Abstract
INTRODUCTION:The insertion of a speculum is a common procedure performed during a gynecologic exam. With the intention to improve the patient experience, healthcare providers often use terms with unpleasant emotional content such as “it will feel uncomfortable” to guide patients through medical procedures. It is assumed that such words help patients but there is little evidence to support this belief. The objective of this study is to evaluate the impact of using phrases of anticipated discomfort on the perception of pain and discomfort during speculum exams.
METHODS:A randomized single blind trial in patients undergoing speculum examination during their well woman gynecologic visit. Patients were randomized to the anticipated discomfort group were the following phrases were used “You are going to feel pressure” “This will be very uncomfortable” or the objective description group “I am going to introduce the speculum” and “I am going to open the speculum.” Patient were asked to rate the pain perceived during the speculum exam using the Wong-Baker facial grimace scale. Descriptive statistic was used to analyze the data.
RESULTS:Both groups were similar regarding age, BMI, ethnicity, menopausal status and parity. Patients from the objective description group rate the pain perceived during the speculum exam at 0.8 ±SD0.8 compared to 2.9 ±SD1.5 (p<0.000). The objective group were also more likely to describe the pain as less than anticipated (p<0.000) in the post exam questionnaire.
CONCLUSION:The use of phrases with unpleasant emotional content significantly worsened the pain perception during speculum examination.
