Understanding pre- and post-hysterectomy levels of negative affect: a stress moderation model approach

Adrian Donoghue, A P Donoghue, Henry J. Jackson, H J Jackson, R F Lebron Pagano, R Pagano
Journal of psychosomatic obstetrics and gynaecology · 2003 · vol. 24(2) , pp. 99–109 · doi:10.3109/01674820309042807 · PMID:12854394 · W2102665610
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This study investigated pre- and post-hysterectomy negative affect, finding that pre-operative depression, concerns about outcome, neuroticism, and extraversion were key risk factors, mediated by coping and appraisal.

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Abstract

Before and after hysterectomy, 60 women completed self-report questionnaires. Measures of personality (NEO-Five Factor Inventory, NEO-FFI), coping (Coping Inventory for Stressful Situations, CISS), and procedure appraisal were completed pre-operatively. Measures of depression and anxiety were completed pre- and post-operatively. Pre-op, 34% of women reported depression at clinical levels, and 29% reported clinical anxiety. The prevalence of depression fell to 8% 3-months post-op although clinical levels of anxiety persisted post-op in 22% of women. Regression analyses revealed that the principal risk factors for post-op negative affect were pre-op levels of depression and concerns about hysterectomy outcome. In assessing proposed models of post-hysterectomy outcome, structural equational modelling revealed the key position of neuroticism and extraversion, which were both directly and indirectly related to pre- and post-operative depression and anxiety. The mediating variables in this model included coping dispositions and procedure appraisal. It is concluded that the variables contained within stress moderation models provide a useful framework for understanding the processes that may lead to elevated levels of negative affect both before and after hysterectomy. Such an approach may prove beneficial for other surgical-outcome studies.

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MeSH descriptors

Affect Hysterectomy Postoperative Care Postoperative Complications Preoperative Care Stress, Psychological Adaptation, Psychological Adult Anxiety Anxiety Depression Depression Depression Female Humans Hysterectomy Middle Aged Personality Personality Inventory Stress, Psychological

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