Xie Meilian, Huang Xin, Zhao Shan, Chen Yingtong, Zeng Xiuqun
Department of Gynecology, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China.
Front Med (Lausanne). 2022 Apr 25;9:878815. doi: 10.3389/fmed.2022.878815. eCollection 2022.
Hysterectomy is one of the most frequently performed operations worldwide. However, postoperative complications and body image changes may induce psychological distress after hysterectomy. The study aimed to evaluate the effect of psychological intervention on pelvic floor function and psychological outcomes following hysterectomy among patients with benign indications.
Ninety-nine patients underwent hysterectomy were randomly divided into intervention group ( = 50) and control group ( = 49). Patients in the control group received routine postoperative nursing care, while extra psychological intervention was provided to patients in the intervention group, including psychological support, regular lectures and family support. After 6 months, patient's psychological statuses were assessed by Generalized Anxiety Disorder scale (GAD-7) and Patient Health Questionnaire-9 (PHQ-9). The pelvic floor function of patients was evaluated using Pelvic Floor Impact Questionnaire (PFIQ-7) and Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire (PISQ-12). Furthermore, the incidence of postoperative complications, including uracratia, pelvic organ prolapses, sexual dysfunction and chronic pelvic pain, was evaluated.
After 6-month intervention, the GAD-7 and PHQ-9 scores were significantly decreased in the intervention group ( < 0.001 and = 0.018 respectively). Both scored were significantly lower than that in the control group ( < 0.001 and < 0.001). Compared with control group, the incidence of uracratia, pelvic organ prolapse, sexual dysfunction and chronic pelvic pain for intervention group was significantly lower ( = 0.003, = 0.027, = 0.001, = 0.002 respectively) and the pelvic floor muscle strength was significantly stronger ( = 0.001). Besides, the postoperative Urinary Incontinence Impact Questionnaire (UIQ-7), Pelvic Organ Prolapse Impact Questionnaire (POPIQ-7), and Colorectal-Anal Impact Questionnaire (CRAIQ-7) scores were significantly lower ( = 0.025, = 0.04, < 0.001) and PISQ-12 score was significantly higher in intervention group ( < 0.001).
Psychological intervention could effectively improve the psychological condition of patients with hysterectomy, which may facilitate patients' postoperative recovery in pelvic floor function. These findings emphasized the necessity of psychological intervention in routine postoperative nursing care.
子宫切除术是全球最常开展的手术之一。然而，术后并发症和身体形象改变可能会在子宫切除术后引发心理困扰。本研究旨在评估心理干预对良性指征患者子宫切除术后盆底功能和心理结局的影响。
99例行子宫切除术的患者被随机分为干预组（n = 50）和对照组（n = 49）。对照组患者接受常规术后护理，而干预组患者则接受额外的心理干预，包括心理支持、定期讲座和家庭支持。6个月后，通过广泛性焦虑障碍量表（GAD - 7）和患者健康问卷 - 9（PHQ - 9）评估患者的心理状态。使用盆底影响问卷（PFIQ - 7）和盆腔器官脱垂/尿失禁性功能问卷（PISQ - 12）评估患者的盆底功能。此外，评估术后并发症的发生率，包括排尿困难、盆腔器官脱垂、性功能障碍和慢性盆腔疼痛。
经过6个月的干预，干预组的GAD - 7和PHQ - 9评分显著降低（分别为P < 0.001和P = 0.018）。两组评分均显著低于对照组（P < 0.001和P < 0.001）。与对照组相比，干预组排尿困难、盆腔器官脱垂、性功能障碍和慢性盆腔疼痛的发生率显著更低（分别为P = 0.003、P = 0.027、P = 0.001、P = 0.002），且盆底肌肉力量显著更强（P = 0.001）。此外，干预组术后尿失禁影响问卷（UIQ - 7）、盆腔器官脱垂影响问卷（POPIQ - 7）和结直肠 - 肛门影响问卷（CRAIQ - 7）评分显著更低（分别为P = 0.025、P = 0.04、P < 0.001），而PISQ - 12评分显著更高（P < 0.001）。
心理干预可有效改善子宫切除术后患者的心理状况，这可能有助于患者盆底功能的术后恢复。这些发现强调了心理干预在常规术后护理中的必要性。
