The Effect of Information About Gynecological Examination on the Anxiety Level of Women Applying to Gynecology Clinics: A Prospective, Randomized, Controlled Study

Kahraman Ulker, Yuksel Kivrak, Kahraman Ulker, Yuksel Kivrak

Abstract

Background: Crowded hospital outpatient clinics and endless waiting lines that make patients feel overlooked tend to exaggerate patients' anxiety levels. In addition, fear of pain, shyness, religious and traditional thoughts, women's sexual role in society, and previous information and experience also contribute to people's anxiety levels with regard to gynecologic examination.

Objectives: We aimed to analyze the effect of specific information about gynecologic examination on anxiety levels of women applying to gynecology clinics.

Materials and methods: In this randomized prospective study, the women applying for a gynecological examination were randomly allocated into control, intervention 1, and intervention 2 groups. Power analysis indicated that in order to achieve a one-point decrease from the previous anxiety score of 43.85 ± 5.41 at one side alpha 0.05 with a power of 80%, at least 79 women were needed in each group. Four medical school students interviewed 75 women (25 in control, 25 in intervention 1, and 25 in intervention 2). The data were collected using the demographic, social, and economic data form, and the Turkish version of the state-trait anxiety inventory (STAI). The women in the intervention 1 and 2 groups were instructed to read a paper that contained brief information about the gynecological examination procedure and the profits obtained from forests, respectively. All participants, including the women in the control group, filled the STAI by themselves. The three groups were compared appropriately.

Results: The demographics pertaining to age, gravidity and parity, miscarriage, induced abortion, ectopic pregnancy, offspring number, place of residence, working status, education level and previous experience of gynecological examination did not differ among the groups (P > 0.05). According to the STAI scores, all groups had mild state (control: 40.20 ± 10.53, intervention 1: 42.00 ± 11.98, and intervention 2: 39.53 ± 10.32) and severe continuous (control: 46.78 ± 8.65, Intervention 1: 47.25 ± 9.57, and intervention 2: 46.60 ± 9.72) anxiety levels. However, both state and continuous anxiety scores were not significantly different in all groups (P > 0.05).

Conclusions: Providing brief written information about the gynecological examination procedure and the clinic's working discipline is not sufficient to lower the anxiety of women applying for a gynecological examination.

Keywords: Anxiety Disorders; Comparative Study; Gynecological Examination; Hospitals; Obstetrics and Gynecology Department; Outpatients.

References

    1. Billings JA, Stoeckle JD. Pelvic examination instruction and the doctor-patient relationship. J Med Educ. 1977;52(10):834–9.
    1. Cengiz G. Patients admitted to the hospital and nurses. Türk Hemşireler Dergisi. 1980;1(4):44–7.
    1. Birol L. Investigation of patients hospitalized medical terminology. Ege Universitesi Hemsirelik Yuksekokulu Dergisi. 1985;12(1):15–22.
    1. Huang X. Patient attitude towards waiting in an outpatient clinic and its applications. Health Services Management Research. 1994;7(1):2–8.
    1. Erbil N, Şenkul, A., Sağlam, Y., Ergül, N. Turkish women before gynecological examination to determine attitudes on anxiety levels and inspection. Uluslararası İnsan Bilimleri Dergisi. 2008;5(1):1–13.
    1. Ulker K, Temur I, Gul A. Effects of modernisation and new population policies on reproductive health in Kars, Turkey. Eur J Contracept Reprod Health Care. 2012;17(3):187–96. doi: 10.3109/13625187.2012.665102.
    1. Spielberger CD. Manual for the State-Trait Anxiety Inventory STAI (form Y)(" self-evaluation questionnaire"). 1983.
    1. Oner N, Le Compte A. Manual of state-trait anxiety inventory. Istanbul: Bogazici Universitesi Yayinlari; 1983.
    1. Yurumez Y, Cevik T, Yavuz Y. Do we know the Patients' Rights? Akademik Acil Tip Dergisi. 2010;2:67–71.
    1. Mete S. The effect of anxiety that occur in nursing women from a gynecological examination. Hemşirelik Yüksekokulu Dergisi. 1998;2(2):1–8.
    1. Pehlivan S, Ovayolu N, Koruk M, Pehlivan Y, Ovayolu O, Gulsen MT. Effect of providing information to the patient about upper gastrointestinal endoscopy on the patient's perception, compliance and anxiety level associated with the procedure. Turk J Gastroenterol. 2011;22(1):10–7.
    1. Galaal KA, Deane K, Sangal S, Lopes AD. Interventions for reducing anxiety in women undergoing colposcopy. Cochrane Database System Rev. 2007;3.
    1. van Zuuren FJ, Grypdonck M, Crevits E, Vande Walle C, Defloor T. The effect of an information brochure on patients undergoing gastrointestinal endoscopy: a randomized controlled study. Patient Educ Couns. 2006;64(1-3):173–82. doi: 10.1016/j.pec.2005.12.014.
    1. Pereira SP, Hussaini SH, Wilkinson ML. Informed consent for upper gastrointestinal endoscopy. Gut. 1995;37(1):151–3.
    1. Levy N, Landmann L, Stermer E, Erdreich M, Beny A, Meisels R. Does a detailed explanation prior to gastroscopy reduce the patient's anxiety? Endoscopy. 1989;21(6):263–5. doi: 10.1055/s-2007-1012965.
    1. Lanius M, Zimmermann P, Heegewaldt H, Hohn M, Fischer M, Rohde H. [Does an information booklet on gastrointestinal endoscopy reduce anxiety for these examinations? Results of a randomized study with 379 patients]. Z Gastroenterol. 1990;28(12):651–5.
    1. Bytzer P, Lindeberg B. Impact of an information video before colonoscopy on patient satisfaction and anxiety - a randomized trial. Endoscopy. 2007;39(8):710–4. doi: 10.1055/s-2007-966718.
    1. Aabakken L, Baasland I, Lygren I, Osnes M. Development and evaluation of written patient information for endoscopic procedures. Endoscopy. 1997;29(1):23–6. doi: 10.1055/s-2007-1004056.
    1. Luck A, Pearson S, Maddern G, Hewett P. Effects of video information on precolonoscopy anxiety and knowledge: a randomised trial. Lancet. 1999;354(9195):2032–5.
    1. Kutluturkan S, Gorgulu U, Fesci H, Karavelioglu A. The effects of providing pre-gastrointestinal endoscopy written educational material on patients' anxiety: a randomised controlled trial. Int J Nurs Stud. 2010;47(9):1066–73. doi: 10.1016/j.ijnurstu.2010.01.007.
    1. Pager CK. Randomised controlled trial of preoperative information to improve satisfaction with cataract surgery. Br J Ophthalmol. 2005;89(1):10–3. doi: 10.1136/bjo.2004.048637.
    1. Trevisani L, Sartori S, Gaudenzi P, Gilli G, Matarese G, Gullini S, et al. Upper gastrointestinal endoscopy: are preparatory interventions or conscious sedation effective? A randomized trial. World J Gastroenterol. 2004;10(22):3313–7.
    1. Herbig B, Dragano N, Angerer P. Health in the long-term unemployed. Dtsch Arztebl Int. 2013;110(23-24):413–9. doi: 10.3238/arztebl.2013.0413.
    1. Pattyn E, Van Praag L, Verhaeghe M, Levecque K, Bracke P. The association between residential area characteristics and mental health outcomes among men and women in Belgium. Arch Public Health. 2011;69(1):3. doi: 10.1186/0778-7367-69-3.
    1. Shidhaye R, Patel V. Association of socio-economic, gender and health factors with common mental disorders in women: a population-based study of 5703 married rural women in India. Int J Epidemiol. 2010;39(6):1510–21. doi: 10.1093/ije/dyq179.

Source: PubMed

Patrocinadores e Colaboradores

Condições médicas

Intervenções de drogas

3
Se inscrever