Institut de Recherche interdisciplinaire sur les Enjeux Sociaux (IRIS), Aubervilliers, France.
Direction de la protection maternelle et infantile et promotion de la santé, Créteil, France.
Trauma Violence Abuse. 2024 Dec;25(5):4030-4044. doi: 10.1177/15248380241270038. Epub 2024 Aug 20.
Pelvic examination, a routine practice for gynecological care, can cause anxiety and be considered traumatic. This study aimed to define the association between domestic or sexual violence and the experience of pelvic examination, as well as the uptake of gynecological care following domestic or sexual violence. Pubmed, Cochrane Library, ScienceDirect, and Google Scholar were searched, up to April 30, 2023. Cohort, cross-sectional, case-control studies and controlled trials assessing perception of pelvic examination or the use of gynecological care for women with a history of violence were selected and analyzed. Each study underwent a descriptive analysis and was assessed for bias using the Newcastle-Ottawa scale and the RoB2 tool. Twenty-three articles met the inclusion criteria. Eleven studies, including 7,329 women, investigated the experience of pelvic examination following lifetime or childhood sexual violence. Most reported an association between violence and adverse experiences of pelvic examination, such as discomfort, anxiety, distress, and pain perceptions. Ten studies, including 9,248 women, investigated the uptake of gynecological care following domestic or sexual violence and reported mixed results, such as a decreased or an increased uptake, particularly for acute symptoms. Two studies, including 1,304 women, examined both outcomes. The present study highlights the association between violence and adverse experiences of pelvic examination, as well as mixed results on the uptake of gynecological care. It argues for the necessity to screen for violence in consultations, particularly when considering a pelvic examination, to guarantee the utility of pelvic examinations, and to consider the traumatic impact of sexual violence in care.
盆腔检查是妇科护理的常规做法，但可能会引起焦虑，并被视为创伤性检查。本研究旨在确定家庭暴力或性暴力与盆腔检查体验之间的关联，以及家庭暴力或性暴力后接受妇科护理的情况。我们检索了 PubMed、Cochrane 图书馆、ScienceDirect 和 Google Scholar，检索时间截至 2023 年 4 月 30 日。选择并分析了评估有暴力史的女性对盆腔检查的感知或使用妇科护理情况的队列研究、横断面研究、病例对照研究和对照试验。对每项研究进行描述性分析，并使用纽卡斯尔-渥太华量表和 RoB2 工具评估偏倚。有 23 篇文章符合纳入标准。11 项研究，包括 7329 名女性，调查了一生中或儿童时期遭受性暴力后接受盆腔检查的经历。大多数研究报告了暴力与盆腔检查不良体验之间存在关联，例如不适、焦虑、痛苦和疼痛感知。10 项研究，包括 9248 名女性，调查了家庭暴力或性暴力后接受妇科护理的情况，结果喜忧参半，例如急性症状的就诊率降低或增加。两项研究，包括 1304 名女性，同时调查了这两个结果。本研究强调了暴力与盆腔检查不良体验之间的关联，以及在接受妇科护理方面的结果喜忧参半。这表明有必要在咨询中筛查暴力，特别是在考虑盆腔检查时，以保证盆腔检查的有效性，并考虑性暴力对护理的创伤性影响。
