Supplementary_file_1 - Patient-Reported Experiences After Hysterectomy: A Cross-Sectional Study of the Views of Over 2300 Women (original) (raw)
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Journal of Patient Experience, 2019
Objective: To evaluate women’s experiences after hysterectomy and predictors of their contentment and regret with the surgical approaches. Methods: Cross-sectional, Patient-Reported Experience Measures survey in 2319 Australian women aged 21 to 90 years (median age of 52 years) who had received hysterectomy in the preceding 2 years. Results: Overall, the vast majority of women (>96%) did not regret having had the hysterectomy. Women who received an open abdominal hysterectomy reported slower recovery with about 7% of women still not fully recovered after 12 months compared to those whose surgery was through a less invasive approach. Women who reported no adverse events, having been given a choice of type of hysterectomy, women who received an alternative to open abdominal hysterectomy, and women who felt prepared for discharge from hospital were significantly more likely to be content with their hysterectomy and report positive patient experiences. Conclusions: Compared with thos...
Self‐reported long‐term outcomes of hysterectomy
… of Obstetrics & …, 1991
To investigate women's perceptions of and satisfaction with the long-term outcomes from a hysterectomy performed between 2 and 10 years ago and to determine whether satisfaction is related to demographic factors, factors associated with the hysterectomy, and the number or type of perceived benefits and problems associated with the hysterectomy. Retrospective survey by telephone interview and postal questionnaire of 236 women who had a hysterectomy between 2 and 10 years ago. Women who had had a hysterectomy were identified from a community survey in the Hunter Region of NSW, Australia. Two hundred and thirty-six women who self-reported having had a hysterectomy between 2 and 10 years ago. Perceived benefits resulting from the hysterectomy; perceived physical and psychological problems caused by the hysterectomy; satisfaction with care. Relief from heavy bleeding was the most frequent benefit (57%) and the most important benefit (32%). Most of the women reported improvements in symptoms experienced before hysterectomy but more than half the women had symptoms which they believed had been worsened or caused by the hysterectomy. Despite this, high levels of satisfaction with the operation were reported. The results highlight the need to examine more closely decision-making about treatment for menstrual symptoms such as heavy bleeding.
Women's Hysterectomy Experiences and Decision-Making
Women & Health, 2003
The goal of the study was to examine women's experiences with gynaecologic symptoms and how they decided to undergo hysterectomy. For this purpose, twenty-nine women were interviewed in hospital within three days of undergoing hysterectomy. The interviews elicited information about the nature of the problem that caused the women to seek medical help, actions taken to solve their problem, their relationship with their gynaecologist, information seeking patterns and decision-making about hysterectomy. Although findings revealed that the symptoms women suffered had a negative impact on their lives, most women delayed seeking medical help and attributed their symptoms to factors other than a physical problem in their reproductive system. Most of the participants' information about the symptoms and possible treatments came from their consulting other women with similar problems. The women reported that their gynaecologist did not initiate a comprehensive discussion about other treatments and their advantages and dis-Ayse K. Uskul is PhD Candidate,
The Lived Experience of Hospitalized Women Undergoing Hysterectomy: A Phenomenological Study
Tanta Scientific Nursing Journal
Background: Hysterectomy is one of the main gynecological procedures which affect a woman's life in numerous ways, including physically, psychologically, socially, and sexually. Following hysterectomy, these effects on the women's physical and mental health are contradictory, despite improvements in their biopsychosocial function. The aim of the current study is to explore the lived experience of hospitalized women undergoing hysterectomy. Design: A phenomenological qualitative research design was utilized to achieve the aim of the study. Sample: A purposive sample of fifteen women who had a hysterectomy. Tools for data collection: three tools were used for data collection; a structured interviewing questionnaire; an unstructured interviewing questionnaire; the digital voice recorder and field notes. Setting: The interview was conducted at the high-risk pregnancy unit and gynecological inpatient department at Obstetrics and Gynecological Hospital which is affiliated with Cairo University Hospitals. Results: The overall experience as perceived by the participants could be described, within a framework of time sequences, as the following: 1) The immediate reaction towards hysterectomy was reflected by different feelings such as acceptance of the diagnosis, shock, sadness, and depression; 2) Early post-procedure suffering due to physical and psychological factors; 3) Expected later concerns and actual needs such as concern about family and children, sexual concern, need for affections and support from husband, needs for education; 4) Late post-procedures complaints due to fatigability, weight loss, social effects, loss feminine role, anxiety, altered sexual behavior and excitement. Conclusion: The current study concluded that hysterectomy has negative physical, psychological, and social impacts on women's lives in this study sample. Recommendation: Before women are discharged from the hospital, healthcare professionals in postoperative departments must address these potentially distressing psychological and physical consequences of hysterectomy.
REFLECTION ON HYSTERECTOMIES AND WOMEN HEALTH: A REVIEW OF LITERATURE
International Journal of Multidisciplinary Educational Research , 2022
Hysterectomy as emerging trend in a few societies are associated with premature menopause with the early onset at the age of 40 and before; this has been a growing concern in the field of women health in India (Conway, 2000; Shyamla, 2005; IIPS, 2007). Recently in India, hysterectomy has received increased attention in public health policy debates, where the media reports have highlighted an unusual rise in the number of women undergoing hysterectomy in many parts of the country. A significant number of cases involving young and per-menopausal women from poor families were reported from state of Katakana. The objective of the present study is to review, understand the physical, psychological issues experienced by the women before and after undergoing the hysterectomy. However, the incidence of depression, anxiety and mood disorder are reported in several studies. Hysterectomy includes both physical and psychological health issues. This current paper deals with the arguments based on the existing literature, and the evidences shows that many of the young women are undergoing hysterectomy and they are facing physical and psychological issues in the later stages.
Perspective of Women about Her Body after Hysterectomy
2020
Hysterectomy is the most common major gynecological operation in worldwide and Arabic countries. However, the psychological, physical and sexual consequences of hysterectomy are conflicting and the findings are mixed. While, some studies report that patients have experience greater improvement in their mental health, sexual desire and overall satisfaction. Others show that patients report various negative outcomes, with detrimental effects on sexual functioning being the main concern. My previous study demonstrated that hysterectomy had significantly negative effects on patients’ body image, self-esteem, and identified common meanings and themes associated with hysterectomy stressors, which includes difficulties or limitations in physical and psychological aspects perceived by patients after hysterectomy. In this chapter, author will expand that discuss in details the different factors that influence the perspective of women about body after hysterectomy. Mainly, author will focus o...
The Psychosocial Outcomes of Total and Subtotal Hysterectomy: A Randomized Controlled Trial
The Journal of Sexual Medicine, 2006
Introduction. Current controversies involve the adverse effects of hysterectomy on women's psychosocial functioning and whether subtotal as opposed to total hysterectomy mitigates these effects. Aim. To investigate the psychosocial effects of hysterectomy by examining sexual, pain, and psychological outcomes of total vs. subtotal hysterectomy in a randomized controlled trial. Methods. Patients suffering from benign gynecological conditions were randomly assigned to one of two groups: (i) total hysterectomy, that is, laparoscopic assisted vaginal hysterectomy (TOT, N = 32); or (ii) subtotal hysterectomy, that is, supracervical laparoscopic hysterectomy (SUB, N = 31). Both groups were premenopausal and underwent hysterectomy without concurrent oophorectomy. Two premenopausal control groups: (i) minor gynecological surgery (SURG-CON, N = 30); and (ii) healthy nonsurgical controls (NORM-CON, N = 40), were also tested. All surgical groups were assessed 2-3 weeks before surgery and then 6-7 months afterward; the nonsurgical control group was assessed at the time of recruitment and 6-7 months later. Outcome Measures. Assessments included semistructured interviews, standardized questionnaires, and standardized gynecological examinations. Results. For the TOT group, sexual drive, arousal, and sexual behavior significantly improved postoperatively. For the SUB group, sexual behavior and overall sexual functioning significantly improved. For both TOT and SUB groups, unprovoked pain in the abdomen and pain in the abdomen during gynecological examinations was significantly reduced. For both TOT and SUB groups, overall psychological functioning did not significantly change postoperatively. Although between 3% and 16% of women undergoing hysterectomy reported adverse changes in psychosocial well-being after surgery, similar percentages of women in the control groups reported such effects. Conclusions. Hysterectomy resulted in a consistent reduction in abdominal pain, some improvement in sexual functioning, but no change in overall psychological functioning. There was no evidence supporting the idea that subtotal hysterectomy produced more favorable psychosocial outcomes than total hysterectomy nor was there any evidence that either type of hysterectomy resulted in adverse effects. Flory N, Bissonnette F, Amsel RT, and Binik YM. The psychosocial outcomes of total and subtotal hysterectomy: A randomized controlled trial. J Sex Med 2006;3:483-491.
Perceptions of Indian women on hysterectomy
International Journal of Reproduction, Contraception, Obstetrics and Gynecology
Background: Women who undergo hysterectomy face a multitude of physical and psychosocial problems. The objective of the study was to assess the impact of pre-operative education on post-operative psychosocial health.Methods: It was an interventional research in 96 women who were randomly divided into two groups; one received pre-operative education about surgery and the other given routine preoperative advice. With the help of a questionnaire the perceptions of women on hysterectomy were assessed.Results: Post-operation, 47 of the intervened patients and all the patients of control group were satisfied with the surgery, statistically insignificant; fisher's exact of 1. For 20 intervened patients and 6 patients of control group were very acceptable with the fact that the uterus was no longer present in the body post-surgery, statistically significant; fisher's exact of 0.001. 45 of the intervened group were not feeling depressed whereas 19 patients of the control group were f...
Hysterectomy: Advances in Perioperative Care
Hysterectomy, 2012
2. Psychology 2.1 Preoperative psychology and coping skills Understandably, undergoing surgery is often the cause of great concern for patients. We know that as many as 60% of patients are anxious (Hashimato, 1993), with females, depressed and www.intechopen.com Hysterectomy 226 patients in pain being particularly prone (Caumo, 2002; Karanci, 2003). This anxiety is caused by uncertainty/lack of information about what is going to happen and an existential component (Caumo, 2002; Sjölin, 2003). While uncertainties about oncoming events may be reduced by relevant information and proper expectations, existential anxieties are often resistant to intervention (Kain, 2001). Studies have shown that most patients are scared of thoughts of the unknown, severe pain, nausea and vomiting, or imminent death (Kindler, 2000). Previous experiences and personality usually dictate the style and ability of coping and dealing with serious life events such as surgery. Studies using the Spielberger State and Trait Anxiety Index (Johnson, 1968) or the Amsterdam Preoperative Anxiety and Information Scale (Moerman, 1996) have documented that particular personality structures and coping skills of the patient are in part responsible for the intensity and duration of postoperative pain, with subsequent self-imposed limitations to mobilization and restoration of normal activities (Riddle, 2010). Such psychological traits may in fact be so strong that they overshadow effective pain treatment (Maranets, 1999; Caumo, 2002; Kalkman, 2003). Neurologically, the interaction between the amygdala (fear-avoidance centre), the frontal cortex (centre of experience and value-setting), and the nucleus accumbens (reward centre) are pivotal, all of which are influenced by personality, obesity, alcoholism, depressive disorders and more (Di Chiara, 2002). The personality structure that is most reliably used is the five factor model (Big Five Inventory) which uses five independent personality measures (openness to change, conscientiousness, extroversion, agreeableness, and neuroticism) (Digman, 1990). The variability of these measures is dynamic, and at least three measures rapidly change following surgery: patients become less open to changes, more introvert, and more negative in thought. These changes lead to distorted and inefficient coping skills, depressive or defeatist mood swings, and catastrophizing (imagining unlikely and potentially catastrophic events from simple and harmless signs and symptoms). These emotions are strong and overwhelming and must be addressed in order to secure a return to postoperative well-being. 2.2 The impact on postoperative well-being Preoperative pain or depression may be seen in as many as 50% (Davies, 2002). In a study on chronic pain following hysterectomy, most patients having pain at four months after surgery had pain that resembled the preoperative pain; preoperative "pain problems elsewhere" and strong acute postoperative pain were associated with the development of chronic pain, again emphasizing the psychological dimension (Brandsborg, 2009). Women with preoperative depression and pain had 3 to 5 times the odds of continued impaired quality of life for both physical function, mental health, social function and dyspareunia, compared to those who did not have depression or pain (Hartmann, 2004). The extent (subtotal vs total hysterectomy) or method (laparoscopic vs abdominal) of surgery does not seem to influence these long-term effects (Thakar, 2004; Flory, 2006). Most studies support a general increase in psychosocial well-being at 6 months following surgery (Davies, 2002; Persson, 2010), and it is worth noting that this long-term well-being does not seem to be associated with perioperative complications or hormone disturbances (Persson, 2010). 2.3 Long-term psychological effects following hysterectomy Women undergoing hysterectomy are in a particularly difficult position, since surgery may alter both their perception of body image and sexuality, and impose hormonal How to reference In order to correctly reference this scholarly work, feel free to copy and paste the following:
Hysterectomy- “A Boon or Bane”
Objective: Hysterectomy has become one of the commonest surgery, even the general surgeons are doing the surgery by the patient’s wish without surgical indication. The retrospective study was carried out in patients, who had come with complaints after hysterectomy and required admissions. Study also included referred cases of post hysterectomy. Their indications, complications, and follow up period were noted. Analysis done. Material and Methods: 75 patients study with history of hysterectomy were studied and analysed. Results: 60% of patients were operated for benign conditions which could have been treated conservatively. 20% patients had post hysterectomy ovarian tumours followed by infection, urinary symptoms, psychological disturbances and carcinoma of vault /stump accounting for 12 % each. Conclusion: Hysterectomy surgery is not the ultimate treatment for most of conditions.