Jinekolojik Muayene Öncesi Multimedya Eğitiminin Hastaların Kaygı, Korku ve Pelvik Ağrı Düzeyleri Üzerine Etkisi: Tek Kör Prospektif Randomize Kontrollü Çalışma
Year 2025,
Volume: 9 Issue: 3, 368 - 382, 30.09.2025
Neriman Temel Aksu
,
Alime Büyük
,
Gokce Yagmur Gunes Gencer
,
Mehmet Sakıncı
Abstract
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.
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-
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-
3. O'Laughlin, D.J., Strelow, B., Fellows, N., Kelsey, E., Peters, S., Stevens, J.,
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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.
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-
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
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cervical screening results. BMC Medical Research Methodology, 20, 89.
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-
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women undergoing a gynecological examination. Clinical Nursing
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-
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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.
-
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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
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-
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j.aorn.2010.04.017.
-
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-
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j.1365-2702.2009.03028.x.
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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
Year 2025,
Volume: 9 Issue: 3, 368 - 382, 30.09.2025
Neriman Temel Aksu
,
Alime Büyük
,
Gokce Yagmur Gunes Gencer
,
Mehmet Sakıncı
Abstract
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.
References
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-
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.
-
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