Pelvic Examination Fear and Education
Condition: Pelvic Pain; Pelvic Floor; Relaxation
MeSH terms: Pelvic Pain
Study type: Interventional

Summary: 
      Objectives: Gynecologic examination has been a concern for women. The aim of this study is to
      evaluate the effect of multimedia education on the fear of gynecologic examination.

      Material and Methods: This randomized controlled study will conducted with 80 voluntary
      patients. Participants will grouped as training group and control group. The multimedia-based
      information about vaginal examination is a video based patient education program. The anxiety
      levels/ scores of the patients will be assessed using the State-Trait Anxiety Inventory
      (STAI-S [state], STAI-T [trait]) and the Visual Analog Scale (VAS). The entire evaluation
      will be repeated before and after the examination.
    

Detailed description: 
      The pelvic examination has been a worrisome examination for women since the initial years of
      gynecology science until today. Intense anxieties experienced by the patients during this
      examination include primarily, shame and fear of pain or pathology. Reasons such as lack of
      information about the gynecologic examination, previously established myths by the patient,
      the speculum being cold, the doctor's attitude, and the position of the examination are also
      among the reasons why the woman during the examination experienced anxiety. The form of
      gynecologic examination has varied to a large extent to this day and the examination has
      begun to be performed in the lithotomy position upon the invention of gynecologic examination
      tables. It is important that the gynecologist informs patients about the vaginal examination
      to be performed in this position or healthcare professionals provide short training to them.
      Information training typically involves the explanation of the vaginal examination and of the
      pelvic anatomy. The training is aimed to provide relaxation and render the examination more
      comfortable by explaining pelvic anatomy and pelvic floor muscles. It has been observed that
      these training which is provided before the interview form pelvic floor relaxation and cause
      less pain in the patient during the vaginal examination. Patients receiving proper and
      adequate training are able to understand their own complaints better and manage their
      disease/examination better. Patient training reduces anxiety and helps to create a more
      comfortable examination environment.

      Previous studies have discussed patient anxieties experienced during interventions such as
      radiological imaging, endoscopy, colonoscopy, bronchoscopy, and invasive cardiac
      interventions. Short informative videos that do not cause any cost loss or harm, increase the
      tolerance with these applications and reduce patient anxiety. Additionally, many studies have
      emphasized that doctors have no time to provide information training for the vaginal
      examination while conducting their intense practices. Information that cannot be provided
      before the gynecologic examination due to limited time causes pelvic pain in women due to the
      anxiety experienced during the examination. The concept of chronic pelvic pain is defined as
      a non-cyclical pain that lasts longer than six months and develops in the pelvis and the area
      below the umbilicus and between the gluteal lines. Pelvic pain is observed depending on the
      excessive activity of pelvic floor muscles during the examination in patients who have a fear
      of the gynecologic examination.

      The aim of this study is to evaluate the effects of multimedia education provided before the
      gynecologic examination on the patient's pelvic pain, anxiety, and fear.
    

Intervention name(s): Multimedia education video
Intervention type(s): Other
Intervention description(s): The multimedia education video was a 30 minutes information-based patient education program and contained information about pelvic anatomy and how to practice vaginal examination. The same gynecologist (M.S.) (male) who 15 years of experience explained details of vaginal examination, who told about vaginal examination in this video to the study participants, also did the gynecologic examination. The gynecologic examination which contained pelvic ultrasound scan and vaginal examination lasted approximately 20 minutes practice.
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: None (Open Label)
Primary purpose: Supportive Care