Doula support in office hysteroscopy: results from a pilot study

Jonas Hermansson,Lena Sandin Wranker,Louise Danielsson,Rocio Montejo

doi:10.31083/j.ceog4804151

Abstract

Background: This pilot study aimed to evaluate the feasibility of doula support in office hysteroscopy and the potential effectiveness of doula support during office hysteroscopy to reduce anxiety and pain. Methods: Twenty-eight women, median age 43.5 (range 21–73), with indications for office hysteroscopy received doula support (intervention) or routine care (control group) during the procedure. Feasibility was measured in terms of successful office hysteroscopies, duration, and adverse events. Outcome measures were Spielberg State-Trait Anxiety Inventory-S (STAI-S), and the Numeric Rate Scale (NRS) for pain intensity. Results: The results showed similar success rates, duration, and adverse events between the groups, with no differences in reported pain intensity. Both groups had high, comparable levels of anxiety before the procedure (Doula group mean STAI-S score = 45.4, control group = 45.8). After the procedure, the doula group showed slightly increased anxiety while the control group showed slightly decreased anxiety. There was a significant difference between groups favoring the control group when comparing STAI-S mean score post-procedure (48.6 in the Doula group versus 44.1 in the control group p = 0.033). However, when analyzing the mean change across groups (p = 0.205) that difference was not significant. Discussion: To conclude, this pilot study suggests that Doula support may be feasible but not superior to routine care support in office hysteroscopy. High anxiety levels may be more relevant than pain during the procedure. Further investigation of the state and trait anxiety in office hysteroscopy populations in different health care contexts is recommended.

Highlights

This pilot study aimed to evaluate the feasibility of doula support in office hysteroscopy and the potential effectiveness of doula support during office hysteroscopy to reduce anxiety and pain
High anxiety levels may be more of an issue than pain during the procedure
There were no significant differences between the two groups regarding baseline characteristics (Table 1) and indications for office hysteroscopy (Table 2)

Summary

Introduction

This pilot study aimed to evaluate the feasibility of doula support in office hysteroscopy and the potential effectiveness of doula support during office hysteroscopy to reduce anxiety and pain. Office hysteroscopy is a widely used approach in gynaecology [1], effective pain management during the procedure is insufficient in about a third of patients [1], and pre-procedural anxiety is significantly higher than in those attending the gynaecologist’s office for other reasons [2]. It was hypothesized that the presence of a doula supporting the patient during office hysteroscopy would be beneficial. This pilot study aimed to evaluate a) the feasibility of doula support in office hysteroscopy and b) the potential effectiveness of doula support during office hysteroscopy to reduce state anxiety and pain

Methods

Results

Discussion

Conclusion