Recovery time period and quality of life after hysterectomy

Tools for assessing the quality of life of hysterectomized women: A systematic review

AIMS AND OBJECTIVES

Since hysterectomy surgery is a major and invasive procedure, it can affect the quality of life of women in many ways. This study aimed to review and critique the psychometric properties of tools used to measure the quality of life of hysterectomized women.

METHOD

An advanced search was conducted in international (PubMed, Web of Science, Scopus, PsycINFO, Embase) as well as national databases (SID and Magiran) to retrieve articles published from 2000 to 2024, using keywords related to hysterectomy and quality of life. Then, the psychometric properties of the tools found in these articles were evaluated by COSMIN checklist.

RESULTS

The psychometric properties of tools were analyzed using the COSMIN checklist. Among the 20 general and specific tools examined, content validity had not been evaluated in 15 tools, construct validity had not been evaluated in four tools, criterion validity had not been evaluated in eight tools, internal consistency had not been evaluated in five tools, responsiveness had not been evaluated in 16 tools, and interpretability had not been assessed in 18 tools, and measurement error had not been evaluated in any of the tools.

CONCLUSION

The results showed that none of the evaluated tools have all the criteria of Cosmin's checklist. Of course, construct validity and reliability had been assessed in most of the tools. Meanwhile, there was no tool to measure the quality of life of hysterectomized women specifically. Therefore, it seems that developing a tool with acceptable psychometric properties is necessary to measure the quality of life of hysterectomized women specifically.

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.

Sexual dysfunction among gynecologic cancer survivors in a population-based cohort study

Treatment for gynecologic cancer is associated with sexual dysfunction, which may present during and/or after treatment. The aim of this study was to investigate the risk of sexual dysfunction among gynecologic cancer survivors compared to cancer-free women in a population-based cohort study. We identified a cohort of 4863 endometrial, ovarian, and cervical cancer survivors diagnosed between 1997 and 2012 in the Utah Cancer Registry. Up to five cancer-free women were matched to cancer survivors (N = 22,693). We used ICD-9 codes to identify sexual dysfunction. Cox proportional hazards models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for sexual dysfunction with adjustment for potential confounders. Approximately 6.6% of gynecologic cancer survivors had sexual dysfunction diagnoses 1-5 years after cancer diagnosis. Gynecologic cancer survivors had higher risks of overall sexual dysfunction (HR: 2.51, 95% CI: 2.16, 2.93), dyspareunia (HR: 3.27, 95% CI: 2.63, 4.06), and vaginal dryness (HR: 2.63, 95% CI: 2.21, 3.12) compared to a general population of women, 1-5 years after cancer diagnosis. Sexual dysfunction was associated with advance cancer stage (HRRegional vs. Localized: 1.61, 95% CI: 1.19, 2.31), radiation therapy (HR: 1.73, 95% CI: 1.29, 2.31), and chemotherapy (HR: 1.80, 95% CI: 1.30, 2.50). This large cohort study confirms that there is an increased risk of sexual dysfunction among gynecologic cancer survivors when compared to the general population. Further investigation is needed to address the risk factors for sexual dysfunction and to improve patient-provider communication, diagnosis, documentation, and treatment of sexual dysfunction among gynecologic cancer survivors.

Husband’s and Health Workers Support Increase Self-acceptance After Hysterectomy

Background: There have been many studies on the importance of various interventions to increase self-acceptance after hysterectomy, but in general none of the above studies have explained the importance of husband and health workers' support in increasing self-acceptance after hysterectomy. This study aims to analyze the correlation between husband's support and health workers with self-acceptance after hysterectomyMethods: The data measured were the support of husbands and health workers as well as self-acceptance obtained from women after hysterectomy through the SAS-EB (Self-Acceptance - Scale for Persons with Early Blindness) questionnaire to measure self-acceptance and a questionnaire containing support to measure support from husbands and health workers. Statistical analysis used was Chi Square to analyze the support of husbands and health workers with self-acceptance after hysterectomyResult: This study found the importance of husband's support, especially support from health workers. The most important support from health workers is the provision of information about hysterectomy including care before and after hysterectomyConclusion: In general, this study proves that husband's and health workers support increase self-acceptance after hysterectomy

Women's interdependence after hysterectomy: a qualitative study based on Roy adaptation model

Background

Hysterectomy is a difficult process that some women encounter that can affect their interdependence, but its impact on women’s Interdependence has received less attention. Therefore, this study aimed to explain women’s Interdependence after hysterectomy.

Methods

This qualitative study was performed using a directed content analysis approach in Mashhad (Iran). Thirty women with a history of hysterectomy were included in the study by purposive sampling method. Data were collected from August 2018 to November 2019 using semi-structured interviews based on the interdependence mod of the Roy adaptation model until data saturation. Data analysis was performed using MAXQDA software and the deductive approach of Elo and Kingas (J Adv Nurs 62(1):107–115, 2008. 10.1111/j.1365-2648.2007.04569.x).

Results

Data analysis led to the production of 537 initial codes from participants’ experiences. By merging and categorizing them, the theme of “increasing interdependence” emerged, which consists of 2 categories: “Evolution independence and interaction with important people in life” and “Reinforced support system”, that include six subcategories.

Conclusion

After hysterectomy, women not only feel a strong need for support from family members, especially their husbands, they are also seeking support from health care providers and their colleagues. Before the hysterectomy, it is recommended that family members be consulted to ensure the emotional support and care of women after the hysterectomy. It can help the adaptation to hysterectomy.

Self-acceptance Affects Attitudes in Caring for Sexual Function after Hysterectomy

BACKGROUND: A comprehensive understanding of several approaches, both pharmacological and non-pharmacological, is needed to reduce sexual function problems after hysterectomy. As one example, the research of Rawland et al. (2015) and that study found that cognitive, affective, motivational, behavioral, self-efficacy, and sexual acceptance responses could potentially play an important roles in the assessment of appropriate care. However, in general, there is no research that explains that self-acceptance can affect attitudes. AIM: This study aims to analyze the correlation between self-acceptance with attitudes toward caring for sexual function after hysterectomy. METHODS: The data measured were self-acceptance and attitudes toward treatment of sexual function after hysterectomy which was obtained from post-hysterectomy women. Data on self-acceptance using the Self-acceptance – Scale for Persons with Early Blindness (SAS-EB) questionnaire and data on attitudes toward caring for sexual function were made by researchers using references from the theory planned of behavior (TPB) (Alshawish et al., 2020). Statistical analysis used was Chi-square to analyze self-acceptance with attitudes to caring for sexual function after hysterectomy. RESULTS: This study found the importance of self-acceptance in determining attitudes toward caring for sexual function after hysterectomy. A person’s positive attitude will affect behavior to treat sexual function after hysterectomy. CONCLUSION: In general, this study proves that self-acceptance is related to attitudes to caring for sexual function after hysterectomy.