Abstract
BACKGROUND: Hysteroscopy without anaesthesia is a routine gynaecological procedure but is commonly associated with patient anxiety and pain. OBJECTIVES: To compare preoperative information provision using usual verbal interaction with the use of an animated video on patients' anxiety and pain associated with outpatient hysteroscopy. METHODS: Patients were allocated to receive verbal explanations immediately prior to the outpatient hysteroscopy or via an informative short, animated video. MAIN OUTCOME MEASURES: Proportion of patients with moderate-high preoperativee anxiety levels as assessed by the State-Trait Anxiety Inventory questionnaire. Secondary outcomes included maximal intraoperative pain levels recorded on a 10 cm visual analogue scale (VAS) completed directly after the procedure. RESULTS: One hundred patients undergoing 78 diagnostic hysteroscopies and 22 operative hysteroscopies were included in the study, with 50 patients allocated to each intervention group. Preoperative moderate or high anxiety levels were reported by 28 participants who also had higher VAS pain scores (3.6±3.2 cm vs. 2.0±2.5 cm in the lower anxiety group, P=0.02). The rates of preoperative moderate/high anxiety levels were significantly higher in the standard verbal education group compared with the animated video group [19 (38.0%) vs. 9 (18.0%), respectively, P=0.04], although their VAS pain scores were not significantly different. The logistic regression analysis confirmed that a low level of anxiety was associated with education by an animated video (odds ratio: 2.9, 95% confidence interval: 1.1-7.6). CONCLUSIONS: Preoperative education by an animated video prior to hysteroscopy is associated with lower rates of moderate/high anxiety levels compared to the standard verbal education preparation. WHAT IS NEW? Animated videos are an effective and easy-to-implement tool that may reduce anxiety before office hysteroscopy.