Adnan Menderes Üniversitesi Sağlık Bilimleri Fakültesi Dergisi

2587-2427

Aydin Adnan Menderes University

10.46237/amusbfd.1552838

Rehabilitation

Rehabilitasyon

Jinekolojik Muayene Öncesi Multimedya Eğitiminin Hastaların Kaygı, Korku ve Pelvik Ağrı Düzeyleri Üzerine Etkisi: Tek Kör Prospektif Randomize Kontrollü Çalışma

The Effect of Multimedia Education Given Before Gynecological Examination on the Anxiety, Fear and Pelvic Pain Levels of Patients: A Single‐Blind Prospective Randomized Controlled Study

https://orcid.org/0000-0001-7455-8697

Temel Aksu

Neriman

Akdeniz Üniversitesi Sağlık Bilimleri Fakültesi Fizyoterapi ve Rehabilitasyon Bölümü

https://orcid.org/0000-0003-1418-6961

Büyük

Alime

AKDENIZ UNIVERSITY

https://orcid.org/0000-0001-8651-8318

Gunes Gencer

Gokce Yagmur

AKDENIZ UNIVERSITY

https://orcid.org/0000-0001-5074-0005

Sakıncı

Mehmet

AKDENIZ UNIVERSITY

09 30 2025

9 3 368 382 09 19 2024 04 05 2025

2017

Adnan Menderes Üniversitesi Sağlık Bilimleri Fakültesi Dergisi

Amaç: Bu çalışma jinekolojik muayene öncesinde verilen multimedya eğitiminin hastaların kaygı, korku ve pelvik ağrıdüzeyleri üzerine etkisinin değerlendirilmesi amacıyla yapılmıştır.Yöntem: Bu tek kör prospektif randomize kontrollü çalışmaya jinekoloji ve obstetrik kliniğine başvuran 18-50 yaş aralığındaki 80 gönüllü kadın dahil edildi. 80 kadın çalışma (n=40) ve kontrol grubu (n=40) olmak üzere iki gruba randomize edildi. Çalışma grubundaki kadınlara jinekolojik muayene öncesinde multimedya ile bilgi verilerek eğitim verildi. Hastaların kaygısı Durum-Özellik Kaygı Envanteri (STAI-1-2) ve Görsel Analog Skala (VAS) kullanılarak değerlendirilmiştir. Jinekolojik muayene korkusu ve pelvik ağrısı VAS ile değerlendirilmiştir. Tüm değerlendirme muayene öncesi ve sonrasında tekrarlanmıştır.Bulgular: Eğitim grubunda, grup içi değişim analizi STAI-1, pelvik ağrı (VAS), anksiyete (VAS) ve korku (VAS) puanlarında istatistiksel olarak anlamlı bir iyileşme gösterdi (p=0,002; p=0,001; p=0,001; p=0,001). Gruplar arasında anksiyete düzeyinde anlamlı bir fark vardı (p=0,005). Eğitim grubundaki hastaların STAI-1, pelvik ağrı (VAS), anksiyete (VAS) ve korku (VAS) düzeyleri zamanla azaldı.Sonuç: Jinekolojik muayeneden önce multimedya hasta bilgilendirme eğitiminin hastaların anksiyetesini azaltmada çok etkili bir yöntem olduğu düşünülmektedir.

Objective: This study was conducted to evaluate the effects of multimedia education given before gynecological examination on the anxiety, fear and plevic pain levels of patients.Method: This single-blind prospective randomized controlled study included 80 volunteer women aged 18-50 years who applied to the gynecology and obstetrics clinic. 80 women were randomized into two groups as study (n=40) and control group (n=40). The women in the study group were given information and training via multimedia before gynecological examination. The anxiety of the patients was assessed using State-Trait Anxiety Inventory (STAI-1-2) and Visual Analog Scale (VAS). Fear of gynecological examination and pelvic pain were assessed with VAS. All assessments were repeated before and after the examination.Results: In the training group, the intragroup change analysis showed a statistically significant improvement in the STAI-1, pelvic pain (VAS), anxiety (VAS) and fear (VAS) scores (p=0.002; p=0.001; p=0.001; p=0.001). There was a significant difference in the anxiety level between groups (p=0.005). The STAI-1, pelvic pain (VAS), anxiety (VAS) and fear (VAS) of the patients in the training group decreased in the course of time.Conclusion: Multimedia patient information training before the gynecologic examination is thought to be a very effective method to reduce the anxiety, fear and pelvic pain of patients.

Anxiety Fear Gynecological examination Multimedia education Women

Anksiyete Jinekolojik muayene Kadın Korku Multimedya eğitim

1. Hilden, M., Sidenius, K., Langhoff‐Roos, J., Wijma, B., & Schei, B. (2003). Women's experiences of the gynecologic examination: factors associated with discomfort. Acta Obstetricia et Gynecologica Scandinavica, 82(11), 1030-1036. https://doi.org/10.1034/j.1600-0412.2003.00253.x.

2. Seymore, C., DuRant, R.H., Jay, M.S., Freeman, D., Gomez, L., Sharp, C., et al. (1986). Influence of position during examination, and sex of examiner on patient anxiety during pelvic examination. The Journal of Pediatrics, 108(2), 312-317. https://doi.org/10.1016/s0022-3476(86)81011-3.

3. O'Laughlin, D.J., Strelow, B., Fellows, N., Kelsey, E., Peters, S., Stevens, J., et al. (2021). Addressing Anxiety and Fear during the Female Pelvic Examination. Journal of Primary Care & Community Health, 12, 2150132721992195. https://doi.org/10.1177/2150132721992195.

4. Marcus, C. (2014). Strategies for improving the quality of verbal patient and family education: a review of the literature and creation of the EDUCATE model. Health Journal of Behavioral Medicine, 2(1), 482-495. https://doi.org/10.1080/21642850.2014.900450.

5. Diefenbach, M.A., & Butz, B.P. (2004). A multimedia interactive education system for prostate cancer patients: development and preliminary evaluation. Journal of Medical Internet Research, 6(1), e3. https://doi.org/10.2196/jmir.6.1.e3.

6. Johansson, K., Nuutila, L., Virtanen, H., Katajisto, J., & Salanterä, S. (2005). Preoperative education for orthopaedic patients: systematic review. Journal of Advanced Nursing, 50(2), 212-223. https://doi.org/10.1111/ j.1365-2648.2005.03381.x.

7. Howard, F. M. (2003). Chronic pelvic pain. Obstetrics & Gynecology, 101(3), 594-611. https://doi.org/10.1016/s0029-7844(02)02723-0.

8. Kawaguchi, R., Matsumoto, K., Akira, S., Ishitani, K., Iwasaku, K., Ueda, Y., et al. (2019). Guidelines for office gynecology in Japan: Japan Society of Obstetrics and Gynecology (JSOG) and Japan Association of Obstetricians and Gynecologists (JAOG) 2017 edition. The Journal of Obstetrics and Gynaecology Research,. 45(4), 766-786. https:// doi.org/10.1111/jog.13831.

9. Tancman, S., HaCohen, N., Lazarus, G., Solt, I., & Sagi-Dain, L. (2022). Silent voices that must be heard - women's perceptions of gynecologic examinations. Journal of Psychosomatic Obstetrics & Gynecology, 43(2), 190-197. https://doi.org/10.1080/0167482X.2020.1864727.

10. Gustafson, L.W., Gabel, P., Hammer, A., Lauridsen, H. H., Petersen, L. K., Andersen, B., et al. (2020). Validity and reliability of State-Trait Anxiety Inventory in Danish women aged 45 years and older with abnormal cervical screening results. BMC Medical Research Methodology, 20, 89. https://doi.org/10.1186/s12874-020-00982-4.

11. Price, D., McGrath, P., Rafii, A., & Buckingham, B. (1983). The validation of visual analogue scales as ratio scale measures for chronic and experimental pain. Pain, 17, 45-56. https:// doi.org/10.1016/0304-3959(83)90126-4.

12. Williamson, A., & Hoggart, B. (2005). Pain: a review of three commonly used pain rating scales. Journal of Clinical Nursing, 14(7), 798-804. https://doi.org/10.1111/j.1365-2702.2005.01121.x.

13. van Dijk, J., Zaslansky, R., van Boeke, R., Cheuk-Alam, J.M., Baart, S.J., Huygen, F., et al. (2021). Postoperative pain and age: a retrospective cohort association study. Anesthesiology, 135(6), 1104-1119. https:// doi.org/10.1097/ALN.0000000000004000.

14. Grundström, H., Wallin, K., & Berterö, C. (2011). ‘You expose yourself in so many ways’: young women's experiences of pelvic examination. Journal of Psychosomatic Obstetrics & Gynecology, 32(2), 59-64. https:// doi.org/10.3109/0167482X.2011.560692.

15. Bates, C.K., Carroll, N. & Potter, J. (2011). The challenging pelvic examination. Journal of General Internal Medicine, 26(6), 651-657. https:// doi.org/10.1007/s11606-010-1610-8.

16. Aktas, D., Kumas, M. B., Odabasıoglu, B. S., & Kaya, A. (2018). Effect of a special examination gown and nature-based sounds on anxiety in women undergoing a gynecological examination. Clinical Nursing Research, 27(5), 521-539. https://doi.org/10.1177/1054773816686475.

17. Meléndez, J.C., & McCrank, E. (1993). Anxiety-related reactions associated with magnetic resonance imaging examinations. JAMA, 270(6), 745-747. https://doi.org/10.1001/jama.1993.03510060091039.

18. Yilmaz, F. T., & Demirel, G. (2021). The relationship between body privacy and anxiety in women having gynecological examination. Journal of Obstetrics and Gynaecology, 41(7), 1112-1115. doi:10.1080/01443615.2020.1835845

19. Aksakal, O. (2001). Jinekolojik muayeneye eşlik eden endişe kaynakları ve hastaların bu konuda bilgilendirilmesinin yararları. (Distress subjects accompanying gynecologic examination and the benefits of informing the patients about these.) Türkiye Klinikleri Tıp Etiği-Hukuku-Tarihi Dergisi, 9(2), 102-106. https://doi.org/10.33715/inonusaglik.762143.

20. Millstein, S.G., Adler, N.E., & Irwin, Jr C.E. (1984). Sources of anxiety about pelvic examinations among adolescent females. Journal of Adolescent Health Care, 5(2), 105-111. https://doi.org/10.1016/ s0197-0070(84)80008-x.

21. Frye, C., & Weisberg, R. (1994). Increasing the incidence of routine pelvic examinations: behavioral medicine's contribution. Women & Health, 21(1), 33-35. https://doi.org/10.1300/J013v21n01_03.

22. Larsen, M., Oldeide, C.C., & Malterud, K. (1997). Not so bad after all..., Women's experiences of pelvic examinations. Family Practice, 14(2), 148-152. https://doi.org/10.1093/fampra/14.2.148.

23. Kocabaş, P., & Khorshid, L. (2012). A comparison of the effects of a special gynaecological garment and music in reducing the anxiety related to gynaecological examination. Journal of Clinical Nursing, 21(5‐ 6), 791-799. https://doi.org/10.1111/j.1365-2702.2011.03958.x.

24. Williams, J.G., Park, L.I., & Kline, J. (1995). Physicians' attitudes toward a new gynecological examination gown. Women & Health, 22(2), 1-9. https://doi.org/10.1300/j013v22n02_01.

25. Bailey, L. (2010). Strategies for decreasing patient anxiety in the perioperative setting. AORN J, 92(4), 445-460. https://doi.org/10.1016/ j.aorn.2010.04.017.

26. Angioli, R., Nardone, C.D.C., Plotti, F., Cafà, E.V., Dugo, N., Damiani, P. et al. (2014). Use of music to reduce anxiety during office hysteroscopy: prospective randomized trial. Journal of Minimally Invasive Gynecology, 21(3), 454-459. https://doi.org/10.1016/j.jmig.2013.07.020.

27. Simavli, S., Kaygusuz, I., Gumus, I., Usluogulları, B., Yildirim, M., & Kafali, H. (2014). Effect of music therapy during vaginal delivery on postpartum pain relief and mental health. Journal of Affective Disorders, 156, 194-199. https://doi.org/10.1016/j.jad.2013.12.027.

28. Liu, Y.H., Chang, M.Y., & Chen, C.H. (2010). Effects of music therapy on labour pain and anxiety in Taiwanese first‐time mothers. Journal of Clinical Nursing, 19(7‐8), 1065-1072. https://doi.org/10.1111/ j.1365-2702.2009.03028.x.

29. Davis, C.A. (1992). The effects of music and basic relaxation instruction on pain and anxiety of women undergoing in-office gynecological procedures. Journal of Music Therapy, 29(4), 202-216. https://doi.org/10.1093/jmt/29.4.202.

30. Ellett, L., Villegas, R., Beischer, A., Ong, N., & Maher, P. (2014). Use of a multimedia module to aid the informed consent process in patients undergoing gynecologic laparoscopy for pelvic pain: randomized controlled trial. Journal of Minimally Invasive Gynecology, 21(4), 602-611. https://doi.org/10.1016/j.jmig.2014.01.002.

31. Chow, C.H., Wan, S., Pope, E., Meng, Z., Schmidt, L.A., Buckley, N., et al. (2018). Audiovisual interventions for parental preoperative anxiety: A systematic review and meta-analysis. Health Psychology, 37(8), 746. https://doi.org/10.1037/hea0000627.

32. Aydal, P., Uslu, Y., & Ulus, B. (2023). The effect of preoperative nursing visit on anxiety and pain level of patients after surgery. Journal of Perianesthesia Nursing : Official Journal of the American Society of PeriAnesthesia Nurses, 38(1), 96–101. https://doi.org/10.1016/ j.jopan.2022.05.086.

33. Millett, C.R., & Gooding, L.F. (2017). Comparing active and passive distraction-based music therapy interventions on preoperative anxiety in pediatric patients and their caregivers. Journal of Music Therapy, 54(4), 460-478. https://doi.org/10.1093/jmt/thx014.

34. Zarei, B., Valiee, S., Nouri, B., Khosravi, F., & Fathi, M. (2018). The effect of multimedia-based nursing visit on preoperative anxiety and vital signs in patients undergoing lumbar disc herniation surgery: A randomised clinical trial. Journal of Perioperative Practice, 28(1-2), 7-15. https:// doi.org/10.1177/1750458917742045.

35. Shaw, M.J., Beebe, T.J., Tomshine, P.A., Adlis, S.A., & Cass, O.W. (2001). A randomized, controlled trial of interactive, multimedia software for patient colonoscopy education. Journal of Clinical Gastroenterology, 32(2), 142-147. https://doi.org/10.1097/00004836-200102000-00010.

36. Abdulghani, H.M., Haque, S., Ahmad, T., Irshad, M., Sattar, K., Al-harbi, M.M., et al. (2019). A critical review of obstetric and gynecological physical examination videos available on YouTube: Content analysis and user engagement evaluation. Medicine, 98(30), e16459. https://doi.org/10.1097/ MD.0000000000016459.

37. İldan Çalım, S., Cambaz Ulaş, S., Sülüden, E., Ataç, N., Göçer, Ş., & Yürekli, Z.N. (2022). Akademisyen Kadınların Jinekolojik Muayene Deneyimleri ve Beklentilerinin Belirlenmesi. Adnan Menderes Üniversitesi Sağlık Bilimleri Fakültesi Dergisi, 6(1), 125-134. https://doi.org/10.46237/ amusbfd.89144.

38. Kocabaş, P., & Khorshid, L. (2012). A comparison of the effects of a special gynaecological garment and music in reducing the anxiety related to gynaecological examination. Journal of Clinical Nursing, 21(5‐ 6), 791-799. https://doi.org/10.1111/j.1365-2702.2011.03958.x.

39. Aktas, D., Kumas, M. B., Odabasıoglu, B. S., & Kaya, A. (2018). Effect of a Special Examination Gown and Nature-Based Sounds on Anxiety in Women Undergoing a Gynecological Examination. Clinical Nursing Research, 27(5), 521-539. https://doi.org/10.1177/1054773816686475.

40. Kurt, G., & Ozcan, N. K. (2024). The Effect of Virtual Reality On Pain and Anxiety Management During Pelvic Examination: A Randomized Controlled Trial. Journal of Midwifery & Women's Health, 69(4), 543–549. https://doi.org/10.1111/jmwh.13587.

41. Tugut, N., Demirel, G., Baser, M., Ata, E. E., & Karakus, S. (2017). Effects of lavender scent on patients' anxiety and pain levels during gynecological examination. Complementary Therapies inCclinical Practice, 28, 65-69. https://doi.org/10.1016/j.ctcp.2017.05.006.

42. Erbil, N. (2011). Prevalence and risk factors for female sexual dysfunction among turkish women attending a maternity and gynecology outpatient clinic. Sexuality and Disability, 29, 377-386. https:// doi.org/10.1007/s11195-011-9202-z