Lee Ching-Fang, Wen Fur-Hsing, Lin Shu-Shan, Lin Hsien-Ming
Department of Nursing, Oriental Institute of Technology College, National Taiwan Normal University, Taipei, Taiwan.
J Formos Med Assoc. 2009 May;108(5):414-22. doi: 10.1016/S0929-6646(09)60086-3.
BACKGROUND/PURPOSE: Most women undergo a hysterectomy to relieve symptoms and improve their quality of life rather than to solve a life-threatening problem. We used hierarchical linear modeling to evaluate the changes, in a 6-8-week period, in the quality of life of women who had undergone hysterectomy.
This was a prospective follow-up study of 64 women who had undergone hysterectomy and 68 controls of similar age and marital status. A quasi-experimental design was used. The World Health Organization Questionnaire on Quality of Life: BREF-Taiwan Version was used to assess quality of life before surgery, at discharge, and 2 and then 6-8 weeks after surgery. The control group was measured three times: after their initial hospital visit, and 2 and then 6-8 weeks later.
Women with hysterectomy (H-group) had significantly lower scores for the physical health dimension of quality of life at all time-points as compared with the control group, yet postoperatively, they showed a more dramatic increase in this dimension. As for the group mean trajectories, the vaginal hysterectomy (VH) subgroup had a relatively low quality of life immediately after surgery, which then gradually improved, especially in the dimension of physical health. As for the social relationships dimension, the abdominal hysterectomy (AH) subgroup showed an upward curve similar to the pattern of their physical health dimension. The psychological and environmental dimensions did not show a clear trajectory for either group. As for individual trajectories, the social relationships and environmental dimensions showed different patterns for women with hysterectomy.
Hysterectomy can improve physical health. In the VH subgroup, physical health was improved significantly, especially from 6-8 weeks postoperatively. In the AH subgroup, physical health and social relationships were improved significantly postoperatively. Social relationships and environmental dimensions tended to show different patterns for women with hysterectomy. These findings may be useful to doctors and nurses, especially in counseling women who have had, or plan to have, a hysterectomy.
背景/目的：大多数女性接受子宫切除术是为了缓解症状并改善生活质量，而非解决危及生命的问题。我们采用分层线性模型来评估子宫切除术后6 - 8周内女性生活质量的变化。
这是一项对64例接受子宫切除术的女性和68例年龄及婚姻状况相似的对照组进行的前瞻性随访研究。采用准实验设计。使用世界卫生组织生活质量问卷：台湾版简表在手术前、出院时、术后2周以及术后6 - 8周评估生活质量。对照组在初次就诊后、2周后以及6 - 8周后进行三次测量。
与对照组相比，子宫切除组（H组）在所有时间点的生活质量身体健康维度得分均显著较低，但术后该维度得分有更显著的增加。就组均值轨迹而言，阴道子宫切除（VH）亚组术后即刻生活质量相对较低，随后逐渐改善，尤其是在身体健康维度。就社会关系维度而言，腹式子宫切除（AH）亚组呈现出与身体健康维度模式相似的上升曲线。两组的心理和环境维度均未呈现明确轨迹。就个体轨迹而言，子宫切除女性的社会关系和环境维度呈现不同模式。
子宫切除术可改善身体健康。在VH亚组中，身体健康显著改善，尤其是术后6 - 8周。在AH亚组中，术后身体健康和社会关系均显著改善。子宫切除女性的社会关系和环境维度往往呈现不同模式。这些发现可能对医生和护士有用，尤其是在为已接受或计划接受子宫切除术的女性提供咨询时。
