Fundamental and situational components in a strategy for attaining a positive patient experience of the pelvic examination: a conceptual approach

Factors of importance for developing a trustful patient-professional relationship when women undergo a pelvic examination

We examined gynecological teaching women's perception on what factors are important for developing a trustful patient-professional relationship when women undergo a pelvic examination. A qualitative research design was conducted with repeated focus group discussions. Our results show that healthcare professionals' communications skills can strengthen a trustful patient-professional relationship. Treating women with dignity could make them feel less vulnerable and make the relationship trustworthy based on respect. Thus, having the ability to identify factors important for a trustful relationship may support healthcare professional's ability to strengthen women's health issues. A trustful relationship might also affect quality of care.

Creating a more positive patient experience of pelvic examination

PURPOSE

To explore through descriptive comparative analysis an alternative method of pelvic examination to increase patient comfort.

DATA SOURCES

Sixty-two participants were recruited from a convenience sample of patients at an ambulatory women's healthcare clinic operated by a teaching hospital in the Southwest United States. Twenty-five were examined using the conventional pelvic examination technique; 37 with a new technique that we call the Rad technique, named after a co-author of the study. Three women's health nurse practitioners were trained in both methods and alternated the exam technique used. Visualization of the cervix was measured by clinician responses to the Speculum Exam Questionnaire for Clinicians; level of pain was determined from patient responses to the Wong-Baker FACES Pain Rating Scale. Results were analyzed using a t-test for independent samples. Pain was further analyzed using chi-square test of association.

CONCLUSIONS

Although the relationship between the variables of visualization and pain was not statistically significant, 16% of women in the conventional technique group reported vaginal pain compared with 5.4% in the Rad technique group.

IMPLICATIONS FOR PRACTICE

Changing from the conventional pelvic examination to the Rad technique may create a more positive patient experience and thereby engage more women in recommended in gynecological health care.

Women's attitudes and expectations regarding gynaecological examination

OBJECTIVE

to describe women's expectations of doctors and nurses during gynaecological examination, to identify if women have a preference for the doctor's gender, to investigate women's feelings during examination, and to determine why women consult the gynaecological outpatient clinic.

DESIGN

a descriptive and cross-sectional study using a questionnaire administered face to face.

SETTING

this study was performed with women recruited from those making an appointment for gynaecological examination at the gynaecological outpatient clinic at Manisa Maternity and Child Hospital between September 2004 and February 2005.

PARTICIPANTS

four hundred and thirty-three women who applied to the gynaecological outpatient clinic at Manisa Maternity and Child Hospital.

MEASUREMENTS

the questionnaire included questions about the women's socio-demographic and reproductive characteristics, feelings with regard to pelvic examination, expectations of doctors and nurses during gynaecological examination, preferences regarding the gender of the physician, and the reason for the gynaecological examination.

FINDINGS

more than one-half of women felt anxious or worried about their health situation during the pelvic examination (54.8%), and 41.8% of women said that they were embarrassed about having to undress. 45.5% of women reported that they would prefer a female doctor, only 4.2% of women would prefer a male doctor in their obstetric and gynaecological care, and the remaining women (49.9%) expressed no preference. Most women (62.1%) expected the doctor to explain their health situation after examination. 71.8% of women said that the nurse should have an understanding and gentle manner, and 28.2% of women stated that the nurse should offer information to the patient about the pelvic examination.

KEY CONCLUSIONS

it was very important for the women to participate through receiving information during the gynaecological examination. When treated with respect, the women were able to have a positive relationship with the staff. This encourages the women to attend clinics for their own health needs. Gynaecological examination is an essential part of gynaecological care and the most common procedure in gynaecological practice. Many women in the world will have a gynaecological examination several times during their lives, from youth to old age. This study could contribute to improve health programmes to make the gynaecological examination situation more positive for women.

Trust and confirmation in a gynecologic examination situation: a critical incident technique analysis

BACKGROUND

Gynecologic examination is a common measure in reproductive health care. Many women experience the examination as a more or less negative event, with shortcomings in the examiner's behavior. The aim of the study was to describe, in terms of critical incidences, women's experiences concerning the personnel's behavior in the situation of gynecologic examination.

METHODS

The informants were strategically chosen and consisted of 30 Swedish women between the ages of 18-82 years old. The data collection method was qualitative research interviews analyzed by critical incident technique.

RESULTS

The result consisted of 30 subcategories, five categories, and two main areas - trust and confirmation. The personnel enabled trust when they promoted participation, created confidence, and were supportive. The opposite behavior contributed to the lack of trust. Confirmation described behavior that confirmed, respectively, did not confirm the women. This was shown through the presence or lack of respect and engagement.

CONCLUSION

The personnel's positive behavior enabled trust and confirmed the women as individuals, while negative behavior was decisive in an unfavorable way. A complexity of patterns of knowing in nursing was identified. Participation through information that contributed to trust was important and amounted to one fourth of the incidents in the material. Respect and engagement, which confirmed the women, facilitated a positive caring relationship. The examination situation can be improved through reflection of the personnel's own behavior and further research about women's own experiences.