Neuhaus W, Kusche M, Wellmann-Barth M, Fervers-Schorre B, Bolte A
Klinik und Poliklinik für Frauenheilkunde, Universität zu Köln.
Geburtshilfe Frauenheilkd. 1991 Mar;51(3):203-7. doi: 10.1055/s-2007-1023704.
Within the framework of this exploratory study, 37 sterilised women wishing to be refertilised, were questioned thoroughly on what had indicated their sterilisation and why they wish to be refertilised. Assuming the existence of an interactive behaviour pattern, we concentrated on the psycho-social circumstances accompanying the definitive decision to be sterilised. Here, a critical situation in the relationship between the partners at the time of sterilisation could be established as a prognostically unfavourable factor. Accordingly, 20 of the 37 patients developed the wish to be refertilized because of a new partnership. Those who felt induced by their gynaecologist or partner to undergo sterilisation had significantly more problems in overcoming the psychological stress accompanying such an operation than those who, after repeated consultations, had enough time and possibilities to make their own decision concerning contraception. Furthermore, sterilisation due to medical indication could be suggested as another highly critical factor, especially where the gynaecologist failed to give sufficient explanation of its medical necessity. With regard to the time set for the sterilisation, the study revealed that the patient's psychological condition after the operation was significantly worse, when sterilisation was carried out immediately after a delivery or an abortion. The fact that in such cases sterilisation is often followed by an increase in psychosomatic trouble and depressive states, of mind is also confirmed by literature. The results of the study are a practical contribution towards improving preoperative consultation and coordinating the course of action to be taken where a patient has the wish to be sterilised.
在这项探索性研究的框架内,对37名希望恢复生育能力的绝育女性进行了全面询问,了解她们绝育的原因以及希望恢复生育能力的缘由。假设存在一种互动行为模式,我们重点关注了绝育最终决定所伴随的心理社会状况。在此,绝育时伴侣关系中的危急情况可被认定为一个预后不良因素。相应地,37名患者中有20名因建立了新的伴侣关系而产生了恢复生育能力的愿望。那些感觉是受妇科医生或伴侣诱导而接受绝育的人,在克服该手术所伴随的心理压力方面,比那些经过反复咨询后有足够时间和机会自行决定避孕方式的人有更多问题。此外,因医学指征进行的绝育也可被视为另一个高度关键的因素,尤其是在妇科医生未能充分解释其医学必要性的情况下。关于绝育的时间安排,研究表明,在分娩或流产后立即进行绝育时,患者术后的心理状况明显更差。文献也证实了在这种情况下,绝育后身心问题和抑郁情绪往往会增加。该研究结果对改善术前咨询以及协调患者希望绝育时应采取的行动方案具有实际贡献。