Hysterectomy is one of the most frequently performed procedures for the treatment of disease of the female internal reproductive organs. Pre-and post hysterectomy care is similar to that pertaining to other surgical procedures. However women having a hysterectomy may have problems with physical, psychological and social adapation due to the symbolic meaning of the uterus. Generally, nurses provide good care to promote the physical adaptation of women after a hysterectomy but care may be less effective in the areaskof social and psychological adaptation.
The objective of this study was to develop and test a pre and post operative educational program for women undergoing a hysterectomy and for their husbands, to promote the women´s physiological, psychological and social adaptation.
Roy´s conceptual model of adaptation was used to guide the study.
The subjects, 80 patients who had had a hysterectomy in one of C university´s hospitals for benign uterine disease, and their husbands, were divided in to a control group, -those who had had their hysterectomy during July and August, and an experimental group.
Those who had had a hysterectomy during September and October, 1991.
Two kinds of educational booklets and 34 slides, a physiologic adaptation measurement tool, two kinds of psychological adaptation measurement tools, two kinds of social adaptation measurement tools and a three tools for adaptation related stimuli were used in the study. The educational booklets and measurement tools developed by investigator from the literature were validated by expert judges in-eluding three nursing professors, one pedagogic professor, one obstetrics and gynecological physician, two head nurses, a nursing doctoral candidate and a woman who had, had a hysterectomy. Psychologic adaptation was measured by Rosenberg´s Self-esteem Measurement Tool and the Mood Questionnaire of Ryrnan, Beirsner and LaRocco.
The educational intervention took place with the experimental group at three different times, a group educational session (men and women in separate groups) in the preoperative period and zn educational conversation over the telephone with both men and women 1 week and 1 month after surgery.
The data were collected twice on each woman, at the pre-operative group session and at 2 months post surgery by a mailed questionnaire which measured the level of physiologic, psychologic and social adaptation of the women. Data analysis was done by an SAS program.
Cronbach´s alpha coefficient for the physiological adaptation tool was =.86, for the social adaptation to ols, ?perceived husband´s sup-port, .86 and sexual life, .72 ; for the psycho-logical adaptation tools ? self esteem, .75 and emotional response, .86 : and for stimuli related to adaptation, ? fear of the surgery, 78, marital adjustment, .80, and perceptions about the uterus, .86.
There were no statistical differences between the experimental and control groups in age, educational status, occupation, religion, income, previous hospitalization. Previous sur gery, induced abortion frequency, number of children, diagnosis, type of surgery and attitude of husband toward the surgery, fear of surgery, marital adjustment, perceptions about the uterus, and physiologic, psycho-logic and social adaptation levels before hysterectomy.
The results of the study are summarized as follows :
1) The experimental group of women had higher physiologic adaptation levels than the control group (t=2.43, p=.0087).
2) The experimental group had higher scores for emotional response(t=1.76, p=.0411).
3) The experimental group had higher scores for sexual life adaptation(t=2.58, p=. 0059) .
4) There was a positive correlation between physiological, psychological and social adaptation in the experimental group (P <.05) .
The pre and post operative educational program for the women and their husbands was confirmed as an effective nursing intervention in promoting the women´s physiological adaptation, emotional response and sexual life adaptation.
The use of an educational intervention both prior to and after a surgical procedure is recommended for nursing practice.
Nursing intervention to modify the input stimuli promotes effective adaptation.
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