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Accuracy of providers' assessment of pain during intrauterine device insertion

  • Karla Maguire
    Correspondence
    Corresponding author. 1611 N.W. 12th Ave Suite #7007 Miami, FL 33136. Tel.: +1 305 582 1492, fax: +1 305 585 7651.
    Affiliations
    University of Miami, Miller School of Medicine, Department of Obstetrics and Gynecology, Miami, FL 33136, USA
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  • Kathleen Morrell
    Affiliations
    Columbia University Medical Center, Department of Obstetrics and Gynecology, Division of Family Planning and Preventive Services, New York, NY 10032, USA
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  • Carolyn Westhoff
    Affiliations
    Columbia University Medical Center, Department of Obstetrics and Gynecology, Division of Family Planning and Preventive Services, New York, NY 10032, USA
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  • Anne Davis
    Affiliations
    Columbia University Medical Center, Department of Obstetrics and Gynecology, Division of Family Planning and Preventive Services, New York, NY 10032, USA
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      Abstract

      Background

      Providers often underestimate patient pain. This study investigated if providers accurately assess pain during intrauterine device (IUD) insertion.

      Study Design

      This is a secondary analysis of a randomized trial. Participants rated pain on a 100-mm visual analogue scale (VAS). Providers marked a similar VAS for maximum level and timing of participant pain.

      Results

      The mean patient maximum pain was 64.8 mm (SD, 27) compared to 35.3 mm (SD, 26) rated by the provider (p<.001). Patient and provider agreement on most painful time point of procedure was weak (kappa statistic, 0.16).

      Conclusions

      Providers underestimate pain during IUD insertion.

      Implications

      To our knowledge, this is the first paper to compare provider and patient perceptions of pain during IUD insertion. Understanding this relationship will help guide further research about IUD insertion pain and techniques and could improve patient counseling.

      Keywords

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