Abstract
Study Objective
To understand the factors that influence individuals’ experiences during their first
pelvic examination.
Design, Setting, Participants, Interventions, and Main Outcome Measures
We conducted semistructured interviews with adolescents and young adults, aged 18-24,
who had received at least 1 pelvic examination. Interviews explored contextual factors
of the first pelvic examination, including visit acuity and clinical setting and individuals’
experiences with the pelvic examination itself and elicited recommendations on how
to improve the examination experience. Interviews were transcribed and computer-assisted
content analysis was performed; salient themes are presented.
Results
Thirty participants completed interviews. Nineteen participants described their first
pelvic examination experience as positive; 11 described this examination as a negative
or neutral experience. Factors influencing the experience include the examination
indication and acuity, examination location and physical space, provider features,
relational and interpersonal features, and procedural aspects. Recommendations included:
(1) establish rapport and educate before the examination; (2) establish practices
to orient patients; (3) make no assumptions about identity; and (4) elicit continuous
feedback.
Conclusion
Individuals’ first pelvic examination experiences are influenced by a variety of factors.
Although some factors are directly modifiable by providers, other factors that might
not be modifiable are important to elicit to optimize the examination experience.
These findings call for best practice guidelines and educational interventions to
prepare providers to perform the first pelvic examination.
Key Words
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References
- Committee opinion No. 534: well-woman visit.Obstet Gynecol. 2012; 120: 421
- Committee on Adolescent Health Care: the initial reproductive health visit.Obstet Gynecol. 2014; 123: 1143
- Attitudes towards pelvic examination in a random sample of Swedish women.Acta Obstet Gynecol Scand. 1998; 77: 422
- Women’s attitudes and expectations regarding gynaecological examination.Midwifery. 2009; 25: 500
- Women’s experiences of the gynecologic examination: factors associated with discomfort.Acta Obstet Gynecol Scand. 2003; 82: 1030
- What does a young girl experience in her first gynecological examination? Study on the relationship between anxiety and pain.J Pediatr Adolesc Gynecol. 2000; 13: 139
- ‘You expose yourself in so many ways’: young women’s experiences of pelvic examination.J Psychosom Obstet Gynaecol. 2011; 32: 59
- Attitudes towards pelvic examinations and chaperones: a questionnaire survey of patients and providers.Contraception. 2003; 67: 313
- Qualitative Data Analysis.3rd ed. SAGE Publications, London2014
- Analyzing Qualitative Data: Systematic Approaches.SAGE Publications, Thousand Oaks, CA2009
- Experience of the first pelvic examination.Eur J Contracept Reprod Health Care. 2001; 6: 34
- Committee on Ethics, American College of Obstetricians and Gynecologists: ACOG Committee Opinion No. 373: Sexual misconduct.Obstet Gynecol. 2007; 110: 441
- Use of chaperones during the physical examination of the pediatric patient.Pediatrics. 2011; 127: 991
- Factors influencing young women’s preparedness for their first pelvic exam: a qualitative study.Obstet Gynecol. 2018; 132: 479
- Women’s experiences of pelvic examination: an interview study.J Psychosom Obstet Gynaecol. 2002; 23: 17
- The care of adolescents by obstetrician-gynecologists: a first look.J Pediatr Adolesc Gynecol. 2009; 22: 121
- Clinical report--gynecologic examination for adolescents in the pediatric office setting.Pediatrics. 2010; 126: 583
- How to perform a pelvic exam for the sexually active adolescent.Nurse Pract. 2002; 27: 28
- The first pelvic examination in the adolescent: an update.J Nurse Pract. 2008; 4: 377
- A simulated patient-based program for training gynecologists in communication with adolescent girls presenting with gynecological problems.J Pediatr Adolesc Gynecol. 2009; 22: 79
- Does an advanced pelvic simulation curriculum improve resident performance on a pediatric and adolescent gynecology focused objective structured clinical examination? A cohort study.J Pediatr Adolesc Gynecol. 2016; 29: 276
Article info
Publication history
Published online: November 02, 2018
Footnotes
The authors indicate no conflicts of interest.
Study findings were presented, in part, at the North American Society for Pediatric and Adolescent Gynecology Annual Meeting, West Palm Beach, Florida, April 12-14, 2018.
Identification
Copyright
© 2018 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc.
