Immediate postdischarge concerns and coping of benign posthysterectomy patients

Abstract

The purpose of this study was to identify and describe the concerns and coping abilities of women following a hysterectomy during their first four weeks after hospital discharge. Findings from this study could assist nurses in determining what kind of information and support are needed to prepare women for their recovery after hospital discharge. -- The conceptual framework for this study was based on the theory that women coping with a stressful illness experience, such as having a hysterectomy, is a process that is interpreted differently based on women's perceptions of this event (Cohen & Lazarus, 1979; Lazarus & Folkman, 1984). This would help to explain differences in women's concerns and coping abilities related to having a hysterectomy. -- An exploratory descriptive method was employed for this study. The sample consisted of 60 premenopausal women who had an elective benign hysterectomy. Women with complete or partial ovarian tissue remaining were included. Data were collected from women using a two part structured interview guide constructed by the researcher. Section A included data about biological/demographic information, resources for surgery, hospital experience, expectations, and resources available after surgery. Section B identified women's concerns and severity of concerns and coping actions. Descriptive statistics were used to analyze the data. -- The results indicated women did have concerns about themselves during their first four weeks at home after hospital discharge. Most women were able to cope with their concerns, particularly in light of resources available to them. The most frequent concerns identified by women were related to bodily integrity and comfort, and emotions and feelings. -- Despite the fact women coped fairly well with their concerns during the recovery process, deficiencies were identified. Teaching or information prior to discharge was not sufficient. Lack of information about the recovery process, lack of information about specific concerns, and lack of knowledge related to anatomy and physiology were the three major areas of deficiency identified. -- These women returned home early after discharge without benefit of health care support services. Women relied largely on information provided prior to discharge to manage their recovery. Family and friends were also available to help the majority of women after discharge from hospital. However, a number of women also required additional professional services from doctors, nurses, or hospitals. These findings have implications for discharge planning and suggest that women need more information and support services than were provided to them after discharge from hospital. Therefore, nurses need to reassess the kind of information and support services that are provided to women and base discharge planning on patients' concerns