Psychological Effects of Hysterectomy PDF

Psychological Effects of Hysterectomy Prepared by: Group A1 Under supervision: Prof. Hadayat Amasha Dr. Fatma zaki. Outlines: ✓ Introduction. ✓ Definition. ✓ Psychological and emotional affect before the operation ✓ How to deal and h...

Psychological Effects of Hysterectomy Prepared by: Group A1 Under supervision: Prof. Hadayat Amasha Dr. Fatma zaki. Outlines: ✓ Introduction. ✓ Definition. ✓ Psychological and emotional affect before the operation ✓ How to deal and help women in this period ✓ Nursing action in perioperative period ✓ Psychological and emotional affect after the operation ✓ factors are associated with why many women become depressed or feel low after hysterectomy ✓ How to help women with emotional distress after a hysterectomy ✓ Tips to Ease Hysterectomy Recovery ✓ Role of family and husband. ✓ Role of nurse after Hysterectomy operation. ✓ References. Introduction Hysterectomy is known to be the second most common surgery in women of childbearing age. Women with uncontrollable menstrual bleeding because of fibroids, endometriosis, or other gynecological complexities, such as cervical or uterine cancer, seek hysterectomy. A number of studies had reported that hysterectomy was followed by adverse sequelae including psychosis, depression , agitation and insomnia , anxiety , reduced psychosexual functioning and psychosomatic disorder. On the other hand a few prospective studies concluded that hysterectomy seldom led to psychiatric disorders. Defination Hysterectomy is the partial or total surgical removal of the uterus. It may also involve removal of the cervix,ovaries (oophorectomy), fallopian tubes (salpingectomy), and other surrounding structures. Partial hysterectomies allow for hormone regulation while total hysterectomies do not.  ❖ Psychological and emotional affect before the operation: fearing from surgery complications. grieving the impending loss of fertility. Women who are depressed before having a hysterectomy tend to stay depressed afterward. While it’s normal to experience some anxiety before the procedure, it’s important to calm those fears before you have hysterectomy. ❖ How to deal and help women in this period: psychological health education can improve perioperative negative emotions and psychological stress in young women undergoing hysterectomy. In few cases preoperative assessment and counseling is a key to optimizing postoperative psychological and sexual outcomes. ❖ Nursing action in perioperative period: Nurse should: Be a good listener. Be empathetic. Be honest with him about his illness, while mitigating the explanation of the illness, and be reassured in Your statement is not shocking. It is important to make women understand that they are not alone. Detect any psychological illnesses such as depression and anxiety that exist before the operation. if you’re very anxious, try deep breathing and positive visualization (picture thesurgery going well, and think about how much better you’ll feel afterward).  Relax the night before your surgery. When you’re stressed, your body releases stress hormones, which can weaken the immune system and disrupt the body’s ability to manage pain and infection. Help her practice relaxation and calming exercises, and comfortable breathing. During preliminary contacts, give the patient opportunities to ask questions. ❖ Psychological and emotional affect After the operation: Hysterectomy impacts both the physical and emotional aspects of a patient. ✓ physical complications associated with hysterectomy are: urinary incontinence. pelvic floor prolapse. sexual dysfunction. ✓ psychological consequences including: Depression.  Stress. Anxiety. mood swings. ❖ After the removal of their uterus. Many factors are associated with why many women become depressed or feel low after hysterectomy are: No more childbearing. A hysterectomy represents an end to your childbearing years, which can feel like a huge loss. This loss can be experienced equally by young women who were not prepared for such an early end to their fertility and by women with a family. Even women who felt they did not want children have reported a sense of sadness and loss at no longer having the option. Be prepared to make adjustments to improve your feelings of femininity after your hysterectomy. While you will experience physical changes to your body, the feeling of loss of femininity and self-esteem can be just as troubling. Menopause and hormonal changes. If your ovaries are removed at the time of your hysterectomy your oestrogen production will cease and you will enter the menopause. This sudden change, with no gradual transition, can lead to mood swings, depression, crying spells, insomnia, and irritability in some women. Prior to surgery we will discuss the role of hormone replacement therapy. Even when your ovaries are not removed, you may experience a gradual decline in your oestrogen levels. Pre-existing emotional distress. If you experienced depression, anxiety or other psychological problems pre-surgery, you are more  likely to experience the emotional impact of a hysterectomy. During midlife, many women are already experiencing huge changes within their lives, especially related to career and family. A hysterectomy, especially one that causes a surgical menopause, is likely to exacerbate any stress you are already under. Lack of control. For many women, there is no alternative to having a hysterectomy. If you, like countless other women, suffer from a condition that requires you to have a hysterectomy, you may feel angry at your lack of control over the situation. It might feel like your life is out of your hands and you just have to do as you are told. Feeling like you do not have a say in what happens to your body can be a hard blow to your self- esteem. ❖ How to help women with emotional distress after a hysterectomy: Fortunately, much of the emotional stress associated with a hysterectomy will pass with time, as you recover from the procedure. Know that you are not alone: Over 75,000 hysterectomies are performed each year in the UK and there is evidence that some women feel depressed after the procedure. There is, however, extensive evidence indicating that depression is not an inevitable outcome of hysterectomy (Cohen et al., 2011). One study found that women who went through hysterectomy-induced menopause were no more at risk of depression than women who went through natural menopause (Seaman, 2012).  Seek support: In many cases the emotional after effects of the procedure can be minimised with counselling, a good support system, and the help of your doctor. Having a good support system is essential to having a healthy state of mind in the best of times, and after your hysterectomy you will need it even more. While it is not always appropriate to break down in tears or lose your temper in front of everybody, it is also not a good idea to hide your feelings from your friends and family. This will create a barrier between you and your loved ones that will likely make you feel even more alone. Talk to the people you trust and let them know how they can best support you. Don’t overanalyse the experiences of others: While it is useful to consider the symptoms that those close to you have experienced, the truth is that your post-hysterectomy emotions will be unique. While a well-meaning mother, sister, grandmother, or friend, might describe the mood swings and other emotional effects they experienced after their own hysterectomy, keep in mind that medical science is constantly developing, and that the procedures performed today are much more precise than those 15-years ago. Nobody can predict exactly how your mind or body will respond to the procedure, so try not to scare yourself into experiencing symptoms psychologically. The truth is that the majority of women have a very good chance of a fast recovery, with many experiencing little to no emotional distress after their hysterectomy. Treat yourself: If you find yourself feeling less feminine, as many women do, treat yourself in a way that will help you feel like a woman. Small activities, like getting a manicure, a new dress, or even having a candlelit dinner, can help to speed up your emotional recovery.  If you continue to feel that you simply cannot cope with the loss of your uterus, you may wish to seek professional help. A wide variety of therapeutic and medicinal treatments can help improve your mood, making it easier to recover. Hormone Replacement Therapy (HRT) is usually recommended when both ovaries are removed in order to provide your body with more oestrogen, which in turn will help you feel more feminine. ❖ Tips to Ease Hysterectomy Recovery : ✓ Rest, but don’t lie on the couch all day. Gentle movement and walking are recommended soon after surgery to reduce the risk of blood clots. ✓ Don’t lift anything heavy. Your incisions, both internal and external, need time to heal without added strain. This includes heavy housework, weight-lifting, strenuous exercise and even carrying your children. ✓ Take care of your incision. You will be sent home with detailed wound care instructions to avoid bacterial infections. You should also avoid swimming in pools, lakes and oceans. ✓ No sexual intercourse until the doctor gives you the OK (usually about six weeks after surgery). Physical damage can occur both internally and externally, and it increases your susceptibility to infection. ✓ Keep your hormones in check. Especially important if your hysterectomy requires removal of your ovaries and induces menopause.  ✓ Eat healthy and drink lots of water. To help ease postsurgical constipation include fiber and fresh fruit in your diet. ❖ Role of family and husband: ✓ Quite common for husbands to have a lot of mental reservations after their wife had hysterectomy. However, you should not let these concerns completely derail your sex life. For many women, sex after a hysterectomy can help them feel like things are f inally getting back to normal. Therefore, there is no reason to stop enjoying a healthy sex life with your spouse. ✓ Any major surgical procedure can have a big effect on a relationship, and hysterectomies are no exception. Due to the sensitive nature of the surgery, The best advice for husbands after hysterectomy is simply to continue treating your wife with love, respect, andattention. To avoid making any major mistakes, follow these dos and don’ts of maintaining your relationship after a hysterectomy. ✓ For women who have not reached menopause, menstruation will no longer occur, nor will pregnancy be possible after hysterectomy. After ovary removal, estrogen levels will decline and may lead to early menopause symptoms. Hysterectomy does not affect libido or sexual pleasure. ❖ Role of nurse after Hysterectomy operation: ✓ Assess the emotional stress the patient is experiencing. Identify the meaning of loss for the patient and SO. Encourage the patient to vent feelings appropriately. ✓ Note withdrawn behavior, negative self-talk, use of denial, or concern with actual and/or perceived changes. ✓ Provide accurate information, reinforcing information previously given. ✓ Provide time to listen to the concerns and fears of patients and SO. Discuss the patient’s perceptions of self related to anticipated changes and her specific lifestyle. ✓ Ascertain individual strengths and identify previous positive coping behaviors. ✓ Encourage the patient to share thoughts and concerns with the partn. ✓ Review the effects of surgical procedures and future expectations. The patient needs to know that she will no longer menstruate or bear children, and the possible need for hormonal replacement. ✓ Discuss the resumption of activity. Encourage the patient to do light activities initially, with frequent rest periods and increasing activities or exercise as tolerated. Stress the importance of individual response in recuperation. ✓ Identify individual restrictions: avoiding heavy lifting and strenuous activities, prolonged sitting, or driving. Avoid tub baths and douching until the physician allows it.  REFERENCES: U.S. Department of Health & Human Services Office on Women’s Health. Uterine fibroids. https://www.womenshealth.gov/a-z-topics/uterine- fibroids. Accessed January 31, 2023. Havryliuk Y, Setton R, Carlow JJ, Shaktman BD. Symptomatic fibroid management: systematic review of the literature. JSLS. 2017;21(3):e2017.00041. doi:10.4293/JSLS.2017.00041 Chudnoff SG, Berman JM, Levine DJ, Harris M, Guido Rs, Banks E. Outpatient procedure for the treatment and relief of symptomatic uterine myomas. Obstet Gynecol. 2013;121(5):1075-1082. doi:10.1097/AOG.0b013e31828b7962 Goudarzi, F. et al. (2022) Women's interdependence after hysterectomy: a qualitative study based on Roy adaptation model. BMC Women's Health, 22(1), 40. https://doi.org/10.1186/s12905-022-01615-2 Emotional Changes After A Hysterectomy. (2022) [Online] Available at: https://www.hysterectomycentre.com/what-we- do/post-operative-advice/emotional/ Bougie, O. et al. (2020) Evaluating the Prevalence of Regret With the Decision to Proceed With a Hysterectomy in Women Younger than Age 35. Journal of Obstetrics and Gynaecology Canada, 42(3), pp. 262– 268. https://doi.org/10.1016/j.jogc.2019.08.006.