Effects of information and coping instructions on prepubertal children's reactions to gynecological exams

Date of Award




Degree Name

Doctor of Philosophy (Ph.D.)

First Committee Member

Donald K. Routh - Committee Chair


It has been common pediatric practice for uncooperative children who are in need of a gynecological exam, to be sedated or rescheduled to receive the exam under general anesthesia. This investigation explored whether psychological preparation would be a viable alternative to reducing children's distress during gynecological exams.Thirty children, suspected victims of sexual abuse, between the ages of 5 to 10 years were randomly assigned to one of two treatment groups. The information plus coping group received procedural and sensory information and were taught a coping strategy for the exam. The attentional placebo group received a quiet play period. A child psychiatrist, gynecologist, nurse and parent rated the child's level of distress during the medical exam on the Frankl. The same three medical professionals also rated the child's distress on the Observation Measure of Behavioral Distress (OSBD). The children themselves rated their distress immediately after the intervention and after the pelvic exam on the Childrens Fear Thermometer (CFT).Fifteen of the children also received a second medical procedure of blood drawing for which they were not prepared. The same raters completed the same measurements of distress. The children also rated their distress after the blood drawing on the CFT.Findings indicated that children in the information plus coping group were less distressed than the attentional placebo group during the pelvic exam. All children displayed more behavioral distress during the blood drawing, however, those children in the information plus coping group displayed less distress. More than half the children in the information plus coping group reported to actually use the coping strategy they had been taught. Older children were observed to display more behavioral distress during the pelvic exam but not during the blood drawing. No relationship was found between factors of sexual abuse and childrens' distress. These results indicate that providing a child with a brief 20 minute intervention can be an effective alternative to the common pediatric practice of sedating a child.


Health Sciences, Medicine and Surgery; Psychology, Clinical

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