To reduce the procedural pain of Pap smear, this study expects to apply the peak-end rule to Pap smear by prolonging the insertion of speculum after samples are obtained from the cervix. This study aims to conduct a randomized controlled study at a tertiary center, National Taiwan University Hospital (NTUH). The investigators expect to compare the recalled pain intensity of the intervention and control groups.
Purpose: In order to reduce the procedural pain, this study expects to apply the peak-end rule to Pap smear by prolonging the insertion of speculum after samples are obtained from the cervix. Methods: This study aims to conduct a randomized controlled study at NTUH. Approximately 200 subjects are expected to be recruited. The investigators will utilize the peak-end rule by adding a non-painful step right after the most uncomfortable phase in the intervention group. All study subjects are requested to score on a numeric pain scale during the Pap test. All operators experienced in techniques for performing a Pap test should attend workshops for a standard operating procedure. A well-trained research assistant is also responsible for ensuring standardization of procedures to eliminate interoperator variability. The primary outcome was the recalled pain intensity at five minutes after the Pap smear test.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
SCREENING
Masking
SINGLE
Enrollment
268
Adding a non-painful step after the most uncomfortable phase of Pap smear
National Taiwan University Hosputal
Taipei, Taiwan
Recalled pain just after the Pap smear test using a 1-5 numeric scale
This recalled pain intensity is evaluated with a 1-5 numeric scale (1:no pain; 5: maximal pain).
Time frame: Five minutes after the Pap test
Recalled pain just after the Pap smear test using a a 0-10 visual analog scale
This recalled pain intensity is evaluated with a 0-10 visual analog scale (0: no pain; 10: maximal pain), where pain was categorized as mild, moderate, and severe.
Time frame: Five minutes after the Pap test
Real-time pain during the Pap test using a 1-5 numeric scale
The participants are asked to evaluate and record their pain every five seconds throughout the test. The real-time pain is recorded with a 1 to 5 numeric scale (1:no pain; 5: maximal) at the beginning, the first quarter, the second quarter, the third quarter, and the end of the regular course in all participants; as well as right after the additional 15-second step in the group receiving modified Pap tests. The average pain, the maximal pain, as well as real-time pain at the beginning, the first quarter, the second quarter, the third quarter, and the end of the regular course are compared between the two groups. For each group, we also compare the average pain of the first half and the second half of the total course. For participants receiving the modified Pap test, we further compare the average pain, the maximal pain, and the last recorded real-time pain of the 15-second step with that of the regular course.
Time frame: Every five seconds throughout the Pap test
Long-term recalled pain after the Pap test using a 1-5 numeric scale
Evaluated with a 1-5 numeric scale (1: no pain; 5: maximal pain).
Time frame: One year after the Pap test
Long-term recalled pain after the Pap test using a 0-10 visual analog scale
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Evaluated with a 0-10 visual analog scale (0: no pain; 10: maximal pain).
Time frame: One year after the Pap test
Willingness to receive further Pap tests
0-10 grades (0: unwillingness; 10: highest grade of willingness)
Time frame: One year after the Pap test