Utilization of a Mirror During Pelvic Examinations: Does it Improve the Patient’s Experience?

Abstract Attorneys use the term pain and suffering to indicate the subjective, intangible effects of an individual's injury, and plaintiffs may seek compensation for “pain and suffering” as part of a personal injury case although it is not usually an element of a workers’ compensation case. The AMA Guides to the Evaluation of Permanent Impairment (AMA Guides), Fifth Edition, provides guidance for rating pain qualitatively or quantitatively in certain cases, but, because of the subjectivity and privateness of the patient's experience, the AMA Guides offers no quantitative approach to assessing “pain and suffering.” The AMA Guides also cautions that confounders of pain behaviors and perception of pain include beliefs, expectations, rewards, attention, and training. “Pain and suffering” is challenging for all parties to value, particularly in terms of financial damages, and using an individual's medical expenses as an indicator of “pain and suffering” simply encourages excessive diagnostic and treatment interventions. The affective component, ie, the uniqueness of this subjective experience, makes it difficult for others, including evaluators, to grasp its meaning. Experienced evaluators recognize that a myriad of factors play a role in the experience of suffering associated with pain, including its intensity and location, the individual's ability to conceptualize pain, the meaning ascribed to pain, the accompanying injury or illness, and the social understanding of suffering.

Download Full-text

Women's experiences of pelvic examinations

Reproductive Health Matters ◽

10.1016/s0968-8080(98)90127-6 ◽

1998 ◽

Vol 6 (11) ◽

pp. 165

Keyword(s):

Women’S Experiences ◽

Women's Experiences ◽

Pelvic Examinations

Download Full-text

Measuring the Patient's Experience of VA Health Care

PsycEXTRA Dataset ◽

10.1037/e578252006-003 ◽

2004 ◽

Author(s):

Charles Humble ◽

Jim Schaefer ◽

Barbara Fleming

Keyword(s):

Health Care ◽

Patient’S Experience

Download Full-text

Starting points for therapeutic change

Communication & Medicine ◽

10.1558/cam.33827 ◽

2020 ◽

Vol 16 (2) ◽

pp. 117-128

Author(s):

Claudio Scarvaglieri

Keyword(s):

Societal Perspective ◽

Therapeutic Change ◽

Psychodynamic Therapy ◽

Second Step ◽

Change Processes ◽

Collective Knowledge ◽

Patient’S Experience ◽

Client Centered Therapy ◽

Therapy Sessions ◽

Crucial Part

Based on a corpus of 70 tape-recorded therapy sessions (client-centered therapy, psychodynamic therapy), this paper presents analyses of therapists’ interventions that have the potential to trigger change processes. Using a conversation analytic approach, we identify utterances that re-formulate the patient’s experience from a different perspective. In a second step, we draw on concepts from cognitive and pragmatic linguistics, mainly “frame” and “category”, to analyze the conceptual side of these rewordings. We show that, besides processes of general abstraction, the conceptualization of the patient’s experience from a societal perspective is a crucial part of the rewordings. The verbal re-framing creates a potential for accessing stocks of societal knowledge that would not have been accessible based on the patient’s initial, individualistic and often erratic presentation of events. By changing the wording an experience is referred to, the therapist thus creates links to established collective knowledge about experiences of this category. Once such links to collective knowledge have been created, it then becomes possible to understand differently how the experience in question came to pass, which features it is characterized by and how it can be dealt with in a way that is collectively known to be helpful.

Download Full-text

Association of Emergency Department Waiting Times With Patient Experience in Admitted and Discharged Patients

Journal of Patient Experience ◽

10.1177/23743735211011404 ◽

2021 ◽

Vol 8 ◽

pp. 237437352110114

Author(s):

Andrew Nyce ◽

Snehal Gandhi ◽

Brian Freeze ◽

Joshua Bosire ◽

Terry Ricca ◽

...

Keyword(s):

Emergency Department ◽

Length Of Stay ◽

Patient Experience ◽

Waiting Times ◽

Hospital Length ◽

Short Length ◽

Hospital Length Of Stay ◽

Patient’S Experience ◽

Discharged Patients ◽

The Impact

Prolonged waiting times are associated with worse patient experience in patients discharged from the emergency department (ED). However, it is unclear which component of the waiting times is most impactful to the patient experience and the impact on hospitalized patients. We performed a retrospective analysis of ED patients between July 2018 and March 30, 2020. In all, 3278 patients were included: 1477 patients were discharged from the ED, and 1680 were admitted. Discharged patients had a longer door-to-first provider and door-to-doctor time, but a shorter doctor-to-disposition, disposition-to-departure, and total ED time when compared to admitted patients. Some, but not all, components of waiting times were significantly higher in patients with suboptimal experience (<100th percentile). Prolonged door-to-doctor time was significantly associated with worse patient experience in discharged patients and in patients with hospital length of stay ≤4 days. Prolonged ED waiting times were significantly associated with worse patient experience in patients who were discharged from the ED and in inpatients with short length of stay. Door-to-doctor time seems to have the highest impact on the patient’s experience of these 2 groups.

Download Full-text

O70 Patient reported experiences through PBC foundation app: what impacts upon a PBC patient’s experience?

10.1136/gutjnl-2020-bsgcampus.70 ◽

2021 ◽

Author(s):

Robert Mitchell-Thain ◽

Andrew Yeoman ◽

Vinod Hegade

Keyword(s):

Patient Reported ◽

Patient’S Experience

Download Full-text

Successive ipsilateral surgery of Vibrant Soundbridge and Bonebridge devices for congenital bilateral conductive hearing loss: a case report

Journal of International Medical Research ◽

10.1177/0300060520972280 ◽

2020 ◽

Vol 48 (12) ◽

pp. 030006052097228

Author(s):

Yujie Liu ◽

Ran Ren ◽

Shouqin Zhao

Keyword(s):

Hearing Loss ◽

Case Report ◽

Conductive Hearing Loss ◽

Vibrant Soundbridge ◽

Patient’S Experience ◽

Hearing Devices ◽

Conductive Hearing ◽

Subjective Outcomes

The Bonebridge and Vibrant Soundbridge systems are semi-implanted hearing devices, which have been widely applied in patients with congenital conductive hearing loss. However, comparison between these two hearing devices is rare, especially in the same patient. We report a 23-year-old man who underwent successive implantation of Vibrant Soundbridge and Bonebridge devices in the same ear because of dysfunction of the Vibrant Soundbridge. We provide insight on the patient’s experience and compare the audiological and subjective outcomes of satisfaction.

Download Full-text

Addressing Anxiety and Fear during the Female Pelvic Examination

Journal of Primary Care & Community Health ◽

10.1177/2150132721992195 ◽

2021 ◽

Vol 12 ◽

pp. 215013272199219

Author(s):

Danielle J. O’Laughlin ◽

Brittany Strelow ◽

Nicole Fellows ◽

Elizabeth Kelsey ◽

Sonya Peters ◽

...

Keyword(s):

Risk Factors ◽

Health Care Providers ◽

Negative Symptoms ◽

Behavioral Therapy ◽

Treatment Options ◽

Pelvic Examination ◽

Care Providers ◽

Emotional Symptoms ◽

Pelvic Examinations ◽

Anxiety And Fear

To review the anxiety and fear risk factors, pathophysiology, symptoms, screening and diagnosis while highlighting treatment considerations for women undergoing a pelvic examination. Methods: We reviewed the literature pertaining to anxiety and fear surrounding the pelvic examination to help guide health care providers’ on available screening options and to review options for individualized patient management. Results: Anxiety and fear are common before and during the pelvic examination. In fact, the pelvic exam is one of the most common anxiety-provoking medical procedures. This exam can provoke negative physical and emotional symptoms such as pain, discomfort, anxiety, fear, embarrassment, and irritability. These negative symptoms can interfere with preventative health screening compliance resulting in delayed or avoided care and significant health consequences. Conclusion: Assessing women for anxiety related to pelvic examinations may help decrease a delay or avoidance of examinations. Risk factor and symptom identification is also a key component in this. General anxiety questionnaires can help identify women with anxiety related to pelvic examinations. Strategies to reduce anxiety, fear and pain during a pelvic examination should routinely be implemented, particularly in women with high-risk factors or those identified with screening techniques as having anxiety, fear or pain with examinations. Treatment options should be targeted at understanding the patient’s concerns, starting conversations about pelvic examinations early, educating patient’s about the examination and offering the presence of a chaperone or support person. During an examination providers should ensure the patient is comfortable, negative phrases are avoided, the correct speculum size is utilized and proper lubrication, draping, dressing and positioning are performed. Treating underlying gynecologic or mental health conditions, consideration of cognitive behavioral therapy and complementary techniques such as lavender aromatherapy and music therapy should also be considered when appropriate.

Download Full-text