Fernandez-Feito, A., Lana, A., Cabello-Gutierrez, L., Franco-Correia, S., Baldonedo-Cernuda, R., & Mosteiro-Diaz, P. (2015). Face-to-face information and emotional support from trained nurses reduce pain during screening mammography: Results from a randomized controlled trial. Pain Management Nursing, 16, 862–870.

DOI Link

Study Purpose

To determine if an educational and support intervention could reduce pain during mammography

Intervention Characteristics/Basic Study Process

The day before mammography, women were randomized to a usual care control group or the experimental group. The experimental group received a standardized nursing intervention consisting of 10 minutes of face-to-face education about the procedure and accompanying the women during the procedure to provide support and answer questions. Pain was assessed in all women immediately after the test and 10 minutes later. Anxiety was measured prior to the procedure.

Sample Characteristics

  • N = 436   
  • AGE: 54.3% were younger than age 60 years
  • FEMALES: 100%
  • CURRENT TREATMENT: Not applicable
  • KEY DISEASE CHARACTERISTICS: All were undergoing breast cancer screening
  • OTHER KEY SAMPLE CHARACTERISTICS: 72% had no or only primary school education. 96% had previous mammographies.

Setting

  • SITE: Multi-site   
  • SETTING TYPE: Outpatient    
  • LOCATION: Spain

Phase of Care and Clinical Applications

PHASE OF CARE: Diagnostic

Study Design

RCT

Measurement Instruments/Methods

  • Visual analog scale for pain
  • Speilberger State Trait Anxiety Inventory

Results

State anxiety prior to the mammography was higher in the control group (p = 0.03). In the control group, 26.3% experienced pain, compared to 19% of the experimental group (OR = 0.44, 95% CI [0.24, 0.81]). The intervention was only shown to be effective in women who did not expect pain and did not fear outcomes of the screening.

Conclusions

The education and support intervention provided appeared to reduce pain associated with mammography, particularly for women who had an expectation of pain or feared screening outcomes.

Limitations

  • Baseline sample/group differences of import
  • Risk of bias (no blinding)

Nursing Implications

A psychoeducational intervention by nurses was helpful to reduce post-mammography pain among women undergoing screening mammography.