{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T04:19:13Z","timestamp":1792642753273,"version":"4.5.0"},"reference-count":57,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2026,3,25]],"date-time":"2026-03-25T00:00:00Z","timestamp":1774396800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,3,25]],"date-time":"2026-03-25T00:00:00Z","timestamp":1774396800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BJOG"],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Pelvic examinations are a routine element of gynaecological and obstetric care but may generate discomfort, pain and anxiety.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:sec>\n                      <jats:title>Objectives<\/jats:title>\n                      <jats:p>To evaluate the effectiveness of interventions to improve women's experience of pelvic examinations.<\/jats:p>\n                    <\/jats:sec>\n                    <jats:sec>\n                      <jats:title>Search Strategy<\/jats:title>\n                      <jats:p>Medline, Cochrane Library, Embase, Web of Science and ScienceDirect were searched to identify randomised interventional trials published between January 1990 and December 2024.<\/jats:p>\n                    <\/jats:sec>\n                    <jats:sec>\n                      <jats:title>Selection Criteria<\/jats:title>\n                      <jats:p>Eligible studies compared an intervention group and control group of &gt;\u200915\u2010year\u2010old women undergoing pelvic examinations and reported physical and emotional responses, such as pain, anxiety, discomfort and embarrassment.<\/jats:p>\n                    <\/jats:sec>\n                    <jats:sec>\n                      <jats:title>Data Collection and Analysis<\/jats:title>\n                      <jats:p>\n                        Two reviewers independently screened, extracted data, and assessed the risk of bias using the Cochrane Risk\u2010of\u2010Bias 2 (RoB2) tool. Data were analysed using pooled standardised mean differences (SMD) with 95% confidence intervals (CI) and random effects models. Heterogeneity was assessed with the\n                        <jats:italic>I<\/jats:italic>\n                        <jats:sup>2<\/jats:sup>\n                        statistic.\n                      <\/jats:p>\n                    <\/jats:sec>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Main Results<\/jats:title>\n                    <jats:p>\n                      Sixteen RCTs (4641 women) were analysed. Fourteen studies assessed interventions targeting women's perceptions: procedural strategies (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200910), environmental adaptations (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20092), and cognitive approaches (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20092). Two studies evaluated the information provided to the patient about the examination and an online preparatory training (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20092). The meta\u2010analysis showed a significant reduction in pain (SMD \u20130.87, 95% CI \u20131.56 to \u22120.18;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.001; 8 studies) and in anxiety (SMD \u20131.13, 95% CI \u20131.86 to \u22120.38;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.003; 5 studies). Risk of bias was high (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20095), some concerns (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20094), and low (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20097). Heterogeneity was high (pain:\n                      <jats:italic>I<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      \u2009=\u200996.3%; anxiety:\n                      <jats:italic>I<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      \u2009=\u200994.8%).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Simple interventions may reduce pain and anxiety during pelvic examinations and support trauma\u2010informed care, but the heterogeneous evidence requires more high\u2010quality research.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/1471-0528.70227","type":"journal-article","created":{"date-parts":[[2026,3,25]],"date-time":"2026-03-25T23:40:02Z","timestamp":1774482002000},"page":"1717-1730","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Effectiveness of Interventions to Improve Women's Experience of Pelvic Examinations: A Systematic Review and Meta\u2010Analysis"],"prefix":"10.1111","volume":"133","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2504-8145","authenticated-orcid":false,"given":"St\u00e9phanie","family":"Mignot","sequence":"first","affiliation":[{"name":"Clinical Research Centre CIC 1402, CHU de Poitiers, INSERM, Department of General Practice University of Poitiers College of Medicine and Pharmacy  Poitiers France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean\u2010Pierre","family":"Menard","sequence":"additional","affiliation":[{"name":"Direction de la protection maternelle et infantile et promotion de la sant\u00e9, Val\u2010de\u2010Marne  Cr\u00e9teil France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elisabeth","family":"Iraola","sequence":"additional","affiliation":[{"name":"Department of Midwifery, Faculty of Health Sorbonne Universit\u00e9  Paris France"},{"name":"Sorbonne Universit\u00e9, INSERM UMR\u2010S 1136, Institut Pierre Louis d'\u00c9pid\u00e9miologie et de Sant\u00e9 Publique (iPLesp), Equipe Epid\u00e9miologie Sociale Sant\u00e9 Mentale, Addictions (ESSMA)  Paris France"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,3,25]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.7326\/M14-0701"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0000000000002895"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jogc.2018.12.007"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejogrb.2023.10.007"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1034\/j.1600-0412.2003.00253.x"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1080\/0167482X.2020.1864727"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejogrb.2011.02.025"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0b013e31818e4678"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1089\/jwh.2009.1673"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejogrb.2024.02.055"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11606-020-06334-8"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1743-6109.2008.01139.x"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1111\/jmwh.13189"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.1984.03340330025016"},{"issue":"2","key":"e_1_2_10_16_1","first-page":"104","article-title":"Patient Comfort During Pelvic Examination. 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