A randomised trial of photographic reinforcement during postoperative counselling after diagnostic laparoscopy for pelvic pain.
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.
Onwude
Joseph L
JL
Department of Obstetrics and Gynaecology, St. John's Hospital, Wood Street, Chelmsford CM2 9BG, UK. jlonwude@btopenworld.com
Thornton
Jim G
JG
Morley
Stephen
S
Lilleyman
Janet
J
Currie
Ian
I
Lilford
Richard J
RJ
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