Abstract

MIRANDA, Alexandra et al. Patient experience in office versus tradicional hysteroscopy. Acta Obstet Ginecol Port [online]. 2019, vol.13, n.1, pp.10-19. ISSN 1646-5830.

Overview and Aims: Technology has allowed hysteroscopy to be increasingly performed in the office (HO). Yet, fear of patient pain associated with HO still prevents clinicians from choosing it instead of traditional hysteroscopy (HA). We aimed to compare pain perception and satisfaction in patients submitted to HO versus HA and to determine socio-demographic and clinical factors that influence patient experience. Methods: We performed a prospective, observational, descriptive and analytical study, comparing women submitted to HA (n=119) and HO (n=113), between September and December 2016 and January to July 2017, respectively. Three self-report questionnaires were answered by the patients before, immediately and one month after the hysteroscopy, and another questionnaire was answered by the clinician in charge of the technique. Results: Both HA and HO groups showed similar socio-demographic characteristics. Differences were found between felt and expected pain, both in HA (p<0,001) and HO (p= 0,001), with expected pain being higher in both groups. Despite HO group reported higher levels of pain (visual analog scale 4 versus 1,87 in the HA group), patients in this group presented significantly higher satisfaction regarding information given before (p=0,040) and after procedure (p<0,001) and with changes in their daily life (p<0,001). Generally, HO group showed higher levels of global satisfaction concerning the procedure (mean 20,45 versus mean 19,4 in the HA group, p= 0,001). Furthermore, the waiting time until hysteroscopy was lower in the HO group (p=0,007). We found no association between patients characteristics and the level of global satisfaction and experienced pain during hysteroscopy. Conclusion: HO presents higher levels of global satisfaction, which may be related to better communication, less waiting time until procedure and faster return to daily activities. Thus, given the safety and cost-effectiveness of HO, fear of patient pain should not prevent most diagnostic and simple surgical hysteroscopies from being performed in the HO context.

Keywords : Hysteroscopy; Office; Ambulatory; Satisfaction; Pain.

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