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      The effect of music in gynaecological office procedures on pain, anxiety and satisfaction: a randomized controlled trial

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          Abstract

          Background

          Pain can interfere with office procedures in gynaecology. The aim of this study is to measure the positive effect of music in gynaecological office procedures.

          Methods

          A randomized controlled trial was performed between October 2014 and January 2016. Women scheduled for an office hysteroscopy or colposcopy were eligible for randomization in the music group or control group. Stratification for hysteroscopy and colposcopy took place. The primary outcome is patients’ level of pain during the procedure measured by the visual analogue scale (VAS). Secondary outcomes include patients’ level of pain after the procedure, anxiety and satisfaction of patient and doctor.

          Results

          No positive effect of music on patients’ perception of pain during the procedure was measured, neither for the hysteroscopy group (57 mm vs. 52 mm) nor for the colposcopy group (32 mm vs. 32 mm). Secondary outcomes were also similar for both groups.

          Conclusions

          This study showed no positive effect of music on patients’ level of pain, anxiety or satisfaction of patient or doctor for office hysteroscopy and colposcopy. We believe a multimodal approach has to be used to decrease patient distress in terms of pain and anxiety, with or without music.

          Trial registration

          Dutch Trial Register, NTR4924

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          Most cited references8

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          Do absorption and realistic distraction influence performance of component task surgical procedure?

          Background Surgeons perform complex tasks while exposed to multiple distracting sources that may increase stress in the operating room (e.g., music, conversation, and unadapted use of sophisticated technologies). This study aimed to examine whether such realistic social and technological distracting conditions may influence surgical performance. Methods Twelve medical interns performed a laparoscopic cholecystectomy task with the Xitact LC 3.0 virtual reality simulator under distracting conditions (exposure to music, conversation, and nonoptimal handling of the laparoscope) versus nondistracting conditions (control condition) as part of a 2 x 2 within-subject experimental design. Results Under distracting conditions, the medical interns showed a significant decline in task performance (overall task score, task errors, and operating time) and significantly increased levels of irritation toward both the assistant handling the laparoscope in a nonoptimal way and the sources of social distraction. Furthermore, individual differences in cognitive style (i.e., cognitive absorption and need for cognition) significantly influenced the levels of irritation experienced by the medical interns. Conclusion The results suggest careful evaluation of the social and technological sources of distraction in the operation room to reduce irritation for the surgeon and provision of proper preclinical laparoscope navigation training to increase security for the patient.
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            Prospective multicentre randomized controlled trial to evaluate factors influencing the success rate of office diagnostic hysteroscopy.

            Diagnostic hysteroscopy is not widely performed in the office setting, one of the reasons being the discomfort produced by the procedure. This randomized controlled trial was performed to evaluate the effects of instrument diameter, patient parity and surgeon experience on the pain suffered and success rate of the procedure. Patients were randomly assigned to undergo office diagnostic hysteroscopy either with 5.0 mm conventional instruments (n=240) or with 3.5 mm mini-instruments (n=240). Procedures were stratified according to patient parity and surgeon's previous experience. The pain experienced during the procedure (0-10), the quality of visualization of the uterine cavity (0-3) and the complications were recorded. The examination was considered successful when the pain score was 1 and no complication occurred. Less pain, better visualization and higher success rates were observed with mini-hysteroscopy (P <0.0001, P <0.0001 and P <0.0001, respectively), in patients with vaginal deliveries (P <0.0001, P <0.0001 and P <0.0001, respectively) and in procedures performed by experienced surgeons (P=0.02, P=NS and P=NS, respectively). The effects of patient parity and surgeon experience were no longer important when mini-hysteroscopy was used. Our data demonstrate the advantages of mini-hysteroscopy and the importance of patient parity and surgeon experience, suggesting that mini-hysteroscopy should always be used, especially for inexperienced surgeons and when difficult access to the uterine cavity is anticipated. They indicate that mini-hysteroscopy can be offered as a first line office diagnostic procedure.
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              Anxieties in women undergoing colposcopy.

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                Author and article information

                Contributors
                +31-40 888 8384 , N.mak@alumni.maastrichtuniversity.nl
                Journal
                Gynecol Surg
                Gynecol Surg
                Gynecological Surgery
                Springer Berlin Heidelberg (Berlin/Heidelberg )
                1613-2076
                1613-2084
                9 August 2017
                9 August 2017
                2017
                : 14
                : 1
                : 14
                Affiliations
                [1 ]ISNI 0000 0004 0477 4812, GRID grid.414711.6, Department of Obstetrics and Gynaecology, , Máxima Medical Centre, ; Veldhoven, The Netherlands
                [2 ]ISNI 0000 0004 0477 5022, GRID grid.416856.8, Department of Obstetrics and Gynaecology, , VieCuri Medical Centre, ; Venlo, The Netherlands
                [3 ]Department of Obstetrics and Gynaecology, Rode Kruis Hospital, Beverwijk, The Netherlands
                [4 ]GRID grid.412966.e, Department of Obstetrics and Gynaecology, , GROW—School for Oncology and Developmental Biology, Maastricht University Medical Centre, ; Maastricht, The Netherlands
                Article
                1016
                10.1186/s10397-017-1016-2
                5570770
                44e44e47-b025-4def-868e-131a095c585d
                © The Author(s). 2017

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.

                History
                : 22 March 2017
                : 26 July 2017
                Categories
                Original Article
                Custom metadata
                © The Author(s) 2017

                Obstetrics & Gynecology
                pain,anxiety,music,office procedures,hysteroscopy,colposcopy
                Obstetrics & Gynecology
                pain, anxiety, music, office procedures, hysteroscopy, colposcopy

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