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

Exploring Turkish women's gynecological examination perceptions based on their metaphors: a qualitative study

BACKGROUND

During the gynecological examination, women especially feel uncomfortable with the lithotomy position and experience shame and anxiety. This study aims to explore metaphors used by women who have experienced gynecological examinations.

METHODS

This study is qualitative and phenomenological. The study group consisted of 90 women. Data were collected online using a data form in May-June 2021. It consisted of the sociodemographic characteristics of women and their metaphorical perceptions of gynecological examination. Data were analyzed and interpreted using a metaphorical analytical method inspired by Kochis and Gillespie. Metaphoric linguistic expressions, sequences, words, and sentences related to each other, were highlighted. The Consolidated criteria for Reporting Qualitative research (COREQ) checklist was used in the study report.

RESULTS

The average age of the women was 37.29 ± 10.14, and 73.0% were high school graduates. Three different conceptual categories were created by associating each metaphor image with a certain theme concerning women's perspective on gynecological examination. The characteristics compiled during the category development phase were used to collect 24 metaphors under a specific category. The metaphor revealed that the process, instrument (examination table), and affective aspects of the gynecological examination are in interaction. In this study was found that the main metaphor image for the gynecological table was a "fork," the gynecological examination brought to mind "the pregnancy" because of the reason for the procedure, and most of the women used the metaphors of "ache/pain" for their gynecological examination experience.

CONCLUSIONS

The metaphors used for the gynecological examination expressions suggested that women's experiences were negative. Such metaphors may reflect physical and emotional discomfort experienced during the examination. Health professionals' understanding of these negative perceptions and their empathy may facilitate positive experiences for women and the detection and treatment of health problems.

Experiencing fertility preservation in adolescence - a qualitative interview study indicating gender disparities in AYAs diagnosed with cancer

Introduction

Fertility counselling on options for fertility preservation is increasingly implemented for children and adolescents at time of cancer diagnosis. Sperm cryopreservation has been standard of care for male patients during several decades and the procedure is not expected to delay the onset of cancer treatment. However, oocyte cryopreservation in female adolescents remains controversial, the reasons include the need of ovarian stimulation, gynecological exams and interventions, in all a potentially distressing experience for patients without previous experience of this type of examination or without previous sexual debut. With this study we wished to investigate how adolescent cancer patients experience fertility preservation procedures aiming at semen banking or oocyte cryopreservation.

Methods

Adolescent patients diagnosed with cancer that underwent fertility preservation at the Reproductive Medicine Clinic of Karolinska University Hospital were invited to participate in the study. Inclusion required the ability to communicate in Swedish or English. Exclusion criteria were current age under 15 at time of the interview and ongoing cancer treatment. The study had a qualitative study design and phenomenological approach with semi-structured individual face-to-face interviews. Ten interviews with six female and four male study participants were conducted between June and August 2023.

Results

The analysis resulted in three identified main themes: Communication about the risk of infertility and the fertility preservation, Freezing gametes - the process and healthcare encounters, and The decision to preserve gametes for one's own sake. Gender specific gaps in communication about fertility risks and fertility preservation procedures were found, with young females expressing a wish for improved communication and reporting experiences of discomfort during the procedures needed for oocyte cryopreservation, whereas young men were generally satisfied with their experience. Limitations include a risk of responder bias since not all patients who were contacted agreed to interview.

Discussion

Although gender disparities were identified in this study, fertility preservation was perceived as a positive experience and mitigated fertility-related distress in both male and female adolescent patients. Our study adds to the scarce literature on adolescents of both sexes undergoing fertility preservation and underscores the importance of specialized communication in fertility counselling and treatment of AYAs diagnosed with cancer.

A practical guide to the trauma-informed physical examination

ABSTRACT

About two-thirds of patients have a trauma history, such as experiencing abuse or community violence. Clinicians must be knowledgeable about trauma because of its high prevalence and long-lasting effect on patients. The medical encounter can be triggering for patients with a history of trauma, especially when power differentials are intensified, such as during the physical examination. Clinicians can improve the interaction by incorporating simple trauma-informed techniques, such as adjusting communication, positioning, and contact during the physical examination. These modifications foster a sense of patient safety and collaborative decision-making. This article describes the background of trauma-informed care and outlines trauma-informed techniques for physical examinations.

The effect of online training and counseling on women's attitudes and anxiety toward gynecological examination: A randomized controlled study

Gynecological examination has an very place among to maintain women's health. Negative attitudes and anxiety about gynecological examination may affect coming to the examination. In this study, we aimed to determine the effect of online training and counseling on women's attitudes and anxiety toward the gynecological examination. We randomized 100 women participating in the study into experimental and control groups. We concluded that online training and counseling had a positive effect on the attitudes of women in the experimental group toward gynecological examination. Also we determined that online training and counseling reduced women's state anxiety toward gynecological examinations.