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Improving women's experience during speculum examinations at routine gynaecological visits: randomised clinical trial
Dean A Seehusen1, Dawn R Johnson, J Scott Earwood
1Department of Family and Community Medicine, Eisenhower Army Medical Center, Fort Gordon, GA 30905, USA. dseehusen@msn.com
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.
