CHAPTER ONE

INTRODUCTION

     Background of Study

Transvaginal Ultrasonography (TVUS) is an essential examination of the female pelvis. TVUS has been in use for both gynecological and obstetric case management for over two decades Komolafe et al., (2016). It is a diagnostic technique and an endo-cavity dynamic scanning modality in which a transducer is inserted into vagina used for the evaluation of the female pelvis and can overcome many of the limitations of traditional trans-abdominal scanning (Ugwu, 2014).

Transvaginal Sonography has been provided to unselected women with apparently normal pregnancies, either to assess fetal abnormalities and the risk of preterm delivery. It has many advantages being clearer images of the ovaries in follicular assessment and monitoring, earlier evaluation and management of first trimester pregnancies and its complications and assessment of cervical length. Also, it used to assess cervical changes, especially in the late stages of pregnancy; as well as assess the placenta position and post-menopausal screening for ovarian cancer risks (Atalabi et al. 2012) & (Mubuuke, 2014).

There are special preparations should be done for performing TVUS procedure. Prescanning, the woman lies in the lithotomy position.  Then, the Sonographer distributes KY jelly over an ultrasound transducer before covering it with a sheath.  Also, the top of the covered transducer should be lubricated and the transducer is subsequently inserted into the vagina.  During scanning, from time to time the transducer can be manipulated in multiple levels to gain images in different views (Mubuuke, 2014)

The transvaginal ultrasound examination involves inserting of the lengthy probe into the female’s body through the vaginal orifice, thus triggering some responses in the patient for it touches the woman’s intimate body parts. A woman may anticipate pain or discomfort towards the procedure. The sonographer and the responsible nurse has to explain the procedure to the concerned patient and any perceived changes while performing the procedure (Onderi et al. 2015).

Despite its significance, many women may find the transvaginal sonography procedure invasive, unacceptable and uncomfortable because of physical or psychological pain that may be involved. Although most women often agree to have TVUS and many of them if they have given the choice, they would voluntarily refuse it (Al Inizi et al. 2008). 

Perception means the ability to understand, see, believe and feel something. The main basis of personal attitude lies in the perceptions and awareness regarding special situation Ugwu, (2014). According to Modica, (2017) that the acceptance by health care providers and the patients is widespread, but it has many advantages includes greater clinical competence, increased performance, and efficiency as well as reduced costs. The nurse's role in women counseling, education, and management is a vital component of the care of the patient undergoing transvaginal sonography.

 Transvaginal sonography may be uncomfortable for most women. It can be physically and psychologically stressful for female patients, mainly in the examination of the pelvic region. Some patients may be anxious about the procedure; some may have feared that it might be a painful procedure. Female patient’s perception towards the endo-cavity ultrasound is hinged to the stimulus that invokes the five senses Onderi et al. (2015). Moreover, after the woman has perceived TVS ultrasound, she may develop an attitude and response towards the procedure that could be positive or negative based on the patients’ perception. Consequently, it is very important to investigate women’s perception and response towards the transvaginal ultrasound and its effect on the level of pain and anxiety among the female patients (Ugwu, 2014).

Statement of Problem

The perception of most women in Nigeria towards transvaginal sonography has been negative. This is due to the fact that the painful experience of these women during ultrasound is so unbearable. The pain cause by the equipment causes women to stay away from transvaginal sonography.

1.3 Research Objectives

1.3.1 Specific Objectives

This study aimed to assess the perception and response among women undergoing Transvaginal Ultrasonography in Image Diagnostic, Port Harcourt

1.3.2 Broad Objectives

1. To determine the perception of women towards transvaginal sonography in Image Diagnostic, Port Harcourt.

2.To determine the responses of women towards transvaginal sonography in Image Diagnostic, Port Harcourt

3. To determine the effect of transvaginal sonography among women on the level of women’s pain and anxiety in Image Diagnostic, Port Harcourt

 Study Questions:

1.What is the women’s perception towards transvaginal sonography?

2.What is the women’s response towards transvaginal sonography?

3.What is the effect of transvaginal sonography on the level of women’s pain and anxiety?

Significance of the study:

Despite Trans-vaginal Sonography (TVUS) is an essential examination of the woman’s pelvis. It is one of the primary screening modality. Unfortunately, this procedure has received mixed experiences from the women who have undergone it. These experiences may be affected by the cultural and social aspect of invasion of a female patient’s private life.

Although TVS is a relatively invasive procedure and potentially embarrassing for the woman, it is increasingly the routine examination for pelvic assessment, both in younger and older females (Gentry-Maharaj et al. 2013). It was observed that few studies explored the emotional and psychological aspects among women undergoing transvaginal ultrasonography. Accordingly, the presented study is carried out.

Scope of Study

Operational Definition:

Transvaginal Ultrasound: Is an imaging procedure performed to create an image of the female genital tract where the transducer device is inserted directly into the vagina and close to the pelvic structures to produce the ultrasound waves, consequently produce a clearer and less distorted image.

Perception: The process of perceiving and reacting to something, it depends on the function of the nervous system and associated with the person's experience, expectations, feelings, and attention (Alan & Gary. 2011).

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