title: What does a young girl experience in her first gynecological examination? Study on the relationship between anxiety and pain.
abstract: OBJECTIVE
  The purpose of the two-part study was to determine how the initial gynecological examination was experienced, examining the relationship between anxiety and pain.
  
  
  METHODS
  A total of 669 patients who had attended the special gynecological outpatient clinic for female children and adolescents, and 800 female pupils of either high schools (H) or vocational schools (V), were retrospectively asked to complete a standardized questionnaire (30 questions). The statistical instruments used were Chi-square test, loglinear models, and Spearman correlation coefficients.
  
  
  RESULTS
  A total of 169 completed questionnaires could be evaluated in the case of children who attended the special outpatient clinic and 210 in the case of the pupils. (1) There was a significantly positive correlation between anxiety and pain; however, the sex of the examiner had no influence on how the examination was experienced. The accompanying persons underestimated the anxiety of the patients prior to the examination and overestimated the pain experienced. (2) Loglinear models showed that there is no relationship between the type of school attended and the pain score, a significant relationship between the type of school and the anxiety (P <.01), and a significant relationship between the anxiety and pain score irrespective of the type of school attended.
  
  
  CONCLUSIONS
  The studies showed a surprisingly high frequency of pain, anxiety, and their correlation during the initial gynecological examination. Further studies of influencing factors and interventions are needed.
authors.affiliation: Department of Obstetrics and Gynecology, Heinrich-Heine University, Düsseldorf, Germany. bodden@uni-duesseldorf.de
authors.forename: R
authors.initials: R
authors.lastname: Bodden-Heidrich
authors.forename: S
authors.initials: S
authors.lastname: Walter
authors.forename: S
authors.initials: S
authors.lastname: Teutenberger
authors.forename: V
authors.initials: V
authors.lastname: Küppers
authors.forename: V
authors.initials: V
authors.lastname: Pelzer
authors.forename: I
authors.initials: I
authors.lastname: Rechenberger
authors.forename: H G
authors.initials: HG
authors.lastname: Bender
mesh_terms: D000293:Adolescent; D016497:Adolescent Health Services; D001007:Anxiety; D002648:Child; D005260:Female; D005836:Genitalia, Female / Q000033:anatomy & histology*; D006801:Humans; D010146:Pain; D017060:Patient Satisfaction; D010808:Physical Examination / Q000379:methods* / Q000592:standards; D010817:Physician-Patient Relations; D011361:Professional Competence