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Aggarwal H, Aggarwal H, Wanjari A. Unnecessary Hysterectomies Among Premenopausal Women in Developed and Developing Countries: A Critical Review of Steps Taken to Improve Women's Health. Cureus 2023; 15:e49943. [PMID: 38179386 PMCID: PMC10765271 DOI: 10.7759/cureus.49943] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Accepted: 12/05/2023] [Indexed: 01/06/2024] Open
Abstract
Women with pelvic organ disease often require a hysterectomy for better health. Still, in countries like India, there are many challenges for them as they are subjected many a time to unnecessary hysterectomies. Through this article, we suggest many ways to address this menace, such as proper health education and sensitization of women of premenopausal age group by health workers and mass media. Many preventable hysterectomies can be avoided if we guide women about their pathology before giving consent for surgery. Role enhancement of health agencies and nongovernmental organizations for early identification of such women in the society of all segments, stopping the greed of various health institutions using government-sponsored insurance health schemes for personal gain, and law enforcement by courts and health departments should also be our main focus. This study aims to review nonsurgical procedures adopted to decrease unnecessary hysterectomies and make suitable directions by government and lawful agencies to curb this menace. All states and union territories received the "Guidelines to Prevent Unnecessary Hysterectomies" recommendations from the Ministry of Health and Family Welfare for compliance. The recommendations suggest creating hysterectomy monitoring committees at the district, state, and federal levels. The duration of hospital stays and associated expenditures can decrease by performing minimally invasive treatments as outpatient operations. Minimally invasive options may shape the future of gynecology in developed nations.
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Affiliation(s)
- Hitaishi Aggarwal
- Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Hardik Aggarwal
- Medicine, All India Institute of Medical Sciences, Rishikesh, Rishikesh, IND
| | - Anil Wanjari
- Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
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Mortilla S, Pruneti C, Masellis G, Guidotti S, Caramuscio C. Clinical-Psychological Aspects Involved in Gynecological Surgery: Description of Peri-Operative Psychopathological Symptoms and Illness Behavior. Int J Psychol Res (Medellin) 2023; 16:56-66. [PMID: 37547867 PMCID: PMC10402648 DOI: 10.21500/20112084.5981] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Revised: 09/24/2022] [Accepted: 02/13/2023] [Indexed: 08/08/2023] Open
Abstract
Background Within the current literature concerning the gynecological surgery, there are only a few studies that focus on the psychological aspects that characterize the peri-operative period. In this research, the psychopathological symptoms and the illness behavior were assessed in order to confirm previous results about clinical variables such as the type and method of intervention, as well as psychological aspects regarding the positive anamnesis for mental disorders. Moreover, other factors including the desire for maternity and previous surgical interventions and pregnancies were also investigated. Methods In this observational research, 58 women (age = 41.5±8.8), that undergone gynecological surgery (conservative and non-conservative) for benign pathologies, were consecutively recruited. Information on psychopathological symptoms was collected 15 days (T0) and one day before surgery (T1), and at the time of discharge (T2) through the Symptom Questionnaire (SQ). At T2, the Illness Behavior Questionnaire (IBQ) was also administered. Results The descriptive analyzes conducted on the total sample demonstrated that while anxious activation and irritable mood decrease from T0 to T1, somatizations and depression mood increase between T1 and T2. Moreover, the comparisons between groups, dividing the sample according to the clinical-medical and psychological variables, highlighted that the type and modality of the intervention, as well as a positive history for the presence of psychological disorders, the desire for maternity, and previous surgical interventions and pregnancies, can influence the course of psychopathological symptoms. Conclusion This study highlights the need to include a clinical-psychological evaluation and to pay attention to specific clinical variables regarding women that are undergoing a conservative or non-conservative gynecological surgery. Considering the psychological impact of these type of interventions, the clinical history of these women, as well as their fears and desires, could facilitate a better management of the patients in terms of well-being, adherence to treatment, and recovery.
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Affiliation(s)
- Simona Mortilla
- Obstetrics and Gynecology Unit, Carpi Hospital, Modena, Italy.Carpi HospitalModenaItaly
- Clinical Psychology, Clinical Psychophysiology and Clinical Neuropsychology Labs., Dept. of Medicine and Surgery, University of Parma, Italy.Università degli Studi di ParmaUniversity of ParmaItaly
| | - Carlo Pruneti
- Clinical Psychology, Clinical Psychophysiology and Clinical Neuropsychology Labs., Dept. of Medicine and Surgery, University of Parma, Italy.Università degli Studi di ParmaUniversity of ParmaItaly
| | - Giuseppe Masellis
- Obstetrics and Gynecology Unit, Carpi Hospital, Modena, Italy.Carpi HospitalModenaItaly
| | - Sara Guidotti
- Clinical Psychology, Clinical Psychophysiology and Clinical Neuropsychology Labs., Dept. of Medicine and Surgery, University of Parma, Italy.Università degli Studi di ParmaUniversity of ParmaItaly
| | - Chiara Caramuscio
- Clinical Psychology, Clinical Psychophysiology and Clinical Neuropsychology Labs., Dept. of Medicine and Surgery, University of Parma, Italy.Università degli Studi di ParmaUniversity of ParmaItaly
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Li L, Chen Q, Zhang N, Yao X, Wang C. Use of antidepressants following hysterectomy with or without oophorectomy: A national sample in the US. Maturitas 2022; 167:32-38. [DOI: 10.1016/j.maturitas.2022.09.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2022] [Revised: 09/11/2022] [Accepted: 09/25/2022] [Indexed: 10/14/2022]
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Isokääntä S, Ruohoaho UM, Anttila M, Kokki H, Sintonen H, Toroi P, Kokki M. Resilience, pain, and health-related quality of life in gynecological patients undergoing surgery for benign and malignant conditions: a 12-month follow-up study. BMC Womens Health 2022; 22:345. [PMID: 35974326 PMCID: PMC9382813 DOI: 10.1186/s12905-022-01923-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Accepted: 07/26/2022] [Indexed: 11/21/2022] Open
Abstract
Background Gynecological surgery has many impacts on women’s physical and mental health, and efforts to improve recovery from surgery are constantly under evaluation. Resilience is an ability to overcome stressors and adversities, such as traumas and surgeries. This study aimed to explore patients’ resilience and psychological symptoms in relation to recovery, health-related quality of life (HRQoL), and pain one year after gynecological surgery. Methods In a prospective cohort study, we enrolled consecutive elective gynecologic surgery patients who completed questionnaires before and at one year after surgery: the Resilience Scale-25, the 15D instrument of HRQoL (15D), the Life Satisfaction Scale-4, and the Hospital Anxiety and Depression Scale. Their mean 15D scores were compared to those of an age-matched sample of women from the general Finnish population (n = 2743). Results We enrolled 271 women who underwent gynecological surgery due to benign (n = 190) and malignant (n = 81) diagnoses. Resilience was equally high in women with benign and malignant diagnoses at both time points. Higher resilience associated with less pain, analgesic use, and better pain relief from the use of pain medication at 12 months after surgery. Pain intensity was similar in the two groups, but patients with benign diseases had less pain at 12 months than before surgery. Before surgery, patients’ HRQoL was worse than that of the general population, but at 12 months the mean HRQoL of patients with benign diseases had improved to the same level as that in the general population but had decreased further in patients with malignant diseases. Anxiety was higher and life satisfaction was lower in patients with malignant diseases before surgery. At 12 months, anxiety had decreased in both groups, and life satisfaction had increased in patients with malignant diseases. Depression was similarly low in both groups and time points. Conclusions Resilience correlated with less pain one year after surgery. After surgery, HRQoL improved in patients with benign diseases but deteriorated in patients with malignant diseases. Patients with low resilience should be identified during preoperative evaluation, and health care professionals should give these patients psychological support to enhance their resilience. Trial Registration ClinicalTrials.gov; registered October 29, 2019; identifier: NCT04142203; retrospectively registered.
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Ghotbizadeh F, Hantoushzadeh S, Borna S, Khazardoost S, Panahi Z, Ghamari A, Dehghani A, Raisi F. A study on sexual functioning and depression in Iranian women following cesarean hysterectomy due to placental abnormality after 3-6 months. Women Health 2021; 61:503-509. [PMID: 34130611 DOI: 10.1080/03630242.2021.1917481] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
This study aims to investigate the prevalence of depression and impaired sexual function following the hysterectomy in Iran. This study was performed as a retrospective cohort study, from August 2017 to August 2018. Fifty-two patients with a cesarean hysterectomy and 52 with cesarean section were considered as the cases and controls, respectively. Depression and sexual function were assessed 3-6 months following the surgery in both cases and controls. Depression was evaluated by using Beck Depression Inventory (BDI) questionnaire-II-Persian. Sexual function was assessed using the Female Sexual Function Index (FSFI). The average BDI in cases was 15.37 ± 7.6 and in controls was 13.06 ± 6.7. Mild to moderate depression was detected 57.3 percent of whom with hysterectomy and 36.5 percent of whom with C/S, the BDI sum score did not differ significantly between cases and controls (p = .096). The FSFI in cases was 20.06 ± 6.96, and controls was 21.7 ± 9.83 without any significant difference (p = .364). The depression had not been significantly different between women who underwent hysterectomy and were not following 3-6 months after surgery. Furthermore, both groups had impaired sexual function after the surgery.
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Affiliation(s)
- Fahimeh Ghotbizadeh
- Obstetrics and Gynecology Department Vali -asr Hospital, Maternal, Fetal and Neonatal Research Center, Tehran, Iran
| | - Sedigheh Hantoushzadeh
- Obstetrics and Gynecology Department Vali -asr Hospital, Maternal, Fetal and Neonatal Research Center, Tehran, Iran
| | - Sedigheh Borna
- Obstetrics and Gynecology Department Vali -asr Hospital, Maternal, Fetal and Neonatal Research Center, Tehran, Iran
| | - Soghra Khazardoost
- Obstetrics and Gynecology Department Vali -asr Hospital, Maternal, Fetal and Neonatal Research Center, Tehran, Iran
| | - Zahra Panahi
- Obstetrics and Gynecology Department Vali -asr Hospital, Tehran, Iran
| | - Azin Ghamari
- Growth and Development Research Center, Children Medical Center of Excellence, Tehran, Iran
| | | | - Firoozeh Raisi
- Department of Psychiatry, Roozbeh Hospital, Tehran University of Medical Science, Tehran, Iran
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Aquil A, El Kherchi O, El Azmaoui N, Mouallif M, Guerroumi M, Chokri A, Jayakumar AR, Benider A, Elgot A. Body image dissatisfaction and lower self-esteem as major predictors of poor sleep quality in gynecological cancer patients after surgery: cross-sectional study. BMC WOMENS HEALTH 2021; 21:229. [PMID: 34082733 PMCID: PMC8173912 DOI: 10.1186/s12905-021-01375-5] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/01/2020] [Accepted: 05/19/2021] [Indexed: 12/27/2022]
Abstract
Background Sleep quality is among the indicators associated with the quality of life of patients with cancer. A multitude of factors may affect patient sleep quality and are considered as associated predictive factors. The aim of this study was to examine the predictors of poor sleep quality in Moroccan women with gynecological cancer after radical surgery. Methods A cross-sectional study was carried out at the Oncology Department of the Ibn Rochd University Hospital, Casablanca (Morocco), on women who had undergone radical surgery for gynecological cancer (n = 100; mean age: 50.94 years). To assess sleep quality, symptoms of depression and anxiety, self-esteem and body image, the following translated and validated Arabic versions of the tools were used: Pittsburgh Sleep Quality Index (PSQI), Hospital Anxiety and Depression Scale, Rosenberg’s Self-Esteem Scale and Body Image Scale. To determine predictors of sleep quality, multiple linear and hierarchical regressions were used. Results 78% of participants were considered poor sleepers, most of them exhibited very poor subjective quality (53%), longer sleep onset latency (55%), short period of sleep (42%) and low rate of usual sleep efficiency (47%). 79% of these patients did not use sleep medication and 28% were in poor shape during the day. Waking up in the middle of the night or early in the morning and getting up to use the bathroom were the main reasons for poor sleep quality. Higher PSQI scores were positively correlated with higher scores of anxiety, depression, body image dissatisfaction and with lower self-esteem (p < 0.001). The medical coverage system, body image dissatisfaction and low self-esteem predicted poor sleep quality. After controlling for the socio-demographic variables (age and medical coverage system), higher body image dissatisfaction and lower self-esteem significantly predicted lower sleep quality. Conclusion Body image dissatisfaction and lower self-esteem were positively linked to sleep disturbance in women with gynecological cancer after undergone radical surgery. These two predictors require systematic evaluation and adequate management to prevent sleep disorders and mental distress as well as improving the quality of life of these patients. Supplementary Information The online version contains supplementary material available at 10.1186/s12905-021-01375-5.
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Affiliation(s)
- Amina Aquil
- Epidemiology and Biomedical Unit, Laboratory of Sciences and Health Technologies, Higher Institute of Health Sciences, Hassan First University of Settat, 26000, Settat, Morocco
| | - Ouassil El Kherchi
- Epidemiology and Biomedical Unit, Laboratory of Sciences and Health Technologies, Higher Institute of Health Sciences, Hassan First University of Settat, 26000, Settat, Morocco
| | - Naoual El Azmaoui
- Epidemiology and Biomedical Unit, Laboratory of Sciences and Health Technologies, Higher Institute of Health Sciences, Hassan First University of Settat, 26000, Settat, Morocco
| | - Mustapha Mouallif
- Epidemiology and Biomedical Unit, Laboratory of Sciences and Health Technologies, Higher Institute of Health Sciences, Hassan First University of Settat, 26000, Settat, Morocco
| | - Maroua Guerroumi
- Epidemiology and Biomedical Unit, Laboratory of Sciences and Health Technologies, Higher Institute of Health Sciences, Hassan First University of Settat, 26000, Settat, Morocco
| | - Aziz Chokri
- Institut des Sciences du Sport, Hassan First University of Settat, 26000, Settat, Morocco
| | - Arumugam R Jayakumar
- Neuropathology Research Unit, Miami VA Medical Center and Department of Obstetrics, Gynecology and Reproductive Sciences, University of Miami Miller School of Medicine, Miami, FL, 33136, USA
| | - Abdellatif Benider
- Ibn Rochd University Hospital Center, Mohammed VI Center for the Treatment of Cancers, Casablanca, Morocco
| | - Abdeljalil Elgot
- Epidemiology and Biomedical Unit, Laboratory of Sciences and Health Technologies, Higher Institute of Health Sciences, Hassan First University of Settat, 26000, Settat, Morocco. .,Institut supérieur des sciences de la santé, Complexe Universitaire, route de Casablanca, B.P 555, Settat, Morocco.
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Mahardika P, Setyowati S, Afiyanti Y. The holistic needs of women with hysterectomy: A grounded theory study. ENFERMERIA CLINICA 2021. [PMID: 33849172 DOI: 10.1016/j.enfcli.2020.10.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
The objective of study is to qualitative assess for identify the holistic needs of childbearing age women with hysterectomy. This study use grounded theory qualitative study method. The participants in this study were six childbearing age women post hysterectomy, husbands, family members, and three healthcare workers. This study was conducted in West Sumatra Province with Minang culture which adheres to matrilineal kinship system. The results of this study there are seven elements that develop concept of holistic needs on women with hysterectomy. Consists of the need to deal with sexual problems and pain, to be cared by the family, to be more active, to improve relationships with God and self-acceptance, and community values to accept women with hysterectomy. The needs of women with hysterectomy were holistic needs. Nurses can do assessments to understand holistically the needs of women with hysterectomy.
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Affiliation(s)
- Putri Mahardika
- Faculty of Nursing Universitas Indonesia, Depok, West Java, Indonesia
| | | | - Yati Afiyanti
- Faculty of Nursing Universitas Indonesia, Depok, West Java, Indonesia
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Urdzík P, Kalis V, Blaganje M, Rusavy Z, Smazinka M, Havir M, Dudič R, Ismail KM. Pelvic organ prolapse and uterine preservation: a survey of female gynecologists (POP-UP survey). BMC WOMENS HEALTH 2020; 20:241. [PMID: 33109157 PMCID: PMC7590717 DOI: 10.1186/s12905-020-01105-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/31/2020] [Accepted: 10/20/2020] [Indexed: 12/17/2022]
Abstract
Background The aim of this study was to explore the personal views of female gynecologists regarding the management of POP with a particular focus on the issue of uterine sparing surgery. Methods A questionnaire based survey of practicing female gynecologists in the Czech Republic, Slovenia and Slovakia. Results A total of 140 female gynecologists from 81 units responded to our questionnaire. The majority of respondents stated they would rely on a urogynecologist to aid them with their choice of POP management options. The most preferred options for POP management were sacrocolpopexy and physiotherapy. Almost 2/3 of respondents opted for a hysterectomy together with POP surgery, if they were menopausal, even if the anatomical outcome was similar to uterine sparing POP surgery. Moreover, 81.4% of respondents, who initially opted for a uterine sparing procedure, changed their mind if the anatomical success of POP surgery with concomitant hysterectomy was superior. Discussing uterine cancer risk in relation to other organs had a less significant impact on their choices. Conclusions The majority of female gynecologists in our study opted for hysterectomy if they were postmenopausal at the time of POP surgery. However, variation in information provision had an impact on their choice.
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Affiliation(s)
- Peter Urdzík
- Department of Gynecology and Obstetrics, Faculty of Medicine, Safarik's University and L. Pasteur Teaching Hospital in Kosice, SNP Street No. 1, 04001, Košice, Slovak Republic.
| | - Vladimir Kalis
- Biomedical Center, Faculty of Medicine in Pilsen, Charles University, alej Svobody 80, 304 60, Plzeň, Czech Republic.,Department of Obstetrics and Gynecology, University Hospital, Charles University, alej Svobody 80, 304 60, Plzeň, Czech Republic
| | - Mija Blaganje
- Division of Gynecology, University Medical Centre Ljubljana, Šlajmerjeva 3, 1525, Ljubljana, Slovenia
| | - Zdenek Rusavy
- Biomedical Center, Faculty of Medicine in Pilsen, Charles University, alej Svobody 80, 304 60, Plzeň, Czech Republic.,Department of Obstetrics and Gynecology, University Hospital, Charles University, alej Svobody 80, 304 60, Plzeň, Czech Republic
| | - Martin Smazinka
- Department of Obstetrics and Gynecology, University Hospital, Charles University, alej Svobody 80, 304 60, Plzeň, Czech Republic
| | - Martin Havir
- Department of Obstetrics and Gynecology, University Hospital, Charles University, alej Svobody 80, 304 60, Plzeň, Czech Republic
| | - Rastislav Dudič
- Department of Gynecology and Obstetrics, Faculty of Medicine, Safarik's University and L. Pasteur Teaching Hospital in Kosice, SNP Street No. 1, 04001, Košice, Slovak Republic
| | - Khaled M Ismail
- Biomedical Center, Faculty of Medicine in Pilsen, Charles University, alej Svobody 80, 304 60, Plzeň, Czech Republic.,Department of Gynecology and Obstetrics, Faculty of Medicine in Pilsen, Charles University, alej Svobody 80, 304 60, Plzeň, Czech Republic
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Sexuality of Women after Gynecological Surgeries. Healthcare (Basel) 2020; 8:healthcare8040393. [PMID: 33050505 PMCID: PMC7711529 DOI: 10.3390/healthcare8040393] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2020] [Revised: 10/03/2020] [Accepted: 10/08/2020] [Indexed: 11/30/2022] Open
Abstract
(1) Background: Disorders of sexual life negatively impact self-esteem and social relationships. This problem affects patients after gynecological surgery. Providing access to specialist sexologist care constitutes an important aspect of support for this patient group. (2) Objective: The aim of the study was to assess the sexual life of women depending on the time since surgery, extent of gynecological surgery and postoperative chemotherapy and/or radiotherapy. (3) Methods: The study included 136 patients from gynecological outpatient clinics in Szczecin, Poland. The women answered questions from a special three-part questionnaire. Participation was anonymous and voluntary. The data obtained in the survey were subject to statistical analysis. (4) Results: Among patients with a sparing of the cervix, most have never or almost never experienced discomfort or pain during intercourse, and believe that the quality of their sex life has not deteriorated after surgery. It was found that cervical removal, despite the existence of other conditions, increases the chance of pain during sexual activity 11 times. We found that the removal of adnexa did not increase the risk of changing sexual activity. In patients who had not undergone postoperative chemo- and/or radiotherapy, sexual activity did not change after surgery, and they never or almost never experienced discomfort or pain during intercourse. On the other hand, it was shown, despite the smaller study group, that patients treated with postoperative chemo- and/or radiotherapy did not initiate sexual intercourse. (5) Conclusion: The more extended the gynecological surgery of the uterus, the greater the limitation of sexual life.
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Palermo T, Hall BJ, Cirillo C. Enhanced life distress inventory: Development and validation in two African countries. Br J Health Psychol 2020; 25:728-753. [PMID: 32634299 DOI: 10.1111/bjhp.12448] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2020] [Revised: 04/30/2020] [Indexed: 11/28/2022]
Abstract
OBJECTIVE Poverty is linked to poor mental health, and stress is a key pathway. Most existing stress scales were developed in high-income settings. We use primary data collected from three large population-based studies in Ghana and Tanzania to examine the performance and psychometric properties of a new measure of self-perceived stress, the Enhanced Life Distress Inventory (ELDI). METHODS Development of the ELDI was informed by an exploratory qualitative study implemented among youth and adolescents in Ghana, Malawi, and Tanzania and structured following the Life Distress Inventory (LDI). We implemented the ELDI in three ongoing longitudinal impact evaluations involving quantitative household surveys in two studies in Tanzania and in one in Ghana to evaluate its performance and psychometric properties. FINDINGS Sample sizes ranged from N = 608 to N = 2,458, with variation in gender, age, and geographic location. Exploratory factor analysis uncovered three underlying factors of the ELDI, which justified the use of three sub-scales: economic and health-related well-being, risk/security, and social relations. Further analysis demonstrated that the ELDI has adequate psychometric properties, including internal consistency, and construct validity. CONCLUSION A major contribution of the ELDI is its development in and for LMIC settings and its ability to assess different areas (life domains) of distress. This multi-sectoral lens gives the scale the potential to examine not only programmes targeting stress, but also those targeting sources of stress, and to examine whether they improve stress and mental health via those pathways. More testing of the ELDI's performance and psychometric properties is needed in additional settings.
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Affiliation(s)
- Tia Palermo
- Department of Epidemiology and Environmental Health, University at Buffalo (State University of New York), New York, USA
| | - Brian J Hall
- Global and Community Mental Health Research Group, Faculty of Social Sciences (E21-3040), University of Macau, Avenida da Universidade, Taipa, Macao (SAR), People's Republic of China.,Health, Behavior, and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
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- UNICEF Office of Research-Innocenti, Florence, Italy
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Shen YC, Chen W, Tsai IJ, Wang JH, Lin SZ, Ding DC. Association of hysterectomy with bipolar disorder risk: A population-based cohort study. Depress Anxiety 2019; 36:543-551. [PMID: 31025812 DOI: 10.1002/da.22904] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2018] [Revised: 03/17/2019] [Accepted: 04/10/2019] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Hormonal fluctuations may trigger the onset of bipolar disorder. We designed a longitudinal follow-up study to evaluate the association between hysterectomies and bipolar disorder risk. METHODS We conducted a large retrospective cohort study using Taiwan's National Health Insurance Research Database. A total of 4,337 women aged 30 to 50 years who underwent the hysterectomy during 2000-2013 were selected and 17,348 patients without hysterectomy were selected for comparison (1:4 match). Poisson regression analysis was used to calculate the incidence rate ratio (IRR) and 95% confidence interval (CI). RESULTS During the follow-up of 7.93 years, 20 participants with hysterectomy and 28 without hysterectomy developed bipolar disorder. Receiving hysterectomy was associated with the risk of developing bipolar disorder (adjusted IRR = 2.80; 95% CI = 2.54-3.09). Women with hysterectomy had a higher risk of bipolar disorder in follow-up durations of <1 year (adjusted IRR = 2.18 with 95% CI = 1.94-1.45) and ≥1 year (adjusted IRR = 2.85 with 95% CI = 2.58-3.15). Endometriosis and Premarin use increased bipolar disorder incidence in the hysterectomy group (adjusted IRR = 3.17 [95% CI = 2.83-3.56] and 4.22 [95% CI = 3.71-4.80], respectively). CONCLUSION This study concluded that women with hysterectomy have an increased risk of bipolar disorder. Endometriosis and hormone therapy may add to the risk of bipolar disorder after hysterectomy. Knowledge about how surgical or natural hormonal withdrawal influences mood is fundamental and emphasizes the importance of coordinated psychiatric and gynecological care.
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Affiliation(s)
- Yu-Chih Shen
- Department of Psychiatry, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Tzu Chi University, Hualien, Taiwan
| | - Weishan Chen
- Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan.,College of Medicine, China Medical University, Taichung, Taiwan
| | - I-Ju Tsai
- Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan.,College of Medicine, China Medical University, Taichung, Taiwan
| | - Jen-Hung Wang
- Department of Research, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Tzu Chi University, Hualien, Taiwan
| | - Shinn-Zong Lin
- Department of Neurosurgery, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Tzu Chi University, Hualien, Taiwan
| | - Dah-Ching Ding
- Department of Obstetrics and Gynecology, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Tzu Chi University, Hualien, Taiwan.,Institute of Medical Sciences, Tzu Chi University, Hualien, Taiwan
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12
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Hysterectomies Are Associated with an Increased Risk of Depression: A Population-Based Cohort Study. J Clin Med 2018; 7:jcm7100366. [PMID: 30340333 PMCID: PMC6210125 DOI: 10.3390/jcm7100366] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2018] [Revised: 10/16/2018] [Accepted: 10/17/2018] [Indexed: 01/11/2023] Open
Abstract
Using the National Health Insurance Research Database of Taiwan, we investigated whether undergoing a hysterectomy increases the risk of depression. A total of 7872 patients aged 30–49 years who underwent a hysterectomy from 2000 to 2013 were enrolled as the hysterectomy group. The comparison group was randomly selected from women who had never undergone a hysterectomy and was four times the size of the hysterectomy group. We calculated adjusted hazard ratios and 95% confidence intervals (CIs) for depression [The International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) codes 296.2, 296.3, 300.4, 311] in these cohorts after adjusting for age, comorbidities, oophorectomy, and hormone therapy. The overall incidence of depression was 1.02 and 0.66 per 100 person-years in the hysterectomy and comparison cohorts, respectively, yielding an adjusted hazard ratio of 1.35 (95% CI = 1.22–1.50) for depression risk. When we stratified patients by age, comorbidities, oophorectomy, and hormone use, hysterectomy increased the risk of depression. Hysterectomy, oophorectomy, and post-surgery hormone use were associated with an increased risk of depression when they occurred alone, but conferred a greater risk if they were considered jointly. Hysterectomy would be a predisposing factor for increased risk of subsequent depression. Our findings provide vital information for patients, clinicians, and the government for improving the treatment strategy in the future.
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Theunissen M, Peters ML, Schepers J, Schoot DC, Gramke HF, Marcus MA. Prevalence and predictors of depression and well-being after hysterectomy: An observational study. Eur J Obstet Gynecol Reprod Biol 2017; 217:94-100. [PMID: 28869813 DOI: 10.1016/j.ejogrb.2017.08.017] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2016] [Revised: 08/10/2017] [Accepted: 08/12/2017] [Indexed: 11/26/2022]
Abstract
OBJECTIVES To assess risk and predictive factors for depression and well-being, 3 and 12 months after elective hysterectomy. Secondary objectives were to assess the incidence of depression, level of well-being, and feelings of femininity. STUDY DESIGN A prospective multicenter cohort study was performed among 419 women, undergoing hysterectomy for benign indication. Data were collected in the week prior to surgery, and in the per- and postoperative period up to the fourth postoperative day and 3 and 12 months after surgery. Sociodemographic variables, baseline health status, psychosocial predictors, and surgery data were assessed. Outcome measures were Center for Epidemiological Studies-Depression scale (CES-D, range 0-60), the 12-item well-being questionnaire energy and positive well-being subscales (range 0-12), and feelings of femininity. Predictor analyses were performed using linear mixed model analyses. RESULTS Levels of depression, energy, and positive well-being after hysterectomy were predicted by their corresponding baseline levels (estimate 0.62 p<0.001, 0.39 p<0.001, 0.37 p<0.001, respectively) and baseline pain (0.31 p=0.003, -0.09 p=0.026, -0.10 p=0.008). Postoperative infection reported at 12 months affected CES-D and energy level. Several other gynaecological, psychosocial, or perioperative factors were also predictive for one of the outcomes. Prevalence of depression at baseline, 3 and 12 months was 24%, 19%, and 21%, respectively. In general, well-being scores were slightly higher 3 and 12 months after hysterectomy than at baseline. Feelings of femininity were not negatively affected in 92% of the patients. CONCLUSIONS Preoperative psychosocial status, perioperative pain, and postoperative infection were found as predictors of psychological outcome after hysterectomy. In the majority of patients we observed small but significant improvements with regard to postoperative depression and well-being, while feelings of femininity were unaffected.
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Affiliation(s)
- Maurice Theunissen
- Department of Anaesthesiology and Pain Management, Maastricht University Medical Centre+, Maastricht, The Netherlands.
| | - Madelon L Peters
- Department of Clinical Psychological Science, Maastricht University, Maastricht, The Netherlands
| | - Jan Schepers
- Department of Methodology and Statistics, Maastricht University, The Netherlands
| | - Dick C Schoot
- Department of Gynaecology, Catharina Hospital, Eindhoven, The Netherland; Department of Gynaecology, Ghent University Hospital, Ghent, Belgium
| | - Hans-Fritz Gramke
- Department of Anaesthesiology and Pain Management, Maastricht University Medical Centre+, Maastricht, The Netherlands
| | - Marco A Marcus
- Department of Anaesthesiology and Pain Management, Maastricht University Medical Centre+, Maastricht, The Netherlands
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Soeda S, Hiraiwa T, Takata M, Kamo N, Sekino H, Nomura S, Kojima M, Kyozuka H, Ozeki T, Ishii S, Tameda T, Asano K, Miyazaki M, Takahashi T, Watanabe T, Taki Y, Fujimori K. Unique Learning System for Uterine Artery Embolization for Symptomatic Myoma and Adenomyosis for Obstetrician-Gynecologists in Cooperation with Interventional Radiologists: Evaluation of UAE From the Point of View of Gynecologists Who Perform UAE. J Minim Invasive Gynecol 2017; 25:84-92. [PMID: 28807810 DOI: 10.1016/j.jmig.2017.08.008] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2017] [Revised: 07/15/2017] [Accepted: 08/05/2017] [Indexed: 11/24/2022]
Abstract
STUDY OBJECTIVE To evaluate a unique learning system for uterine artery embolization (UAE) and examine its feasibility and clinical outcomes for the treatment of symptomatic uterine leiomyomas and adenomyosis when performed by obstetrician-gynecologists in cooperation with interventional radiologists (IVRs). DESIGN Retrospective study (Canadian Task Force classification II-2). SETTING University hospital. PATIENTS One hundred seventy-three patients who underwent UAE for symptomatic leiomyomas and adenomyosis. INTERVENTIONS We examined the medical records of patients who underwent UAE for symptomatic uterine leiomyomas and adenomyosis at our department between 2003 and 2012 using our learning system for UAE for obstetrician-gynecologists in cooperation with IVRs. The charts of all patients were reviewed, and data on etiologic factors, past medical history of leiomyomas and adenomyosis, symptoms, details of UAE, and clinical outcomes after UAE were extracted. MEASUREMENTS AND MAIN RESULTS A total of 173 patients who underwent 177 UAEs were identified, including 4 patients who underwent embolization twice because of primary treatment failure or symptom recurrence. During the study period, 2 gynecologists successfully acquired endovascular skills. The technical success rate was 97.7% (174 of 177). The duration of fluoroscopy in procedures performed by obstetrician-gynecologists who acquired endovascular skills was not significantly different from that in procedures performed by IVRs at our institution; however, this duration was significantly longer in procedures performed by obstetrician-gynecologists who did not have sufficient experience with our learning protocol for UAE because of inadequate live observation of UAEs performed by skilled IVRs. Complications that necessitated discontinuation of the procedure occurred in 2.3% of cases (4 of 177). The clinical outcomes were similar to those reported in previous studies. Adverse events after UAE included myeloid passages in 7.0% (11 of 158), infections in 2.5% (4 of 158), vaginal discharge in 2.5% of patients with leiomyomas (4 of 158), and vaginal discharge in 7.1% of patients with adenomyosis (1 of 14). All the adverse events were adequately treated by the obstetrician-gynecologists themselves. The timing of hysterectomy due to complications or recurrence of symptoms after UAE varied widely. CONCLUSION UAE performed by obstetrician-gynecologists in cooperation with radiologists can be achieved safely and successfully with acceptable clinical outcomes. Live observation of the procedure performed by skilled IVRs is essential to improving the skills and reducing the fluoroscopic time of obstetrician-gynecologists.
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Affiliation(s)
- Shu Soeda
- Department of Obstetrics and Gynecology, Fukushima Medical University School of Medicine, Fukushima, Japan.
| | - Tsuyoshi Hiraiwa
- Department of Obstetrics and Gynecology, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Megumi Takata
- Department of Obstetrics and Gynecology, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Norihito Kamo
- Department of Obstetrics and Gynecology, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Hirofumi Sekino
- Department of Radiology, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Shinji Nomura
- Department of Obstetrics and Gynecology, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Manabu Kojima
- Department of Obstetrics and Gynecology, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Hyo Kyozuka
- Department of Obstetrics and Gynecology, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Takeharu Ozeki
- Department of Obstetrics and Gynecology, Takeda General Hospital, Wakamatsu, Japan
| | - Shiro Ishii
- Department of Radiology, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Tadanobu Tameda
- Department of Radiology, Ota Nishinouchi General Hospital, Iwaki, Japan
| | - Kimisato Asano
- Department of Obstetrics and Gynecology, Higashi-Fuchu Hospital, Tokyo, Japan
| | - Makoto Miyazaki
- Department of Radiation Health Management, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Toshifumi Takahashi
- Fukushima Medical Center for Children and Women, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Takafumi Watanabe
- Department of Obstetrics and Gynecology, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Yasunori Taki
- Department of Radiology, Chofu-keijinkai Clinic, Tokyo, Japan
| | - Keiya Fujimori
- Department of Obstetrics and Gynecology, Fukushima Medical University School of Medicine, Fukushima, Japan
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Gercek E, Dal NA, Dag H, Senveli S. The information requirements and self-perceptions of Turkish women undergoing hysterectomy. Pak J Med Sci 2016; 32:165-70. [PMID: 27022368 PMCID: PMC4795860 DOI: 10.12669/pjms.321.7962] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Objectives: To investigate the affects, information requirements and self-perceptions of Turkish women undergoing hysterectomy. Methods: A descriptive cross-sectional study was conducted on 37 Turkish women undergoing hysterectomy and followed in a gynecology unit of a state hospital in Canakkale, Turkey, between February and August 2012. Data were collected before discharge with a questionnaire composed of 32 questions. Percentage distributions and Chi-square test were used in the evaluation of the data. Results: There was a significant relationship between fear of anesthesia and number of pregnancies (p=0.007) and between death during surgery and number of pregnancies in the preoperative period (p=0.027). The relationship between knowing type of surgery and knowing when sutures would be removed was also significant in post-operative period (p=0.045). In addition, there was a significant relationship between women’s living only with their husbands and worrying about not having children anymore (p=0.032). Conclusion: The women’s information needs were high and women’s self-perceptions had been affected negatively after hysterectomy. It is recommended that nurses, primarily health professionals should have adequate knowledge on comprehensive care and psychosocial support after hysterectomy.
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Affiliation(s)
- Emine Gercek
- Emine Gercek, PhD, RN, Assistant Professor, Nursing Department, Adnan Menderes University, Soke School of Health, Soke, Aydin, Turkey
| | - Nursel Alp Dal
- Nursel Alp Dal, MsC, Lecturer, Nursing Department, Tunceli University, Tunceli School of Health, Tunceli, Turkey
| | - Hande Dag
- Hande Dag, PhD, Research Assistant, Obstetrics and Gynecologic Nursing Department, Ege University, Faculty of Nursing, Bornova, Izmir, Turkey
| | - Seyran Senveli
- Seyran Senveli, Lecturer, Nursing Department, Canakkale Onsekiz Mart University, School of Health, Canakkale, Turkey
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Posttraumatic stress symptoms in women with gynaecologic pathology: the role of temperament, self-esteem and mental health. CURRENT ISSUES IN PERSONALITY PSYCHOLOGY 2016. [DOI: 10.5114/cipp.2016.61680] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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Chou PH, Lin CH, Cheng C, Chang CL, Tsai CJ, Tsai CP, Lan TH, Chan CH. Risk of depressive disorders in women undergoing hysterectomy: A population-based follow-up study. J Psychiatr Res 2015; 68:186-91. [PMID: 26228418 DOI: 10.1016/j.jpsychires.2015.06.017] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2015] [Revised: 06/16/2015] [Accepted: 06/19/2015] [Indexed: 11/26/2022]
Abstract
OBJECTIVE The objective of this study was to assess the risk of depressive disorders in women who underwent hysterectomy in Taiwan. METHODS A retrospective study was conducted in a matched cohort of cases using the National Health Insurance Research Database of Taiwan. Database records from 1689 women who underwent hysterectomy between 2001 and 2005 were included in this study. A control group matched for age and physical comorbidity was selected from the same database (n = 6752). For all cases, medical records were tracked until the end of 2009 to identify whether a depressive disorder was diagnosed during the follow-up period. The hazard ratio (HR) for depression during the observation period was analyzed using multivariable Cox proportional-hazards models, adjusted for age, physical comorbidities, and other socioeconomic factors. RESULTS The HR for depression was 1.78 times higher for the group that underwent hysterectomy than for the control group (adjusted HR = 1.78; 95% CI = 1.46-2.18, p < 0.001). In addition, HR for major depressive disorder in women who underwent hysterectomy was significantly higher (1.84 times) than for the control group (adjusted HR = 1.84; 95% CI = 1.23-2.74, p < 0.01). CONCLUSIONS Our study revealed that, in Taiwan, women who underwent hysterectomy had an increased risk of developing depression. Longitudinal studies to follow-up the psychological outcomes in Taiwanese women who underwent hysterectomy will be necessary to confirm our findings.
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Affiliation(s)
- Po-Han Chou
- Department of Psychiatry, Taichung Veterans General Hospital, Taichung, Taiwan
| | - Ching-Heng Lin
- Department of Medical Research, Taichung Veterans General Hospital, Taichung, Taiwan.
| | - Chin Cheng
- Department of Psychiatry, Chin Bing Hospital, Taichung, Taiwan
| | - Chia-Li Chang
- Department of Medical Research, Taichung Veterans General Hospital, Taichung, Taiwan
| | - Chia-Jui Tsai
- Department of Psychiatry, Taichung Veterans General Hospital, Taichung, Taiwan
| | - Ching-Pei Tsai
- Department of Gynecology and Obstetrics, Taichung Veterans General Hospital, Taichung, Taiwan
| | - Tsuo-Hung Lan
- Department of Psychiatry, Taichung Veterans General Hospital, Taichung, Taiwan; Department of Psychiatry, Faculty of Medicine, National Yang Ming University, Taipei, Taiwan.
| | - Chin-Hong Chan
- Department of Psychiatry, Taichung Veterans General Hospital, Taichung, Taiwan
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Sobral Portela E, Soto González M. Problemas sexuales derivados de la histerectomía. CLINICA E INVESTIGACION EN GINECOLOGIA Y OBSTETRICIA 2015. [DOI: 10.1016/j.gine.2014.05.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Mara M, Kubinova K. Embolization of uterine fibroids from the point of view of the gynecologist: pros and cons. Int J Womens Health 2014; 6:623-9. [PMID: 25018653 PMCID: PMC4074023 DOI: 10.2147/ijwh.s43591] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Uterine artery embolization (UAE) is a minimally invasive procedure with large symptomatic potential in treatment of women with uterine leiomyomas. Due to specificities of this method and possible complications the appropriate indication is crucial. Patient’ symptoms, age, plans for pregnancy, and surgical and reproductive history play a major role in decision-making regarding appropriate subjects for UAE. Close cooperation between the gynecologist and the interventional radiologist is necessary. UAE is usually offered as an alternative to surgical treatment. In patients with no fertility plans, it is a less invasive option than abdominal hysterectomy, with a comparable effect on fibroid-related symptoms and quality of life. The need for reintervention is markedly greater in patients after UAE (up to 35% within 5 years) than after hysterectomy. Women with large symptomatic fibroids wishing to retain the uterus and ineligible for minimally invasive (laparoscopic or vaginal) hysterectomy are good candidates for UAE. However, studies comparing UAE with minimally invasive hysterectomy are lacking. Use of UAE in younger women desiring pregnancy is more controversial, mainly because of the significant risk of miscarriage (as high as 64% in some studies) as well as the increased risk of other complications of pregnancy, such as preterm delivery, abnormal placentation, and post-partum hemorrhage. The risk of infertility or subfertility following UAE is unknown. Even poor candidates for myomectomy should be carefully selected for UAE after counseling about all possible adverse effects on fertility. Good prospective studies focused on fertility comparing UAE with no treatment or with myomectomy are needed but would be ethically questionable. This review summarizes the current knowledge regarding the benefits and potential risks of UAE from the point of view of the gynecologist, who should be responsible for proper indication of this treatment.
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Affiliation(s)
- Michal Mara
- Department of Obstetrics and Gynecology, General Faculty Hospital and First Medical Faculty of Charles University, Prague, Czech Republic
| | - Kristyna Kubinova
- Department of Obstetrics and Gynecology, General Faculty Hospital and First Medical Faculty of Charles University, Prague, Czech Republic
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Psychological outcomes after hysterectomy for benign conditions: a systematic review and meta-analysis. Eur J Obstet Gynecol Reprod Biol 2013; 174:5-19. [PMID: 24398028 DOI: 10.1016/j.ejogrb.2013.12.017] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2013] [Revised: 08/27/2013] [Accepted: 12/06/2013] [Indexed: 11/23/2022]
Abstract
Hysterectomy is one of the commonest operative procedures in the developed world, mostly occurring among premenopausal women, with contradictory results regarding post-operative psychological wellbeing. This review aims to inform practice by examining whether hysterectomy predicts depression or anxiety outcomes. We searched PubMed, EMBASE, and PsycINFO electronic databases for articles published before November 2012. Reference lists of relevant articles were hand searched, and expert opinions were sought. Refereed studies investigating an association between hysterectomy for benign (non-cancerous) conditions and post-operative symptoms of depression or anxiety were chosen for this review. Two authors independently abstracted data from original articles. Authors of relevant studies were contacted for data that could not be extracted from the published articles. Review Manager 5.1 was used throughout the meta-analysis to calculate the summary relative risks (RRs), and the weighted standardized mean difference (WstdMD), and their corresponding 95% confidence intervals (CI). A random effects model was used in data analysis and verified using a fixed effect model. Overall, hysterectomy was associated with a decreased risk of clinically relevant depression (RR=1.69, 95% CI 1.19-2.38). Additionally, hysterectomy was associated with a decrease in standardized depression outcomes (standardized mean difference (SMD) 0.38 (95% CI 0.27-0.49)). Conversely, there was no significant association between hysterectomy and risk of clinically relevant anxiety (RR=1.41, 95% CI 0.72-2.75). In conclusion, data from before and after studies suggest that hysterectomy for benign gynecological conditions is not adversely associated with anxiety and may be positively rather than adversely associated with depression.
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Yount SM. The Impact of Pelvic Floor Disorders and Pelvic Surgery on Women's Sexual Satisfaction and Function. J Midwifery Womens Health 2013; 58:538-45. [DOI: 10.1111/jmwh.12030] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Pinar G, Okdem S, Dogan N, Buyukgonenc L, Ayhan A. The effects of hysterectomy on body image, self-esteem, and marital adjustment in Turkish women with gynecologic cancer. Clin J Oncol Nurs 2012; 16:E99-104. [PMID: 22641334 DOI: 10.1188/12.cjon.e99-e104] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The purpose of this research was to investigate the differences in the effect of hysterectomy on body image, self-esteem, and marital adjustment in Turkish women with gynecologic cancer based on specific independent variables, including age, education, employment, having or not having children, and income. This cross-sectional study compared a group of women who underwent a hysterectomy (n = 100) with a healthy control group (n = 100). The study findings indicate that women who had a hysterectomy were found in worse conditions in terms of body image, self-esteem, and dyadic adjustment compared to healthy women. In terms of dyadic adjustment and body image among women who had undergone a hysterectomy, those with lower levels of income and education were found in poorer conditions. The study's findings show that hysterectomies have negative effects on body image, self-esteem, and dyadic adjustment in women affected by gynecologic cancer. Nursing assessment of self-esteem and marital adjustment indicators and implementation of strategies to increase self-confidence and self-esteem are needed for high-risk women.
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Affiliation(s)
- Gul Pinar
- Department of Nursing in the Faculty of Health Sciences, Yildirim Beyazit University, Ankara, Turkey.
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Wong LP, Arumugam K. Physical, psychological and sexual effects in multi-ethnic Malaysian women who have undergone hysterectomy. J Obstet Gynaecol Res 2012; 38:1095-105. [DOI: 10.1111/j.1447-0756.2011.01836.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Vandyk AD, Brenner I, Tranmer J, Van Den Kerkhof E. Depressive Symptoms Before and After Elective Hysterectomy. J Obstet Gynecol Neonatal Nurs 2011; 40:566-76. [DOI: 10.1111/j.1552-6909.2011.01278.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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Pinar G, Kurt A, Gungor T. The efficacy of preopoerative instruction in reducing anxiety following gyneoncological surgery: a case control study. World J Surg Oncol 2011; 9:38. [PMID: 21477315 PMCID: PMC3088892 DOI: 10.1186/1477-7819-9-38] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2010] [Accepted: 04/08/2011] [Indexed: 11/22/2022] Open
Abstract
Background This is a quasi-experimental case control research focusing on the impact of systematic preoperative instruction on the level of postoperative anxiety in gyneoncologic patients. The population studied consists of the gyneoncologic surgery patients admitted to the Gynecologic Oncology Service at Zekai Tahir Burak Gynecology Training and Research Hospital from May to September 2010. Patients and methods Through a random sampling, 60 patients were recruited in each group. The study group was given a systematic preoperative instruction while the control group was given routine nursing care. Patients were interviewed in the postoperative period and anxiety was measured. The data-collecting tool consisted of the Individual Information Form and the State-Trait Anxiety Inventory. The collected data were analyzed by using the SPSS Program to find the frequency, the percentage, the mean and the standard variables, and the hypothesis was tested with Chi-square, variance, and t-independent test. Results It was found that the incidence rates from the post-operative anxiety score of the study group were lower than those of the control group (p < .05). The results of this research demonstrated that gyneoncologic surgery patients who were given systematic preoperative instruction felt less anxious than the ones who were given merely a routine nursing care. Conclusions Results of this study suggest that preoperative instruction programs aiming at informing gyneoncologic surgery patients at the preoperative stage should be organized in hospitals and have an essential role.
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Affiliation(s)
- Gul Pinar
- Başkent University Health Sciences Faculty, Nursing and Healthcare Services Department, Eskisehir Yolu, 20. km. Balica Campus, Cayyolu/Ankara, Turkey.
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Sözeri-Varma G, Kalkan-Oğuzhanoğlu N, Karadağ F, Özdel O. The effect of hysterectomy and/or oophorectomy on sexual satisfaction. Climacteric 2011; 14:275-81. [DOI: 10.3109/13697137.2010.532251] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Mantani A, Yamashita H, Fujikawa T, Yamawaki S. Higher incidence of hysterectomy and oophorectomy in women suffering from clinical depression: retrospective chart review. Psychiatry Clin Neurosci 2010; 64:95-8. [PMID: 20416028 DOI: 10.1111/j.1440-1819.2009.02044.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
The aim of the present study was to retrospectively evaluate women who were admitted to Hiroshima University Hospital, Department of Psychiatry and Neurosciences, from 1979 to 2008. The women were classified as 'depressed women' (n = 159; mean age, 52.3 +/- 5.7 years) or 'non-depressed women' (n = 182; mean age, 51.5 +/- 4.5 years). A total of 14.5% of the depressed women and 3.3% of the non-depressed women had a hysterectomy and/or oophorectomy; this difference was statistically significant (P = 0.0003). This is consistent with previous reported information as well as clinical experience that depressed women had a higher incidence of hysterectomy and/or oophorectomy.
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