Volume 111, Issue 2 p. 133-142

Women's perceptions of decision-making about hysterectomy

Z. Skea

Corresponding Author

Z. Skea

Health Services Research Unit, University of Aberdeen, UK

*Ms Z. Skea, Health Services Research Unit, University of Aberdeen, Polwarth Building, Foresterhill, Aberdeen AB25 2ZD, UK.Search for more papers by this author
V. Harry

V. Harry

Department of Obstetrics and Gynaecology, University of Aberdeen, Aberdeen Maternity Hospital, UK

Search for more papers by this author
S. Bhattacharya

S. Bhattacharya

Department of Obstetrics and Gynaecology, University of Aberdeen, Aberdeen Maternity Hospital, UK

Search for more papers by this author
V. Entwistle

V. Entwistle

Health Services Research Unit, University of Aberdeen, UK

Search for more papers by this author
B. Williams

B. Williams

Department of Epidemiology and Public Health, Ninewells Hospital and Medical School, University of Dundee, UK

Search for more papers by this author
G. MacLennan

G. MacLennan

Health Services Research Unit, University of Aberdeen, UK

Search for more papers by this author
A. Templeton

A. Templeton

Department of Obstetrics and Gynaecology, University of Aberdeen, Aberdeen Maternity Hospital, UK

Search for more papers by this author
First published: 16 January 2004
Citations: 34

Abstract

Objective  To explore women's views of decision-making relating to hysterectomy.

Design  Structured questionnaire and in-depth interview surveys.

Setting  A teaching hospital and a district general hospital in northeast Scotland.

Sample  Women scheduled for hysterectomy for benign menstrual problems.

Methods  Pre-operative questionnaires were sent to a consecutive sample of women booked for hysterectomy. A purposive sample was interviewed post-operatively.

Main outcome measures  Women's experiences of, and satisfaction with, information provision, communication and decision-making processes; the relationship between views of decision-making processes and decisions made.

Results  One hundred and four women (66%) returned questionnaires. Most responded positively to structured questions about the process by which the decision to have a hysterectomy was reached. Almost all (97%) reported satisfaction with the decision made. Twenty women were interviewed post-operatively. A number, including some who had responded positively on the questionnaire, described aspects of the decision-making process that were suboptimal. Women's perceptions of the decision-making process, including the way their doctors communicated with them, did impinge on their views of the course of action selected. Some women had residual doubts about the appropriateness of hysterectomy.

Conclusions  In a significant minority of women, there are important shortcomings in current patterns of information provision and communication relating to decision-making. These are unlikely to be picked up by conventional structured patient feedback surveys. Further efforts are required to ensure that women are adequately informed and involved in decisions about gynaecological treatments.