title: A randomised trial of photographic reinforcement during postoperative counselling after diagnostic laparoscopy for pelvic pain.
abstract: OBJECTIVE
  To measure the effect of seeing a photograph of the pelvic findings at laparoscopy.
  
  
  METHODS
  Two university teaching hospitals.
  
  
  METHODS
  A randomised-controlled trial.
  
  
  METHODS
  Two hundred thirty-three women undergoing diagnostic laparoscopy for the investigation of chronic pelvic pain.
  
  
  METHODS
  At operation a Polaroid print was taken of the pelvis. If this was of satisfactory quality, the patient was randomly allocated to either see, or not see, the print during the postoperative consultation.
  
  
  RESULTS
  Pain severity and pain belief scores at 3 and 6 months.
  
  
  METHODS
  By intention to treat.
  
  
  RESULTS
  Postoperative consultations with photographs did not improve immediate understanding and satisfaction with the consultation. In addition, compared to controls, both patients and doctors did not perceive particular benefit for communication from the photograph. There was a consistent trend to more pain in the photographic reinforcement group and more negative pain beliefs. At 3 months, the average within person differences showed some benefit in visual analogue pain scores, McGill affect scores, 'permanence' and 'self-blame' scores. These benefits were not statistically significant. At 6 months, there was a consistent pattern of benefit from pain severity and pain beliefs, again these benefits were not statistically significant.
  
  
  CONCLUSIONS
  No clear benefits result from showing patients photographs of their pelvis.
authors.affiliation: Department of Obstetrics and Gynaecology, St. John's Hospital, Wood Street, Chelmsford CM2 9BG, UK. jlonwude@btopenworld.com
authors.forename: Joseph L
authors.initials: JL
authors.lastname: Onwude
authors.forename: Jim G
authors.initials: JG
authors.lastname: Thornton
authors.forename: Stephen
authors.initials: S
authors.lastname: Morley
authors.forename: Janet
authors.initials: J
authors.lastname: Lilleyman
authors.forename: Ian
authors.initials: I
authors.lastname: Currie
authors.forename: Richard J
authors.initials: RJ
authors.lastname: Lilford
mesh_terms: D000328:Adult; D002908:Chronic Disease; D003376:Counseling / Q000379:methods*; D005500:Follow-Up Studies; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D016014:Linear Models; D008875:Middle Aged; D010147:Pain Measurement; D017699:Pelvic Pain / Q000175:diagnosis* / Q000523:psychology; D010781:Photography; D011182:Postoperative Care / Q000379:methods; D011336:Probability; D012016:Reference Values; D012054:Reinforcement, Psychology; D018570:Risk Assessment; D012720:Severity of Illness Index; D016896:Treatment Outcome