Patients’ experiences and providers’ observations on pain during intrauterine device insertion

Akintomide, Hannat; Brima, Nataliya; Sewell, Robert David Edmund; Stephenson, Judith

doi:10.3109/13625187.2015.1031885

Cited by 17 publications

(8 citation statements)

References 21 publications

(16 reference statements)

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“…However, the HCPs completed their assessments retrospectively and would have had difficulty monitoring the patients' facial expressions whilst performing the insertion which could inhibit the clinicians' interpretation of and degree of empathy with the patients' pain (Botvinick et al 2005). Similar results were found in studies on pain in relation to IUC insertion undertaken by Akintomide et al (2015) via questionnaire in the UK and in the Iranian study by HajiEsmaeilou et al (2014) using a VAS. Such concordant findings from three different continents reinforce the assumption that underestimation of patient's pain is a universal problem.…”

Section: Trustmentioning

confidence: 53%

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Intrauterine contraception insertion pain: nursing interventions to improve patient experience

McCarthy

2017

Journal of Clinical Nursing

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Aims and objectives. To examine factors which contribute to the individual's experience of pain in relation to intrauterine contraception insertion and determine evidence-based nursing strategies to best assess and manage this pain. Background. Nurses are increasingly involved in consultations regarding intrauterine contraception. However, concerns regarding painful or difficult insertion may inhibit uptake and discourage nurses from promoting or inserting intrauterine contraception. Design. Integrative review. Methods. Database searches of CINAHL, PubMed, Wiley Online Library and the Cochrane Collaboration for relevant literature. Eight papers met the inclusion criteria and were analysed using an integrative review process. Results. Physical causes and pharmacological interventions for insertion pain have been thoroughly investigated. Absence of previous vaginal delivery and anxiety may increase the likelihood of procedural pain. The literature fails to conclusively determine any universally effective prophylactic analgesia. Cervical anaesthesia may be beneficial in some cases and oral analgesia may relieve postprocedural pain. Distraction in the form of conversation, music or television can be effective in reducing anxiety. Conclusions. A combination of physical, psychological and environmental factors contribute to the individual's pain experience. Nurses have the potential to make a significant impact on pain outcomes by demonstrating clinical expertise and creating a trustful environment. Giving reliable information, acknowledging the significance of anxiety and providing reassurance and distraction are effective pain reducing strategies. Research into nonpharmacological approaches is warranted, especially those which reduce anxiety. Relevance to clinical practice. Increasing uptake of long-acting reversible contraception is a public health goal. Providing effective pain management strategies to improve patient experience may encourage more nurses to recommend, or enhance their scope of practice to include, intrauterine contraception insertion.

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Section: Trustmentioning

confidence: 53%

“…Similar results were found in studies on pain in relation to IUC insertion undertaken by Akintomide et al . () via questionnaire in the UK and in the Iranian study by HajiEsmaeilou et al . () using a VAS.…”

Section: Resultsmentioning

confidence: 99%

Intrauterine contraception insertion pain: nursing interventions to improve patient experience

McCarthy

2017

Journal of Clinical Nursing

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“…The perception of pain is influenced by the patient's relationship with the physician [25][26][27]. One of the risk factors associated with increased pain intensity with gynecological procedures is the prediction a high level of pain prior to the procedure [28,29]. There is still no explanation for this finding in the literature.…”

Section: Discussionmentioning

confidence: 99%

Perception about Intrauterine Devices, Prior to and After Placement—Prospective Survey

Gaspar¹,

Silva²,

Almeida³

2022

Clin. Exp. Obstet. Gynecol.

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Background: Intrauterine devices are effective long-lasting contraceptive methods with a high rate of satisfaction among users. This study aimed at determining women's perception of intrauterine contraception, before and after its placement, and assessing the impact of contraceptive counseling on that perception. Methods: Descriptive prospective study, carried out through a questionnaire, regarding women who underwent a Family Planning (FP) consultation in a Tertiary Hospital Center, from September 1, 2020 to August 31, 2021. Results: 108 women were included in this study. Contraceptive methods used prior to the consultation were mainly hormonal (62%) and barrier (30%). The main reason for choosing the intrauterine device was the advice given by the physician or other health professional (87%). The greatest concern of women regarding this method was the placement process (27%), especially with regard to pain associated with the procedure (50%). 79% of women considered that they were fully clarified prior to device placement. After placement, mean pain intensity was 3.94 (SD = 2.273; Visual Analogue Scale), and it was found to be lower than women's perception prior to placement. 73% thought the process was simpler than expected and 88% would advise the method to other women. All users reported having been informed about possible complications or adverse effects associated with this contraceptive method. Conclusions: Results indicate that the choice of long-acting contraception is mainly associated with correct medical advice. Most of the women were clear after family planning consultation, which made the intrauterine device placement easier and less painful than expected.

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“…Another major contributor to pain at IUD insertion was anxiety. It is well known that higher anxiety levels may increase perceived pain to levels worse than the pain actually is [27][28][29]. A previous study found that women who were more anxious and who anticipated that the procedure would be painful recalled later that it was a painful experience even if they had not experienced any pain during the procedure [4].…”

Section: Dıscussionmentioning

confidence: 99%

A psychological factor associated with pain during intrauterine device insertion: emotional reactivity

Akdemir¹,

Karadeniz²

2020

Clinical and Experimental Obstetrics & Gynecology

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Objective: Although the experience of pain is multidimentional, and general psychological factors such as anxiety are found to be associated with acute pain, it is necessary to investigate individual emotional variables such as emotional reactivity (ER). The aim of this study was to determine if increased ER is associated with pain during intrauterine device (IUD) insertion even without existing pre-procedure anxiety. Study Design: Prospective cohort study. Methods: We measured the anxiety level in 237 women using the Beck Anxiety Inventory and the ER level using the Emotional Reactivity Scale (ERS) at Zonguldak Maternity Hospital between November 2018 and March 2019. The women rated their pain during IUD insertion. To evaluate the role of ER in the prediction of pain during IUD insertion, we divided the women into subgroups based on the presence of anxiety and level of pain during IUD insertion. Results: ER was higher in women who had anxiety and moderate-severe pain (p = 0.001). In women who were not anxious, ER was higher in those who had moderate-severe anticipated pain or IUD insertion pain than in those who had mild anticipated pain or IUD insertion pain (p = 0.001). In anxious women, the ERS cut-off value was ˃ 34 for predicting the level of pain whereas in non-anxious women, it was ˃ 25. Conclusion: ER is a psychological factor strongly associated with pain at IUD insertion and the ERS appears to be a beneficial tool for detecting ER for this purpose. Health professionals should be aware that psychological factors could contribute to perceived pain more than physiological factors do. Implications: ER is a psychological factor associated with pain at IUD insertion and increased ER is a predictive factor for pain during IUD insertion even without existing pre-procedure anxiety. ERS seems to be a beneficial tool for detecting ER.

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Patients’ experiences and providers’ observations on pain during intrauterine device insertion

Cited by 17 publications

References 21 publications

Intrauterine contraception insertion pain: nursing interventions to improve patient experience

Intrauterine contraception insertion pain: nursing interventions to improve patient experience

Perception about Intrauterine Devices, Prior to and After Placement—Prospective Survey

A psychological factor associated with pain during intrauterine device insertion: emotional reactivity

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