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Bridging different realities - a qualitative study on patients' experiences of preoperative care for benign hysterectomy and opportunistic salpingectomy in Sweden

journal contribution
posted on 03.11.2020, 07:06 by E Collins, M Lindqvist, Ingrid Mogren, A Idahl
© 2020 The Author(s). Background: Hysterectomy is a common procedure worldwide and removing healthy fallopian tubes at the time of hysterectomy (opportunistic salpingectomy) to possibly prevent ovarian cancer is increasing in frequency, but still controversial. The experiences and perceptions of women, eligible for the procedure, have not been previously investigated. This study aims to, among women waiting to undergo hysterectomy, explore i) experiences and perceptions of self and healthcare in relation to their elective surgery, ii) perceptions of risks and benefits of hysterectomy, including opportunistic salpingectomy. Methods: A qualitative study, with focus group discussions including women < 55 years, planned for hysterectomy with ovarian preservation, was performed. Participants were recruited through purposive sampling from six gynecological departments in different parts of Sweden, including both country and university hospitals. Focus group discussions were conducted using a semi-structured interview guide, digitally recorded, transcribed verbatim and analysed by qualitative manifest and latent content analysis. Results: Twenty-one Swedish-speaking women participated. They were 40-53 years of age, reported varying educational levels, countries of birth and indications for hysterectomy. Analysis rendered a theme "Bridging different realities"over four categories: "Being a woman today", "Experiencing and managing body failure", "Navigating the healthcare system"and "Processing continuously until surgery", including 17 subcategories. The participants displayed varying attitudes towards the significance of their uterus in being a woman. A vague understanding of their body was described, leading to fear related to the reasons for surgery as well as surgery itself. Participants described difficulties understanding and recalling information but also stated that insufficient information was provided. Perceptions of the risks and benefits of opportunistic salpingectomy varied. Involvement in decisions regarding the hysterectomy and potential opportunistic salpingectomy was perceived to be dependent on the counselling gynecologist. Conclusions: The theme Bridging different realities captures the complexity of women deciding on removal of their uterus, and possibly fallopian tubes. It also describes the women's interactions with healthcare and perceived difference between the health professionals and the women's perception of the situation, as viewed by the women. Bridging the different realities faced by patients is required to enable shared decision-making, through sufficient support from healthcare.

Funding

This study was supported by grants from The Cancer Research Foundation in Northern Sweden, grant number AMP 17-859 and the County Council of Vasterbotten, VLL-7000001. The funding bodies had no role in conception of the study, data collection or analysis, nor in preparation of the manuscript or in the decision to publish. Open access funding provided by Umea University.

Cancer Research Foundation in Northern Sweden | AMP 17-859

County Council of Vasterbotten | VLL-7000001

Umea University

History

Publication Date

01/01/2020

Journal

BMC Women's Health

Volume

20

Issue

1

Article Number

198

Pagination

10p. (p. 1-10)

Publisher

Springer Nature

ISSN

1472-6874

Rights Statement

The Author reserves all moral rights over the deposited text and must be credited if any re-use occurs. Documents deposited in OPAL are the Open Access versions of outputs published elsewhere. Changes resulting from the publishing process may therefore not be reflected in this document. The final published version may be obtained via the publisher’s DOI. Please note that additional copyright and access restrictions may apply to the published version.

Licence

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