title: Improving women's experience during speculum examinations at routine gynaecological visits: randomised clinical trial.
abstract: 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.
authors.affiliation: Department of Family and Community Medicine, Eisenhower Army Medical Center, Fort Gordon, GA 30905, USA. dseehusen@msn.com
authors.forename: Dean A
authors.initials: DA
authors.lastname: Seehusen
authors.forename: Dawn R
authors.initials: DR
authors.lastname: Johnson
authors.forename: J Scott
authors.initials: JS
authors.lastname: Earwood
authors.forename: Sankar N
authors.initials: SN
authors.lastname: Sethuraman
authors.forename: Jamie
authors.initials: J
authors.lastname: Cornali
authors.forename: Kelly
authors.initials: K
authors.lastname: Gillespie
authors.forename: Maria
authors.initials: M
authors.lastname: Doria
authors.forename: Edwin
authors.initials: E
authors.lastname: Farnell
authors.forename: Jason
authors.initials: J
authors.lastname: Lanham
mesh_terms: 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