الفهرس 
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Abstract
Regular gynecological examination done many times in every woman’s life is important attempts used in the estimation of women’s reproductive health. Also gynecological examination is an important part of gynecological controls and in practice it is added that it is very commonly widely method. However, gynecological examination means examination of the genital organs which needs to be covered, hide and protected for most of the women.
Furthermore, the importance and purpose of gynecological examination is to give accurate information and confidential answer to any question concerning sex, sexuality, changing body, prevention through checking the reproductive organ for any health problem and finally, treatment for experience missed period, pain, and other reproductive problems. Gynecological examination includes breast examination, external vaginal examination, internal vaginal examination, bimanual examination, and Pap smear.
In addition, gynecological examination is stressful event that is the women may respond negatively as consequence to no orientation before the examination (stress may lead to anxiety). Gynecological examination anxiety poses an obstacle for women to get the best health care which is possible. The most important reasons of anxiety experienced during gynecological examination are; sex, attitudes, professional profile of health personnel, embarrassment about dressing, examination position, used equipments, previous negative experiences of gynecological examination, inattention to privacy, religious beliefs, fear of pain, fear of pathological diagnosis, fear about personal hygiene, negative first pelvic examination experience and socio-cultural value.
Finally, it is essential that nurses play an integral part in gynecologic examination; before examination women should be given a complete explanation of the procedure and how they performed and also specific instructions necessary for adequate preparation during examination. The nurse must take complete history, reassure the woman during the procedure, perform steps of nursing procedures, while after examination; the nurse must discuss the results of the exam, arrange for any follow up or consultation needed, instruct women regarding laboratory investigation, and finally ask for any further questions.
Aim of the study:
To study women’s emotional response concerning their first gynecological examination.
Research questions:
1. Are women having correct knowledge concerning first gynecological examination?
2. What are women emotional and verbal responses to their first gynecological examination?
3. Is there a correlation between women’s response towards first gynecological examination and their knowledge?
Tools of data collection:
1-Interviewing questionnaire:
It was included two parts:
The first part: To assess female general characteristics (age, occupation, area of residence, and level of education).
The second part: To assess women’s knowledge concerning gynecological clinic as:
*definition of examination
* Importance of the examination
* Position during examination
* Complication due to gynecological examination
Knowledge was scored as correct and incorrect answer for each knowledge question.
Scoring system for evaluating women’s knowledge was developed as the following:
Each question was given 2 scores for correct answer and 1 score for incorrect answer. The level of knowledge score converted into a percentage, and overall adequacy of knowledge graded according to the following criteria: If the score is ≥60% it would be considered a correct level of knowledge. If the score is<60% it would be considered in correct level of knowledge.
2- The emotional situational non verbal response scale(Larsson and (Wilde, 2010), (appendix 1)
It was modified by the researcher to assess women’s response during all gynecological examination. Is a list of words describing different emotions as (irritable, cover her eyes, afraid, attentive co-operative, frustrated). Under each word are three response choices. Circle the choice which best describes Respond as follow:
(1) The word does not correspond to how I felt right then
(2) The word partly corresponds to how I felt right then
(3) The word completely corresponds to how I felt right then.
3- The situational verbal response check list (appendix 2)
It was designed by the researcher to assess women’s response post gynecological examination. It was consisted of eight positive verbal response statements and eight negative verbal response statements. Each statement was checked as (yes) or (no) for each statement. It was written in Arabic language.
4- The visual analogue scale to assess pain level (Gillian A., et al., 2011) (appendix 3)
A Visual Analogue Scale (VAS) is a measurement instrument that tries to measure a characteristic or attitude that is believed to range across a continuum of values and cannot easily be directly measured. It is usually a horizontal line, 100 mm in length, anchored by word descriptors at each end, as illustrated in figure below:
Results:
Based on the findings of the present study the following can be concluded that the women who live in urban area and their age range from (20-26) were housewives and secondery educated came to gynecological clinic than other women.
Also it showed that 14% of the studied sample was from illiterate and 86% were educated. Moreover the study had illustrated that 95% of the studied sample were married, 1% were divorced and 4% were widow. Also the study revealed that 20% of the study sample was working women and 80% of the study sample was a housewife. Additionally 43% of the studied sample had correct knowledge regarding meaning of gynecological examination, more over 76% of the study sample answer yes on ”gynecological examination was stressful event ” and 38% of the study sample answer yes on ”gynecological examination touch my dignity”, most of the studied sample answer yes on ” no orientation before each procedure.
Moreover the study revealed that 63% of the study sample was co-operative and completely correspond, however 31% of the study sample were co-operative and partly correspond.
Study sample had showed that the barrier that facing women during gynecological examination were 29% 0f the studied sample self reported ”no pre and post gynecological examination instruction” 8% reported ”presence of too much medical and nursing student”.
Also 14% reported ”presence of male gynecologist”, ”long waiting time before examination ”and 22% reported ”no barrier ” additionally the study show that there was significant relation between studied sample knowledge and there nonverbal response regarding afraid , women had correct knowledge and completely response 56% than than partly response 49% further more does not response 30% (chi square = 4.701 p value =.056) furthermore no relation regarding irritability (chi square =3.848 , p value = .146).
Also The study had revealed that there was highly significant relation between studied sample verbal and nonverbal response regarding attentive women who had verbal response (yes) were attentive and completely response 54% than women who had no verbal response 31% (chi square 12.595, p value .002) furthermore, there was highly statistically significant relation regarding frustrated women who had verbal response (yes) were frustrated and completely response 61% than women who had no verbal response 34% (chi square = 17.606, p value = 0.00) also there was significant relation regarding afraid women who had verbal response (yes) were afraid and completely respond 54% than women who had no verbal response 35% (chi square =7.600 , p value = 0.022).
Based on the results of the present study the following can be recommended:
1. Designing leaflets, flyers, posters and guidelines concerning the importance, technique and indication of female gynecological examination to enhance women emotional verbal and nonverbal response towards their regular gynecological examination.
2. Nursing administrator must control to limit the number of medical and nursing student at gynecological clinic.
3. Hospital administrators must put in their consideration presence of female gynecologist to replace male gynecologist
4. Designing and implementing training program for health team about communication skills to enhance their practical skills while providing counseling and health education pre and post gynecological examination to promote women verbal and nonverbal response regarding their examination.
5. Woman health and midwifery nursing department must integrate the importance of female verbal and nonverbal emotional aspect during gynecological examination into undergraduate and post graduate student nursing curriculum.