Improving women's experience during speculum examinations at routine gynaecological visits: randomised clinical trial.
OBJECTIVE
To determine if a standardised method of leg positioning without stirrups reduces the physical discomfort and sense of vulnerability and increases the sense of control among women undergoing speculum examination as part of a routine gynaecological examination.


METHODS
Randomised clinical trial.


METHODS
Family medicine outpatient clinic.


METHODS
197 adult women undergoing routine gynaecological examination and cervical smear.


METHODS
Examination with or without stirrups.


METHODS
Women's perceived levels of physical discomfort, sense of vulnerability, and sense of control during the examination, measured on 100 mm visual analogue scales.


RESULTS
Women undergoing examination without stirrups had a reduction in mean sense of vulnerability from 23.6 to 13.1 (95% confidence interval of the difference - 16.6 to - 4.4). Mean physical discomfort was reduced from 30.4 to 17.2 (- 19.7 to - 6.8). There was no significant reduction in sense of loss of control.


CONCLUSIONS
Women should be able to have gynaecological examinations without using stirrups to reduce the stress associated with speculum examinations.


BACKGROUND
US Army Central Investigation Regulatory Office. Trial No DDEAMC 05-11.
Seehusen
Dean A
DA
Department of Family and Community Medicine, Eisenhower Army Medical Center, Fort Gordon, GA 30905, USA. dseehusen@msn.com
Johnson
Dawn R
DR
Earwood
J Scott
JS
Sethuraman
Sankar N
SN
Cornali
Jamie
J
Gillespie
Kelly
K
Doria
Maria
M
Farnell
Edwin
E
Lanham
Jason
J
D000328:Adult; D000553:Ambulatory Care; D005260:Female; D006801:Humans; D007389:Internal-External Control; D009774:Obstetrics / Q000295:instrumentation / Q000379:methods; D010146:Pain / Q000209:etiology; D017060:Patient Satisfaction; D010808:Physical Examination / Q000295:instrumentation / Q000523:psychology*; D011187:Posture; D013315:Stress, Psychological / Q000209:etiology*; D013525:Surgical Instruments; D014626:Vaginal Smears / Q000295:instrumentation / Q000523:psychology*; D016387:Women's Health