Carwile Jenny L, Feldman Sarah, Johnson Natasha R
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.
J Low Genit Tract Dis. 2014 Oct;18(4):317-21. doi: 10.1097/LGT.0000000000000024.
We hypothesized that a passive visual distraction would reduce pain and anxiety among women undergoing colposcopy.
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.
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).
A passive visual distraction reduced perceived pain, but not anxiety, after colposcopy.
我们假设被动视觉干扰能够减轻接受阴道镜检查的女性的疼痛和焦虑。
我们采用非随机干预设计，评估了阴道镜检查期间接受被动视觉干扰与手术相关疼痛和焦虑之间的关联。在布莱根妇女医院阴道镜诊所进行初次或重复阴道镜检查的女性符合参与条件。在研究的前6个月接受阴道镜检查的女性（n = 168）未受到视觉干扰，而在研究的后6个月接受阴道镜检查的女性（n = 153）受到了一种令人愉悦的被动视觉干扰，该干扰由安装在检查室顶灯内的光扩散器上的图像组成。我们使用有序逻辑回归来比较接受和未接受干预的女性中，通过视觉模拟量表测量的自我报告疼痛以及通过斯皮尔伯格状态-特质焦虑量表-6测量的焦虑。
最终分析纳入了216名有完整数据的女性。两组女性均报告了高水平的阴道镜检查相关焦虑。与未接受视觉干扰的女性相比，在阴道镜检查期间接受视觉干扰的女性在保持术前疼痛不变的情况下，经历特定水平的检查后疼痛的几率降低了54%（优势比 = 0.46，95%置信区间 = 0.28 - 0.77）。视觉干扰与检查后焦虑无关（优势比 = 0.95，95%置信区间 = 0.60 - 1.51）。
被动视觉干扰减轻了阴道镜检查后的疼痛感知，但未减轻焦虑。
