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7 "Hysterectomy"
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The Loss Experience in Women with Hysterectomy
Mi Hae Sung
Journal of Nurses Academic Society 1997;27(1):128-140.   Published online March 30, 2017
DOI: https://doi.org/10.4040/jnas.1997.27.1.128
AbstractAbstract PDF

When women are removed with their matrix which is a emotionally significant organ of symbol in psychologically adapting themselves to mother and woman, that is threatened and injured with woman role decisively. This study tried to find the efficient nursing intervention method to maintain and promote their health, to cope with health problem, and to inquire into the loss experience of women with hysterectomy by using the phenomenological method. The analysis of the data was made through the phenomenological analytic method suggested by Giorgi. The result of the study was as follows: The factors which have influence on the loss experience of the subjects are an offer of information, support system, age, occupation, economic situation, family history, character, season, the existence of ovary and religion. The loss experience of matrix was expressed in lingual, reactions to the loss of function, sex, body change and husband, in behavioral behaviors in emotion and body. The loss of matrix of the subjects was relived by religion, perineorrhapy, exercise, reading, watching video and diet. The subjects each showed ways of reaction of fatalism, giving-up, coping on the loss experience of matrix. In conclusion, since we ascertained that the nursing in the process of recovery decide the quality of life, though women with hysterectomy undergo various loss experience and adapt to it in the end, it is necessary to give them enough information and educate husband, having on important effect on the loss experience, to be a good supporter. And technically skilled nurses of consultant are thought to be able to contrive better qualitative life of women with hysterectomy as an important bridge between the subjects and their required information, since the nurses have their well-formed position of relationship of confidence through continuous contact with patients and their family.

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Pre-post changes of sexual satisfaction and spouse support of women who have had a hysterectomy
Soon Bok Chang, Seung Eun Jeong
Journal of Nurses Academic Society 1995;25(1):173-183.   Published online March 30, 2017
DOI: https://doi.org/10.4040/jnas.1995.25.1.173
AbstractAbstract PDF

The research questions of this study were: Will the level of sexual satisfaction of women who have had a hysterectomy 4 months before be decreased compare to the level of sexsual satisfaction before the hysterectomy?, Will the level of perceived spouse support of women who have had a hysterectomy 4 months before be decreased compare to the level before the hysterectomy?, and What is the relationship between sexual satisfaction and spouse support? This is a perspective descriptive correlational study. The number of subjects was 44. The subjects were limited to Korean women who had an abdominal or vaginal hysterectomy for non-malignant diseases, were married (living with their husbands), mentally healthy, and premenopause at the time of operation. The instrument was consisted of 4 items of demographic characteristics, 13 items of spouse support, and 10 items of sexual satisfaction. The instrument of sexual satisfaction was a component of the Derogatis Sexual Function Inventory. Data analysis was done by paired t-test to see the differences between the pre- post scores of sexual satisfaction and spouse support. The Pearson Correlation Coefficiency was calculated to see the relationship between the scores of sexual satisfaction and spouse spport of pre-post hysterectomy. Results were summerized as follow: The mean age of the subjects was 43.5 years; 72. 1% of the subjects were above middle school graduates: their mean income level was 1,453,000 Korean won and 86.4% of the subjects have had bilateral oophrectomy. 1. The scores of sexual satisfaction of women at 4 months after hysterectomy was decreased significantly compare to the score before hysterectomy (paired t=. 274, p=.009). 2. The scores of spouse support of the women at 4 months after hysterectomy was not decreased significantly compare to the score before hys-terectomy(paired t=.19, p=.847). 3. The scores of sexual satisfaction and spouse support before hysterectomy was significantly related(r=.5186, p=.000). 4. The scores of sexual satisfaction and spouse support at 4 months after hysterectomy was significantly related (r=.4110, p=.005) It can be concluded that the sexual satistaction level could be decreased 4 months after the hysterectomy, but the spouse support level may not be decreased at 4 months after hysterectomy. Further studies have to be done to identify the factors related to the decrease of sexual satisfaction and spouse support after hysterectomy.

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Depression of Women after a Hysterectomy
Young Sook Park, Young Lan Ahn
Journal of Korean Academy of Nursing 2000;30(3):709-719.   Published online March 29, 2017
DOI: https://doi.org/10.4040/jkan.2000.30.3.709
AbstractAbstract PDF

The purposes of the study was to identify the depression of women after a hysterectomy and to clarify the factors related to depression. This was a cross-sectional descriptive study. The data was collected by a mailed questionnaire that was composed of the Zung Self-Rating Depression Scale(SDS), support scale of husband and socio-demographic variables from 255 women undergoing hysterectomies for any nonmalignant condition in S. University Hospital. They also must have lived with their spouses from 3 months to 2 years after the operation. The results were as follows: 1. The SDS mean was 42.25 and range was 21 to 67. The incidence of clinical depression (over SDS 50) was 20.8% from 3 months to 2 years after a hysterectomy. 2. The depression of women in 18-24 months after surgery (39.80) was lower than that of any other periods such as 3-5 months, 6-12 months, and 13-17 months (p<0.01). 3. The support form husband was negatively correlated with the depression of women after a hysterectomy. 4. Depression among women had hysterectomies were associated with lower income, less sexual satisfaction, the feeling of being asexual, and the bias of concept the uterus controlling general health.

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The Effect of Hand Massage on the Anxiety of the Hysterectomy Patients in Immediately prior to Surgery
Jeong Mee Kim
Journal of Korean Academy of Nursing 2000;30(2):476-487.   Published online March 29, 2017
DOI: https://doi.org/10.4040/jkan.2000.30.2.476
AbstractAbstract PDF

The purpose of this study was to examine the effects of hand massage as a nursing intervention on the anxiety of the hysterectomy patients in immediately prior to surgery. The method of this study was Nonequivalent Control Group Non-Synchronized Design. The data were selected from at K university hospital in Pusan, and they consisted of Experimental group-25 patients, Control group -24 patients. The data were collected from Jan. 4 to Jan. 30 in 1999. The subjects' self-reports of anxiety (measured by the Spielberger Trait-State anxiety Inventory and Visual Analogue Scale developed by Cline et al.) were recorded before and immediately after the intervention. The objective physiologic measures of blood pressure and pulse rate. The collected data were analysed by means of frequency, percentage, standard deviation, chi- square test, t-test, ANCOVA with SPSS program. The results of this study were as following; 1. Hypothesis 1: The 1st hypothesis that "There will be significant difference of the state anxiety level just before surgery in the experimental group and control group" was supported(P= .000). 2. Hypothesis 2: The 2nd hypothesis that "There will be significant difference of the visual analogue scale score just before surgery in the experimental group and control group"was supported(P= .000). 3. Hypothesis 3: The 3rd hypothesis that "There will be significant difference of the systolic and diastolic blood pressure level just before surgery in the experimental group and control group"was supported (P= .003, P= .041). 4. Hypothesis 4: The 4th hypothesis that "There will be significant difference of the pulse rate just before surgery in the experimental group and control group"was supported(P= .004). In conclusion, hand massage is a benefical nursing intervention that alleviates the psychological, physiological anxiety of the hysterectomy patients in immediately prior to surgery. therefore it is recomended to use the hand massage as a nursing intervention for patients undergoing anxiety. The results of this study appear promising, additional research is recomended to further the appropriate uses of hand massage in nursing practice for this and other patient population.

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A Structural model for Quality of Life in Women Having Hysterectomies
Sook Nam Kim
Journal of Korean Academy of Nursing 1999;29(1):161-173.   Published online March 29, 2017
DOI: https://doi.org/10.4040/jkan.1999.29.1.161
AbstractAbstract PDF

The purpose of this study was to develope and test the structural model for quality of life in women having hysterectomies. A hypothetical model was constructed on the basis of previous studies and a review of literature. The conceptual framework was built around eight constructs. Exogenous variables included in this model were marital intimacy, importance of uterus, professional support, positive coping behavior and pre-operative symptoms. Endogenous variables were spouse's support sense of loss and quality of life. Empirical data for testing the hypothetical model was collected using a self-report questionnaire from 203 women having hysterectomies at the outpatient clinics of four general hospitals and a mail survey in Pusan City. The Data was collected from December, 1997 to January, 1998. Reliability of the eight instruments was tested with Cronbach's alpha which ranged from 0.639-0.915. For the data analysis, SPSS 7.5 WIN Program and LISREL 8.12 WIN Program were used for descriptive statistics and covariance structural analysis. The results of covariance structure analysis were as follows : 1. Hypothetical model showed a good fit with the empirical data. [x2=6.93(df=5, P=.23), GFI=.99, AGFI=.94, RMSR=.019, NNFI=.97, NFI=.98, CN=440, standardized residuals(-2.14-2.10)] 2. For the parsimony of model, a modified model was constructed by deleting 3 paths and adding 1 path according to the criteria of statistical significance and meaning. 3. the modified model also showed a good fit with the data. [x2=5.26(df=7, P=.63), GFI=.99, AGFI=.97, RMSR=.014, NNFI=1.02, NFI=.99, CN=710, standardized residuals(-1.46-1.70)] Results of the testing of the hypothesis were as follows : 1. Marital intimacy(gamma11=.78, t=14.37) and professional support(gamma13=.12, t=2.12) had a significant direct effect on the spouse's support. 2. Pre-operative symptoms(gamma25=.32, t=3.12) , importance of uterus(gamma22=.20, t=2.61) and spouse's support(beta21=-.19, t=-2.43) had a significant direct effect on the sense of loss. 3. Sense of loss(beta32=-.66, t=-9.83) had a direct effect on the quality of life. Marital intimacy had a direct(gamma31=.19, t=3.33), indirect(gamma31=.14, t=2.52) and total effect(gamma31=.25, t=4.41) on the quality of life. Professional support had a direct effect(gamma33=.11, t=2.07) and total effect(gamma33=.13, t=2.31) on the quality of life. The direct effect of pre-operative symptoms(gamma35=-.36, t=-4.02) and positive coping behavior(gamma34=.15, t=2.06) had the insignificant effect on the quality of life while, due to the indirect effect these variables had overall significant effect on the quality of life. The results of this study showed that the sense of loss had the most significant direct effect on the quality of life. Marital intimacy, pre-operative symptoms and spouse's support had a significant direct effect on this sense of loss. These four variables, the sense of loss, marital intimacy, pre-operative symptoms and spouse's support, were identified as relatively important variables. The results of this study suggested that there is needed to determine if nursing intervention would alleviate this sense of loss and promote a greater quality of life in women who have had hysterectomies.

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Frequency, Intensity and Daily Life Distress of Urinary Dysfunction in Women with Cervical Cancer after Radical Hysterectomy
Nami Chun, Gie Ok Noh, Hyun Ju Song, Sang Hee Kim
J Korean Acad Nurs 2016;46(3):400-408.   Published online June 30, 2016
DOI: https://doi.org/10.4040/jkan.2016.46.3.400
AbstractAbstract PDF
Purpose

This study was done to identify frequency, intensity of urinary dysfunction and daily life distress in women after a radical hysterectomy for cervical cancer.

Methods

One hundred and fifty seven women who had undergone a radical hysterectomy and one hundred and sixty five women as healthy controls completed questionnaires on intensity of urinary dysfunction and daily life distress caused by urinary dysfunction.

Results

Women with cervical cancer showed higher frequency of urinary dysfunction than healthy controls. Major urinary dysfunction for women with cervical cancer in order of frequency were night-time incontinence (odds ratio=10.39, p<.001), difficulty in starting urination, weak urine stream and sense of incomplete emptying of bladder. The highest score on intensity was difficulty in starting urination, followed by urgency, weak urine stream, daytime frequency and sense of incomplete emptying. Night-time incontinence was the urinary symptom causing the most daily life distress for cervical cancer women followed by difficulty in starting urination, urgency, sense of incomplete emptying, and night-time frequency.

Conclusion

Results suggest that nurses should address the potential postoperative urinary complications and develop long term interventions to decrease urinary dysfunction and daily life distress for women who have had a radical hysterectomy for cervical cancer.

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Adjustment after a Hysterectomy
Soon Gyo Yeoum, Chai Soon Park
Journal of Korean Academy of Nursing 2005;35(6):1174-1182.   Published online October 31, 2005
DOI: https://doi.org/10.4040/jkan.2005.35.6.1174
AbstractAbstract PDF
Purpose

This study examined the relationship between sexual changes and adjustment and identified the factors which affect adjustment after a hysterectomy.

Method

The subjects were 89 women under 50 years of age registered at gynecology departments of general hospitals in Seoul.

Result

60.7% of the women restarted coitus during six weeks to three months post operation. They felt a decrease in vaginal secretions (68%), and abdominal and pelvic pain (59.8%), but2/3 of them didn't change the frequency of coitus and level of orgasm. With respect to the adaptability of the sexual life, there was a significant difference in the time to restart coitus, lack of vaginal secretions, abdominal and pelvic pain, change of frequency of coitus, experience of orgasm, importance of sex and avoidance of coitus, according to job, income, and health condition.

Conclusion

It is appropriate to restart coitus six weeks to three months after surgery and preliminary information should be given to patients after surgery as abdominal and pelvic pain could be relieved after twelve months. Also, sexual adjustment can be improved if they can recognize the changes after surgery from sexual life before surgery.

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