Connect the Dots—August 2017

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Video Colposcopy for Reducing Patient Anxiety During Colposcopy: A Randomized Controlled Trial
Obstet Gynecol 2017;130:411–9
Many procedures we do in medicine evoke anxiety and fear in patients. Multiple strategies to reduce anxiety and fear for patients have been tried, including environmental changes such as music, art in the room, a quiet ambience, pharmacologic agents, and preprocedure education, to name a few. In this randomized controlled trial (see page 411), investigators randomized women undergoing colposcopy to be able to see live video of their procedure along with a description of the process and findings by the physician compared with no such video.1 Women completed state-trait anxiety inventories preprocedure and postprocedure. There was no difference in anxiety, pain, general unpleasantness, and overall satisfaction between groups. Although it was not a primary outcome, the authors did find that those who were able to watch their procedure on video felt better informed about their procedure and highly valued this.
Patient-centered care will continue to gain importance. Despite being a negative study for their primary outcome, the effort that these authors went through to study a way to diffuse anxiety for a common procedure is valuable. Perhaps the increased knowledge among those women who could watch their procedure is associated with better rates of follow-up, vaccination uptake if appropriate, and preventive self-care. The more opportunities to inform and engage our patients with their care, the better outcomes we can expect for them.
Nancy C. Chescheir, MD
University of North Carolina, Chapel Hill, North Carolina
1. Hilal Z, Alici F, Tempfer CB, Seebacher V, Rezniczek GA. Video colposcopy for reducing patient anxiety during colposcopy: a randomized controlled trial. Obstet Gynecol 2017;130:411–9.
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