A qualitative study of patients’ experience during vaginal examination & transvaginal ultrasound in a tertiary hospital in singapore

Abstract

<h3>Objectives</h3> Pelvic examination via vaginal digital examination & transvaginal ultrasound are routinely performed during gynaecological assessment. This is crucial in screening for gynaecological cancers, testing for infections, evaluating pelvic pain, and other important health-related factors. Many women find gynecological examinations uncomfortable, embarrassing and stressful. Past negative experiences can increase anxiety and discomfort experienced during subsequent examinations. Emotional distress & fear of pain result in women having reduced adherence in undergoing gynaecological screening & follow-up with implications from delayed diagnosis. Traumatic pelvic exams have been reported as a potential cause of vaginismus with associated impact on sexual function, relationship and fertility.This study uses qualitative methods with the aim of exploring the experience of patients who have undergone pelvic examination at the outpatient setting in a tertiary hospital in Singapore. The findings will provide new insights into aspects of care experienced by these patients including what is most valued or can be improved during pelvic examinationto lead improvement in the delivery of care. <h3>Methods</h3> We used qualitative methods to explore the patients' subjective experiences. Twelve patients (age 30-57) were interviewed. The interviews were audio-recorded, transcribed, audited and analysed iteratively based on grounded theory. Emergent themes were first externally validated, and then finalized after rounds of deliberations amongst the investigators. The outcome measures included descriptions & concepts reflecting the most important matters experienced by these women. <h3>Results</h3> The patients found pelvic examination unpleasant and uncomfortable. Four overarching themes emerged from the interviews: the environment & clinic physical set up, patient characteristics, healthcare provider characteristics & attitude and patient information or education. <h3>Conclusions</h3> This study has provided some insight into key facilitating factors contributing to improved patient experience as well as barriers faced. Further work and studies are required to look into sociocultural aspects and what must be done to ensure improvement in this aspect. <h3>Conflicts of Interest</h3> nil