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Use of a simple visual distraction to reduce pain and anxiety in patients undergoing colposcopy
Jenny L Carwile1, Sarah Feldman, Natasha R Johnson
11Department of Epidemiology, Harvard School of Public Health; and Divisions of 2Gynecological Oncology and 3General Gynecology, Department of Obstetrics, Gynecology, and Reproductive Biology, Brigham and Women's Hospital, Boston, MA.
Objective:
We hypothesized that a passive visual distraction would reduce pain and anxiety among women undergoing colposcopy.
Materials And Methods:
We assessed the association between exposure to a passive visual distraction during colposcopy and procedure-related pain and anxiety using a nonrandomized intervention design. Women presenting for initial or repeat colposcopy at Brigham and Women's Hospital Colposcopy Clinics were eligible for participation. Women undergoing colposcopy during the first 6 months of the study (n=168) were not exposed to the visual distraction, whereas women undergoing colposcopy during the second 6 months of the study (n=153) were exposed to a pleasing, passive visual distraction consisting of images on a light diffuser installed within the examination room's ceiling light. We used ordinal logistic regression to compare self-reported pain, measured using the visual analog scale, and anxiety, measured using the Spielberger State-Trait Anxiety Inventory-6, among women receiving and not receiving the intervention.
Results:
Two hundred sixteen women with complete data were included in the final analyses. Women in both groups reported high levels of colposcopy-related anxiety. Compared to women who did not receive the visual distraction, women receiving the visual distraction during colposcopy had a 54% reduction in the odds of experiencing a given level of postexamination pain, holding preprocedure pain constant (odds ratio=0.46, 95% confidence interval=0.28-0.77). Visual distraction was not associated with postexamination anxiety (odds ratio=0.95, 95% confidence interval=0.60-1.51).
Conclusions:
A passive visual distraction reduced perceived pain, but not anxiety, after colposcopy.
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