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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Article info
Publication history
Published online: September 23, 2013
Accepted:
September 13,
2013
Received in revised form:
September 9,
2013
Received:
April 22,
2013
Footnotes
☆Oral presentation at ACOG Clinical Meeting 2012.
☆☆Financial Support: Anonymous Donor.
☆☆☆Potential Conflicts of Interest: Karla Maguire MD, MPH: No conflicts of interest to disclose, Kathleen Morrell MD: No conflicts of interest to disclose, Anne Davis MD, MPH: Bayer (Research support), Merck (Honoraria for training), Carolyn Westhoff MD, MSc: Merck (Consultant), Bayer (Consultant).
Identification
Copyright
© 2014 Elsevier Inc. Published by Elsevier Inc. All rights reserved.