Effect of psychological care given to the women who underwent hysterectomy before and after the surgery on depressive symptoms, anxiety and the body image levels

Adaptation to Hysterectomy: Design and Psychometric Properties Assessment of Hysterectomy Adaptation Scale

Background

Adaptation to complications of hysterectomy is one of the topics of concern for women and health care providers. There is no instrument for evaluating adaptation to hysterectomy. This study aimed to design the Hysterectomy Adaptation Scale (HAS) and assess its psychometric properties.

Materials and Methods

This methodological study was conducted from 2018 to 2020 in Mashhad, Iran. To develop the item pool, qualitative data from directed content analysis and data from the review of adaptation and coping instruments were used. The face, content, construct validity, internal consistency, and stability were used to evaluate the psychometric properties of HAS.

Results

The final version of the HAS consisted of 24 items with a reported content validity index of 0.9. Six factors were extracted from the principal component analysis, which explained 60.3 of the observed variance. Model fit indices in confirmatory factor analysis showed that the model was well fitted. The values of the alpha coefficient and intra-class coefficient were 0.86 and 0.95, respectively.

Conclusions

The HAS is a valid and reliable scale for evaluating the adaptation level of hysterectomized Iranian women. HAS can distinguish between hysterectomized women who have adapted to hysterectomy and those who have not. It can be used to assess the adaptation of hysterectomized women in research and clinical practice.

Examining the changes in women's lives after the hysterectomy operation: Experiences of women from Turkey

PURPOSE

The aim of the study is to examine what kind of changes the operation has brought about in the social and psychological life of women.

METHODS

The study was a hermeneutic-phenomenological research conducted using qualitative research methods. It took place between May and July 2023 at a university hospital located in Istanbul, Turkey. Following ethical approval, the study included a total of 24 women who had undergone a 'total abdominal hysterectomy, bilateral salpingo-oophorectomy.' These participants were selected using a combination of maximum diversity sampling and random sampling methods. Data collection was carried out using a semi-structured interview form. The interviews were conducted using face-to-face interview techniques and in-depth interview methods. Qualitative data analysis involved using the coding paradigm of Grounded Theory and Straus and Corbin's coding framework. For the analysis of quantitative data, SPSS version 28.0 was employed, while qualitative data were analyzed using MaxQDA Analytics Pro 2022.

RESULTS

The study found that the participants had a mean age of 47 ± 7.53, and the majority, 66.7%, had not reached menopause before the operation. The qualitative analysis of the semi-structured interviews revealed five main themes, which were identified as follows: 'hysterectomy experiences', 'the impact of hysterectomy on sexual life', 'the significance attributed to the uterus', 'the significance attributed to femininity', and 'self-efficacy after hysterectomy'.

CONCLUSIONS

The study revealed that women experienced changes in self-perception, body image, a sense of organ loss, and developed negative attitudes towards menopause following a hysterectomy. Additionally, there was a noticeable connection between the meanings attributed to the uterus and femininity, which was often influenced by cultural and social factors. In light of these findings, it is recommended that women receive counseling from healthcare professionals before undergoing a hysterectomy. This guidance can help women better understand and cope with the physical, emotional, and cultural aspects of the procedure.

Nursing educational intervention in hysterectomized women: a mixed method study protocol

OBJECTIVES

To know the meaning of education in the perioperative period, in women undergoing hysterectomy for benign causes and to determine the effectiveness of educational nursing intervention in improving female sexual function, quality of life and self-esteem in women undergoing hysterectomy for benign causes.

METHODS

Mixed design, exploratory sequential Qualitative phase semi-structured interviews and content analysis. Quasi-experimental study quantitative phase, non-equivalent control group. 26 women in 2 groups. Instruments: Biosociodemographic, Female Sexual Function Index, SF-36 Questionnaire, Rosenberg Scale. Both groups will receive traditional care and the experimental group will receive nursing educational intervention with web page support. Ethical requirements will be considered.

EXPECTED RESULTS

The women in the experimental group will improve their sexual function, health-related quality of life and self-esteem in relation to the comparison group.

CONCLUSIONS

Education in the perioperative period of hysterectomy is essential for the recovery of women who go through this experience.

The real experience with women's hysterectomy: A meta-synthesis of qualitative research evidence

AIM

The aim of this meta-synthesis was to identify and synthesize qualitative research evaluating the real feelings, inner needs and emotional experience of women undergoing hysterectomy.

DESIGN

Meta-synthesis.

METHODS

The PubMed, Web of Science, Cochrane Library, CINAHL, Embase, Ovid Medline and Sino Med were systematically searched until November 2021 and updated until June 2022. Two reviewers independently extracted data into a Microsoft Excel sheet. Qualitative meta-synthesis was performed by coding relevant citations, organizing codes into descriptive themes and developing analytical themes.

RESULTS

Qualitative meta-synthesis yielded three themes and nine sub-themes: comprehensive consideration before hysterectomy (a. disease factors; b. fertility factors; c. opinions of others); emotions and experience after hysterectomy (a. postoperative physical condition; b. psychological resilience to the loss of the uterus; c. changes in the couple's relationship); coping strategies (a. self-denial and avoidance; b. change of perception and self-adjustment; c. seek help from others).

Effects and Satisfaction of Comfort Nursing plus Psychological Nursing in the Clinical Nursing of Neurology Patients: A Comparative Study

Objective

To explore the effects and satisfaction of comfort nursing plus psychological nursing in the clinical nursing of neurology patients.

Methods

In this prospective study, 90 neurology patients admitted to our hospital from January 2019 to January 2020 were recruited and randomized into a control group and an experimental group with 45 cases in each group. The control group received routine care, and the experimental group received comfort care plus psychological care. The comfort scores and nursing satisfaction of the two groups were compared. The Hospital Anxiety and Depression Scale (HAD) was used to assess the emotional state of patients before and after the intervention. The Exercise of Self-care Agency Scale (ESCA) was used to assess the patient's self-care ability after the intervention.

Results

The comfort scores of the experimental group were higher than those of the control group (P < 0.05). The experimental group showed significantly higher satisfaction than the control group (P < 0.05). Patients in the experimental group had lower HAD scores after intervention than those in the control group (P < 0.05). After the intervention, the experimental group had higher ESCA scores and a higher Barthel index than the control group (P < 0.05).

Conclusion

Comfort nursing plus psychological care improves nursing satisfaction and self-care ability of neurology patients and relieves their negative emotions.

Effects of Intravenous Analgesia Using Tramadol on Postoperative Depression State and Sleep Quality in Women Undergoing Abdominal Endoscopic Surgery: A Randomized Controlled Trial

Purpose

This study aimed to explore the effects of intravenous analgesia using tramadol on postoperative depression, anxiety, and sleep in women undergoing abdominal endoscopic surgery.

Patients and Methods

Two hundred female patients (100 in each group) who underwent abdominal endoscopic surgery were recruited to randomly receive intravenous analgesia with sufentanil combined with tramadol (tramadol group) or sufentanil (control group). The primary outcome was the incidence of postoperative depression, which was assessed at 1, 2, and 3 days after surgery using the 13-item Beck Depression Inventory. The secondary outcomes were the incidence of anxiety and sleep quality, which were assessed using the 20-item Self-Rating Anxiety Scale and Richards–Campbell Sleep Questionnaire.

Results

The incidence of depression (Beck depression scale≥4) during the 3-day follow-up in the control group was 51%, which was significantly higher than that in the tramadol group of 28% (relative risk [RR]=0.55; 95% confidence interval [CI], 0.38–0.79; P=0.001). No difference was found in the incidence of anxiety state (Self-Rating Anxiety Scale≥40) between the tramadol and control groups (7%vs 5%; RR=1.40; 95% CI, 0.46–4.25; P=0.552). All of the Richards–Campbell sleep scales of patients in the tramadol group at 1 (77.4±15.2 vs 64.2±20.1, P<0.001), 2 (84.1±14.9 vs 71.8±18.8, P<0.001), and 3 days (87.0±12.2 vs 70.3±21.0, P<0.001) after surgery were higher than those in the control group.

Conclusion

Intravenous analgesia using tramadol can effectively improve the postoperative depression and sleep status of women undergoing abdominal endoscopic surgery. Tramadol is recommended for use in postoperative analgesia when improving postoperative mood, and sleep is needed in clinical practice.

Effect of Psychological Intervention on Pelvic Floor Function and Psychological Outcomes After Hysterectomy

Background

Hysterectomy is one of the most frequently performed operations worldwide. However, postoperative complications and body image changes may induce psychological distress after hysterectomy. The study aimed to evaluate the effect of psychological intervention on pelvic floor function and psychological outcomes following hysterectomy among patients with benign indications.

Methods

Ninety-nine patients underwent hysterectomy were randomly divided into intervention group (n = 50) and control group (n = 49). Patients in the control group received routine postoperative nursing care, while extra psychological intervention was provided to patients in the intervention group, including psychological support, regular lectures and family support. After 6 months, patient's psychological statuses were assessed by Generalized Anxiety Disorder scale (GAD-7) and Patient Health Questionnaire-9 (PHQ-9). The pelvic floor function of patients was evaluated using Pelvic Floor Impact Questionnaire (PFIQ-7) and Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire (PISQ-12). Furthermore, the incidence of postoperative complications, including uracratia, pelvic organ prolapses, sexual dysfunction and chronic pelvic pain, was evaluated.

Results

After 6-month intervention, the GAD-7 and PHQ-9 scores were significantly decreased in the intervention group (p &lt; 0.001 and p = 0.018 respectively). Both scored were significantly lower than that in the control group (p &lt; 0.001 and p &lt; 0.001). Compared with control group, the incidence of uracratia, pelvic organ prolapse, sexual dysfunction and chronic pelvic pain for intervention group was significantly lower (p = 0.003, p = 0.027, p = 0.001, p = 0.002 respectively) and the pelvic floor muscle strength was significantly stronger (p = 0.001). Besides, the postoperative Urinary Incontinence Impact Questionnaire (UIQ-7), Pelvic Organ Prolapse Impact Questionnaire (POPIQ-7), and Colorectal-Anal Impact Questionnaire (CRAIQ-7) scores were significantly lower (p = 0.025, p = 0.04, p &lt; 0.001) and PISQ-12 score was significantly higher in intervention group (p &lt; 0.001).

Conclusion

Psychological intervention could effectively improve the psychological condition of patients with hysterectomy, which may facilitate patients' postoperative recovery in pelvic floor function. These findings emphasized the necessity of psychological intervention in routine postoperative nursing care.

Effect of Intelligent Medical Management Platform Combined with Perioperative Detailed Nursing on Cognitive Ability, Postoperative Complications, and Quality of Life of Patients Undergoing Hysterectomy

Objective. To analyze the effect of an intelligent medical management platform combined with perioperative detailed nursing on cognitive ability, postoperative complications, and quality of life (QOL) of patients undergoing hysterectomy. Methods. The clinical data of 76 patients undergoing hysterectomy in our hospital from December 2019 to December 2021 were selected for the retrospective analysis, and the patients were divided into the experimental group (EG, $n=38$ , intelligent medical management platform+perioperative detailed nursing) and the routine group (RG, $n=38$ , routine nursing) according to their admission order, and the cognition of disease and QOL after intervention of patients in the two groups were evaluated by the self-proposed questionnaire on cognition of disease of our hospital and the MOS 36-item short-form health survey (SF-36). Results. After intervention, the scores on cognitive ability, various nursing items, and QOL were significantly higher in EG than in RG ( $P<0.001$ ), and during the study, the total incidence rate of complications was significantly lower in EG than in RG ( $P<0.05$ ). Conclusion. Combining an intelligent medical management platform with perioperative detailed nursing is a reliable method to improve QOL and reduce postoperative complications for patients undergoing hysterectomy. Further research will be conducive to providing a reliable perioperative intervention scheme for such patients.

Urinary incontinence and the association with depression, stress, and self-esteem in older Korean Women

The objectives were to investigate the prevalence of urinary incontinence (UI) and its relationships with depression, stress, and self-esteem in older Korean women from the Korean Study of Women's Health Related Issues (K-Stori), a nationally representative cross-sectional survey. A total of 3000 women between 65 and 79 years were the final study subjects. We applied multiple linear regression models to analyze associations with depression, stress, and self-esteem levels in relation to UI types. Types of urinary incontinence included stress, urge, and mixed UI. UI affects at least one in two older Korean women (52.2%). The prevalences of SUI, UUI, and MUI were 45.7%, 39.6%, and 33.1%, respectively. UI was found to be adversely associated with depression, stress, and self-esteem: women with UI reported significantly higher levels of depression and stress and lower levels of self-esteem than those without UI. Women with MUI reported significantly greater impairment than the women with SUI or UUI. Our results provide an evidence base for the evaluation of mental health in older women with incontinence. The prioritization of UI detection and the identification of psychological factors may help improve the diagnosis and management of UI and potentially yield significant economic and psychosocial benefits.