Strong discomfort during vaginal examination: why consider a history of abuse?
Strong discomfort during vaginal examination: why consider a history of abuse?
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DOI：
10.1016/j.ejogrb.2011.02.025
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发表时间：
2011-08-01
影响因子：
2.6
通讯作者：
Siwe, Karin
中科院分区：
文献类型：
--
作者：
Swahnberg, Katarina;Wijma, Barbro;Siwe, Karin
目的：通过四个假设研究阴道检查时强烈不适感（SD/VE）的相关因素。研究设计：一项横断面邮寄问卷调查研究，在瑞典三个妇产科部门进行，随机抽样（n = 4453）。主要结果测量：自我报告的情感、身体和性虐待史与医疗保健中的虐待、前一年的闪回、与检查者的情感接触之间的关联，和首次访视期间的SD/VE（以10分量表估计的不适; 6 - 10 = SD）。统计分析采用卡方，二元逻辑回归，皮尔逊Correlation.Results：18%的妇女报告SD/VE。SD/VE与终生滥用史之间存在关联。经历过虐待的组合，特别是包括情感虐待和医疗虐待的组合，与SD/VE密切相关。SD/VE还与闪回在前一年，和负面情绪接触的考官在索引visit.Conclusions：我们得出结论，妇女谁意想不到的SD/VE反应更有可能有一个背景的虐待，甚至可能运行的风险，感觉再创伤在VE。一个临床意义是考虑虐待史的病人谁与SD/VE反应或经历负面的情绪接触在咨询过程中。(C)2011爱思唯尔爱尔兰有限公司保留所有权利。
Objective: To study factors associated with strong discomfort during vaginal examinations (SD/VE) by means of four hypotheses.Study design: A cross sectional postal questionnaire study, conducted at three Swedish departments of obstetrics and gynaecology and with a random population sample (n = 4453).Main outcome measures: The associations between a self-reported history of emotional, physical and sexual abuse and abuse in health care, flashbacks during the previous year, emotional contact with the examiner, and SD/VE during the index visit (discomfort estimated on a ten-point scale; six-ten = SD). Statistical analyses used were Chi-square, Binary logistic regression, and Pearson Correlation.Results: Eighteen percent of the women reported SD/VE. There was an association between SD/VE and a lifetime history of abuse. Having experienced combinations of abuse, especially combinations including emotional abuse and abuse in health care, was strongly associated with SD/VE. SD/VE was furthermore associated with flashbacks during the previous year, and negative emotional contact with the examiner during the index visit.Conclusions: We conclude that women who unexpectedly react with SD/VE are more likely to have a background of abuse, and may even run a risk of feeling re-traumatised during the VE. A clinical implication is to consider a history of abuse in patients who react with SD/VE or experience negative emotional contact during the consultation. (C) 2011 Elsevier Ireland Ltd. All rights reserved.