title: Use of a simple visual distraction to reduce pain and anxiety in patients undergoing colposcopy.
abstract: OBJECTIVE
  We hypothesized that a passive visual distraction would reduce pain and anxiety among women undergoing colposcopy.
  
  
  METHODS
  We assessed the association between exposure to a passive visual distraction during colposcopy and procedure-related pain and anxiety using a nonrandomized intervention design. Women presenting for initial or repeat colposcopy at Brigham and Women's Hospital Colposcopy Clinics were eligible for participation. Women undergoing colposcopy during the first 6 months of the study (n=168) were not exposed to the visual distraction, whereas women undergoing colposcopy during the second 6 months of the study (n=153) were exposed to a pleasing, passive visual distraction consisting of images on a light diffuser installed within the examination room's ceiling light. We used ordinal logistic regression to compare self-reported pain, measured using the visual analog scale, and anxiety, measured using the Spielberger State-Trait Anxiety Inventory-6, among women receiving and not receiving the intervention.
  
  
  RESULTS
  Two hundred sixteen women with complete data were included in the final analyses. Women in both groups reported high levels of colposcopy-related anxiety. Compared to women who did not receive the visual distraction, women receiving the visual distraction during colposcopy had a 54% reduction in the odds of experiencing a given level of postexamination pain, holding preprocedure pain constant (odds ratio=0.46, 95% confidence interval=0.28-0.77). Visual distraction was not associated with postexamination anxiety (odds ratio=0.95, 95% confidence interval=0.60-1.51).
  
  
  CONCLUSIONS
  A passive visual distraction reduced perceived pain, but not anxiety, after colposcopy.
authors: 1Department of Epidemiology, Harvard School of Public Health; and Divisions of 2Gynecological Oncology and 3General Gynecology, Department of Obstetrics, Gynecology, and Reproductive Biology, Brigham and Women's Hospital, Boston, MA.
authors: Jenny L
authors: JL
authors: Carwile
authors: Sarah
authors: S
authors: Feldman
authors: Natasha R
authors: NR
authors: Johnson
mesh_terms: D000046:Academic Medical Centers; D000293:Adolescent; D000328:Adult; D000368:Aged; D001007:Anxiety / Q000523:psychology* / Q000628:therapy*; D003127:Colposcopy / Q000009:adverse effects* / Q000523:psychology*; D005260:Female; D006801:Humans; D008875:Middle Aged; D010146:Pain / Q000523:psychology*; D059408:Pain Management / Q000379:methods*; D010775:Photic Stimulation / Q000379:methods*; D016896:Treatment Outcome; D006113:United Kingdom; D055815:Young Adult