.  Preference for the no-stirrup method.

Authors:  Don Klassen
Journal:  Can Fam Physician       Date:  2002-03       Impact factor: 3.275

3.  Not so bad after all..., Women's experiences of pelvic examinations.

Authors:  M Larsen; C C Oldeide; K Malterud
Journal:  Fam Pract       Date:  1997-04       Impact factor: 2.267

4.  De facto evidence for the no-stirrup method.

Authors:  Anne Doig
Journal:  Can Fam Physician       Date:  2002-05       Impact factor: 3.275

5.  The effect of physician gender on women's perceived pain and embarrassment during pelvic examination.

Authors:  A Moettus; D Sklar; D Tandberg
Journal:  Am J Emerg Med       Date:  1999-11       Impact factor: 2.469

6.  Commentary on Wright D, Fenwick J, Stephenson P & Monterosso L (2005) Speculum 'self insertion': a pilot study. Journal of Clinical Nursing 14, 1098-1111.

Authors:  Anne McQueen
Journal:  J Clin Nurs       Date:  2006-06       Impact factor: 3.036

7.  The acceptability of self-collected samples for HPV testing vs. the pap test as alternatives in cervical cancer screening.

Authors:  Ilana G Dzuba; Elsa Yunes Díaz; Betania Allen; Yvonne Flores Leonard; Eduardo C Lazcano Ponce; Keerti V Shah; David Bishai; Attila Lorincz; Daron Ferris; Bernardo Turnbull; Mauricio Hernández Avila; Jorge Salmerón
Journal:  J Womens Health Gend Based Med       Date:  2002-04

8.  A randomised controlled trial comparing a dilating vaginal speculum with a conventional bivalve speculum.

Authors:  A Thomas; E Weisberg; D Lieberman; I S Fraser
Journal:  Aust N Z J Obstet Gynaecol       Date:  2001-11       Impact factor: 2.100

9.  Comparison of self-collected vaginal, vulvar and urine samples with physician-collected cervical samples for human papillomavirus testing to detect high-grade squamous intraepithelial lesions.

Authors:  J W Sellors; A T Lorincz; J B Mahony; I Mielzynska; A Lytwyn; P Roth; M Howard; S Chong; D Daya; W Chapman; M Chernesky
Journal:  CMAJ       Date:  2000-09-05       Impact factor: 8.262

10.  Pain predicts non-adherence to pap smear screening among middle-aged African American women.

Authors:  Cathrine Hoyo; Kimberly S H Yarnall; Celette Sugg Skinner; Patricia G Moorman; Denethia Sellers; LaVerne Reid
Journal:  Prev Med       Date:  2005-08       Impact factor: 4.018

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  10 in total

1.  Stirrups or no stirrups for routine speculum examinations? Patient's perspective.

Authors:  Rosemary Slosek
Journal:  BMJ       Date:  2006-08-05

2.  Stirrups or no stirrups for routine speculum examinations? Patient comfort is secondary to cervical smear quality...

Authors:  Anne Spaar; Milo A Puhan
Journal:  BMJ       Date:  2006-08-05

3.  Stirrups or no stirrups for routine speculum examinations? ...but we do not need to do a trial of smear quality.

Authors:  James A Dickinson
Journal:  BMJ       Date:  2006-08-05

4.  Best practice in primary care.

Authors:  Pippa Oakeshott; Phillip Hay
Journal:  BMJ       Date:  2006-07-22

5.  Vaginal speculum examinations without stirrups.

Authors:  Wendy Brooks Barr
Journal:  BMJ       Date:  2006-07-22

Review 6.  The challenging pelvic examination.

Authors:  Carol K Bates; Nina Carroll; Jennifer Potter
Journal:  J Gen Intern Med       Date:  2011-01-12       Impact factor: 5.128

7.  Does pelvic exam in the emergency department add useful information?

Authors:  Jeremy Brown; Rita Fleming; Jamie Aristzabel; Rocksolana Gishta
Journal:  West J Emerg Med       Date:  2011-05

8.  Effect of vaginal self-sampling on cervical cancer screening rates: a community-based study in Newfoundland.

Authors:  Pauline Duke; Marshall Godwin; Samuel Ratnam; Lesa Dawson; Daniel Fontaine; Adrian Lear; Martha Traverso-Yepez; Wendy Graham; Mohamad Ravalia; Gerry Mugford; Andrea Pike; Jacqueline Fortier; Mandy Peach
Journal:  BMC Womens Health       Date:  2015-06-10       Impact factor: 2.809

9.  Design and preliminary analysis of a vaginal inserter for speculum-free cervical cancer screening.

Authors:  Mercy Nyamewaa Asiedu; Júlia Agudogo; Marlee S Krieger; Robert Miros; Rae Jean Proeschold-Bell; John W Schmitt; Nimmi Ramanujam
Journal:  PLoS One       Date:  2017-05-31       Impact factor: 3.240

10.  A novel speculum-free imaging strategy for visualization of the internal female lower reproductive system.

Authors:  Mercy N Asiedu; Júlia S Agudogo; Mary E Dotson; Erica Skerrett; Marlee S Krieger; Christopher T Lam; Doris Agyei; Juliet Amewu; Kwaku Asah-Opoku; Megan Huchko; John W Schmitt; Ali Samba; Emmanuel Srofenyoh; Nirmala Ramanujam
Journal:  Sci Rep       Date:  2020-10-06       Impact factor: 4.379

  10 in total

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