Effects of Nonpharmacological Interventions on Pain and Patient Satisfaction During Intrauterine Device Insertion: A Systematic Review and Meta-Analysis
J Clin Nurs. 2026 Jun 30. doi: 10.1111/jocn.70420. Online ahead of print.
ABSTRACT
OBJECTIVE: This study aimed to evaluate the effects of nonpharmacological interventions used during intrauterine device (IUD) insertion on pain and patient satisfaction.
DESIGN: This study is a systematic review and meta-analysis.
MATERIALS AND METHODS: PubMed, Web of Science, EBSCOhost, Google Scholar and the National Thesis Center of the Council of Higher Education databases were searched between January 2026 and February 2026, without publication year restriction. Experimental and quasi-experimental studies evaluating nonpharmacological interventions during IUD insertion were included. Methodological quality was assessed using the Joanna Briggs Institute critical appraisal tools. Risk of bias was evaluated using the Cochrane Risk of Bias tool (RoB 2) for randomized controlled trials and ROBINS-I for quasi-experimental studies. The certainty of evidence was assessed using the GRADE approach. Publication bias was evaluated using funnel plots, Egger's test and Duval and Tweedie's trim-and-fill method. Data were synthesized using meta-analysis and narrative synthesis.
FINDINGS: Twelve studies involving 1241 women were included. The interventions examined included virtual reality, distraction techniques, EFT, music, video-assisted information, ultrasound-guided IUD insertion, acupuncture, cold application and the full bladder method. Some interventions, particularly virtual reality, distraction cards, EFT, music and acupuncture, showed positive effects. Overall, nonpharmacological interventions significantly reduced pain during IUD insertion (SMD: 0.803; 95% CI: 0.427 to 1.179; Z = 4.182; p < 0.001; I2 = 90.687). They also significantly increased procedural satisfaction (SMD: -1.046; 95% CI: -1.516 to -0.577; Z = -4.368; p < 0.001; I2 = 85.677).
CONCLUSION: Nonpharmacological interventions may reduce perceived pain and improve patient satisfaction during IUD insertion.
IMPLICATIONS FOR PRACTICE: These interventions may enhance patient comfort and procedural satisfaction in clinical practice.
REPORTING METHOD: PRISMA guidelines were followed.
TRIAL REGISTRATION: This systematic review and meta-analysis was registered in the International Prospective Register of Systematic Reviews (PROSPERO) (Registration No: CRD420261307366).
PMID:42375125 | DOI:10.1111/jocn.70420