Knowledge, expectations and beliefs of pregnant women on antenatal ultrasound.

ABSTRACT

Purpose of the study

This study investigated pregnant women’s awareness of antenatal ultrasound, their knowledge of its benefits, their beliefs on the scan, their expectations from the scan as well as their feelings after the scan so as to uncover the reasons behind underutilisation of antenatal ultrasound at Parirenyatwa Group of Hospitals and Harare hospiatal.

Methodology

The study was a descriptive cross sectional study of pregnant women visiting antenatal clinics at Harare hospital and Parirenyatwa Group of Hospitals. A sample of one hundred participants was selected through consecutive sampling technique. Data was collected through self-administered questionnaires and descriptive statistics were used to analyse the data.

Findings  

The majority of the women (99%) were aware of antenatal ultrasound. Seventy one percent of the participants got their information from relatives and friends. High level of knowledge of the benefits of antenatal ultrasound was exhibited in 85% of the participants. A considerable proportion of the women believed that antenatal ultrasound has negative effects, it is not accurate and that it is expensive (54%, 52% and 57% respectively). The expectation that was mentioned most frequently was knowing the foetal sex (85%).

Conclusions and recommendations

Lack of influence from health workers as well as the belief that antenatal ultrasound has negative effects particularly cancer, the belief that the procedure is expensive and inaccurate could be the reasons for underutilisation of the service in the above mentioned hospitals. Health workers should be trained and encouraged to talk to their patients about the service, sonographers should be properly trained and retrained to increase their accuracy and public education is recommended particularly on theme of safety of the service.   

TABLE OF CONTENTS

                                                                                                                                           PAGE

Dedications ……………………………………………………………………………………i

Acknowledgements……………………………………………………………….………...…ii

Abstract…………………………………………………………………………………….….ii

List of abbreviations……………………………………………………………………….…..x

List of appendices…………………………………………………………………………….xi

List of tables..………………………………………………………………………………...xii

List of figures..………………………………………………………………………………xiii

CHAPTER ONE

1.1  Introduction………………………………………….…………………………………..1

1.2  Background……………………………………………….……………………………..2

1.3  Statement of the problem………………………….………………………………….…2

1.4  Aim…………………………………………………………………….……………….. 3

1.5  Objectives………………………………………………...………………….…………..3

1.6  Research questions………………………………………………………….…...………3

1.7  Justification………………………………………………………………….…………..4

1.8  Theoretic framework…………………………………………………………….………5

1.9  Conclusion……………………………………………………………………….………5

CHAPTER TWO

LITERATURE REVIEW

2.1 Introduction………………………………………………………….…………………….6

2.2 The history of the use of ultrasound in obstetrics…………………………………………6

2.3 Nature of ultrasound…………………………………………………………………….…7

2.4 Uses of ultrasound in obstetrics……………………………………………………………7

2.4.1 Elective uses of ultrasound…………………………………………………..…..8

2.4.2 Reactive uses of ultrasound……………………………………………..……….9

2.5 Effects of ultrasound…………………………………………………………………..…10

2.6 Attitude formation and change and their application to the study………………………..11

2.7 The Health Belief Model…………………………………………………………………13

2.8 Other researches…………………………………………………………………….……17

2.8.1 Pregnant women's beliefs, expectations and experiences of antenatal ultrasound in Northern Tanzania…………………………………………………………………17

 2.8.2 Current knowledge, attitudes and practices of expectant women toward routine sonography in pregnancy at Naguru health centre, Uganda…………………………18

2.8.3 Information, knowledge and expectations of the routine ultrasound scan in Ireland 2006…………………………………………………………………..………19

2.8.4 Knowledge of the Use and Indications for Obstetric Ultrasound Scan among Women Attending A Main Referral Hospital, Sokoto, Nigeria……………………...20

2.8.5 Review of a study that was based on the health belief model…….……………21

2.8.5.1 Examination with the Health Belief Model of Women’s Attitudes to Cervical Cancer and Early Diagnosis in Turkey: A Qualitative Study…..…..21

2.9 conclusion………………………………………………………………………………...21

CHAPTER THREE

METHODOLOGY

3.1 Introduction………………………………………………………………………………22

3.2 Research design………………………………………………………………….……….22

3.3 Population of study…………………………………………………………...…………..22

3.4 Sampling……………………………………………………………………………….....22

3.4.1 Sample size……………………………………………………………………………..23

3.5 Inclusion criteria………………………………………………………………………….23

3.6 Exclusion criteria…………………………………………………………………………23

3.7 Research instruments and Data collection methods…...…………………………………24

3.8 Data analysis and presentation…………………………………………………………...24

3.9 Data management………………………………………………………………………...25

3.10 Reliability and validity………………………………………………………………….25

3.11 Ethical considerations…………………………………………………………………...25

3.12 Limitations……………………………………………………………………………...26

3.13 conclusion……………………………………………………………………………..  26

CHAPTER FOUR

DISCUSSION

4.1 Introduction………………………………………………………………………………27

4.2 Analysis of sample……………………………………………………………………….27

4.2.1 Questionnaire return……………………………………………………………27

4.2.2 Age distribution………………………………………………………………...27

4.2.3 Religion………………………………………………………………………...28

4.2.4 Marital status…………………………………………………………………...28

4.2.5 Gravidity and status of ultrasound scans on previous pregnancies…………….28

4.2.6 Educational Level and Occupation……………………………………………..29

4.3 Awareness of antenatal Ultrasound………………………………………………………30

4.4 Knowledge of the benefits of antenatal ultrasound………………………………………30

4.4.1 Women’s level of knowledge on the benefits of ultrasound…………………...32

4.5 Women’s beliefs on antenatal ultrasound…...……………………………………………33

4.5.1 Who should be scanned? ………………………………………………………33

4.5.2 Risks of the procedure………………………………………………………….34

4.5.3 Cost of the procedure…………………………………………………………..34

4.5.4 Accuracy of the procedure……………………………………………………...34

4.5.5 Fears and decision to have the scan……………………………………………35

4.6 Expectations and beliefs of pregnant women who had not previously had antenatal ultrasound (n=61)…………………………………………………………………………….35

4.6.1 Bad effects of the scan which the participants have heard of…………………..36

4.7 Reasons for antenatal ultrasound and the feelings after the examination in those who had previously had antenatal ultrasound (n=39)………………………………………………….36

4.8 Dissemination of information…………………………………………………………….38

4.9 Accidental findings………………………………………………………………………38

4.10 Correlation statistics of sample demographics vs the objectives of the study………….38

4.10.1 Age vs knowledge level, attitudes and awareness…………………………....38

4.10.2 Marital status vs awareness, knowledge level and beliefs……...……….……38

4.10.3 Level of education vs awareness, level of knowledge and beliefs…...……….39

4.10.4 Occupation vs awareness, level of knowledge and beliefs..………………….40

4.10.5 Gravidity vs awareness, level of knowledge and beliefs...……………………40

4.10.6 Status on previous ultrasound vs awareness, knowledge and beliefs...……….41

4.11 Conclusion………………………………………………………………………42

CHAPTER FIVE

DISCUSSION

5.1 Introduction………………………………………………………………………………43

5.2 Sample demographics and its effect on the objectives of the study……………………...43

5.3 Objectives of the study…………………………………………………………………...46

5.3.1 Awareness of antenatal ultrasound……………………………………………..46

5.3.1.1 Sources of information of antenatal ultrasound………………………47

5.3.2 Women’s knowledge on the benefits of antenatal ultrasound…………………47

5.3.3 Women’s beliefs on antenatal ultrasound…………...…………………………49

5.3.4 Expectations and beliefs of those who had not previously had antenatal ultrasound scans……………………………………………………………………...51

5.3.5 Reasons for scans in those who had previously had antenatal ultrasound……..52

5.3.6 Feelings after the scan………………………………………………………….53

5.3.7 Dissemination of information…………………………………………………..53

5.4 Conclusion………………………………………………………………………..54

CHAPTER SIX

CONCLUSIONS AND RECOMMENDATIONS

6.1 Introduction………………………………………………………………………54

6.2 Conclusions………………………………………………………………………54

6.2.1 Awareness of antenatal ultrasound……………………………………..54

6.2.2 Level of knowledge of the benefits of ultrasound……………………...54

6.2.3 Women’s beliefs on antenatal ultrasound ……………………………...54

6.2.4 Expectations of pregnant women from antenatal ultrasound…………..54

6.2.5 Feelings after the scan………………………………………………….55

6.3 Recommendations………………………………………………………………..55

6.3.1 Suggestions for further studies…………………………………………57

6.4 Conclusion………………………………………………………………………..57