Impact of using words with unpleasant emotional connotations on perceived patient discomfort during vaginal speculum examinations: A randomized controlled trial

Jose Carugno, Douglas Timmons, Madeline Lederer, Mary Mackenzie Grady

Research output: Contribution to journalArticlepeer-review

1 Scopus citations

Abstract

Objectives: Many providers often use terms such as “this might hurt”, or “you might feel pressure” during exams with the intention to be compassionate and to help decrease discomfort. No evidence exists to support this practice. Our objective was to evaluate the impact of the use of words with unpleasant emotional connotation on perceived discomfort at the time of vaginal speculum examination. Study design: A randomized trial was performed on premenopausal women undergoing a routine well-woman speculum exam. 120 total patients were included and randomized into one of two groups; phrases with unpleasant connotation (n = 60) vs. objective phrases (n = 60). During the speculum exam, the provider used either phrases with unpleasant connotation (i.e., “You are going to feel a lot of pressure”), or objective phrases (i.e., “I am going to introduce the speculum”). Following the exam, patients were asked to rate the level of discomfort/pain experienced during the exam and to compare their actual experience to their anticipated experience. Descriptive statistics were performed. Chi-square and independent samples t-test were used with a significance of p < 0.05. Results: Patients in the phrases with unpleasant connotation group had significantly higher pain scores than the objective phrases group (2.9 ± 1.5 vs. 0.8 ± 0.8 (p < .01)). The majority of the patients in the phrases with unpleasant connotation group reported the exam “as painful as anticipated” or “more painful than anticipated” whereas the majority of the patients in the objective phrases group reported the exam as “pain free” or “less painful than anticipated”. Conclusion: Healthcare providers performing speculum examinations should use objective statements and avoid the use of phrases with unpleasant connotation with the intention to minimize perceived pain during exams.

Original languageEnglish (US)
Pages (from-to)203-206
Number of pages4
JournalEuropean Journal of Obstetrics and Gynecology and Reproductive Biology
Volume247
DOIs
StatePublished - Apr 2020

Keywords

  • Discomfort
  • Emotional connotation
  • Objective instructions
  • Pain
  • speculum examination

ASJC Scopus subject areas

  • Reproductive Medicine
  • Obstetrics and Gynecology

Fingerprint Dive into the research topics of 'Impact of using words with unpleasant emotional connotations on perceived patient discomfort during vaginal speculum examinations: A randomized controlled trial'. Together they form a unique fingerprint.

Cite this