title: Impact of clinician gender on examination anxiety among female veterans with sexual trauma: a pilot study.
abstract: BACKGROUND
  The sequelae of sexual trauma, including symptoms or diagnosis of posttraumatic stress disorder (PTSD), may impact women's anxiety and avoidance of preventive healthcare measures such as breast, pelvic, and rectal examinations. As sexual trauma is unfortunately a common occurrence among female patients, particularly veterans, understanding how it influences examination-related distress may improve provision of care to this population. We explored the impact of clinician gender and examination type (breast, pelvic, rectal, and dental) on anticipated examination-related anxiety among women veterans with a history of sexual trauma.
  
  
  METHODS
  We present a cross-sectional pilot study that examines anticipated examination-related distress among 31 female veterans with a history of sexual trauma. Sexual trauma history was verified by chart review. Self-report instruments assessed patient demographics and patients' anticipated anxiety during breast, pelvic, rectal, and dental examinations (stratified by gender of clinician). The PTSD Checklist-Civilian Version (PCL-C) assessed symptom severity.
  
  
  RESULTS
  The women reported significantly more anticipated anxiety during breast, pelvic, and rectal examinations, (p < 0.05) when clinician gender was male. Severity of PTSD symptoms was generally unrelated to anticipated examination-related anxiety.
  
  
  CONCLUSIONS
  Anticipated anxiety was found to be a function of both examination type and clinician gender but not of PTSD symptom severity. These findings emphasize the importance of screening for sexual trauma and the careful consideration of female veterans' unique needs during sensitive medical procedures.
authors.affiliation: Veterans Affairs Palo Alto Health Care System, Menlo Park, California, USA.
authors.forename: Tina T
authors.initials: TT
authors.lastname: Lee
authors.forename: Darrah A
authors.initials: DA
authors.lastname: Westrup
authors.forename: Josef I
authors.initials: JI
authors.lastname: Ruzek
authors.forename: Jennifer
authors.initials: J
authors.lastname: Keller
authors.forename: Julie C
authors.initials: JC
authors.lastname: Weitlauf
mesh_terms: D000328:Adult; D000368:Aged; D000739:Anecdotes as Topic; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008875:Middle Aged; D010549:Personal Satisfaction; D010808:Physical Examination / Q000523:psychology*; D010817:Physician-Patient Relations; D010865:Pilot Projects; D012737:Sex Factors; D012742:Sex Offenses / Q000523:psychology*; D013313:Stress Disorders, Post-Traumatic / Q000175:diagnosis* / Q000523:psychology; D035502:Trust; D014728:Veterans / Q000523:psychology*; D016387:Women's Health