UBC Theses and Dissertations
Factors associated with health outcomes in patients receiving hysterectomy for benign conditions Saleeb, Maria
Hysterectomy is one of the most common surgical procedures among patients. Despite the high volume of this surgery, it is not well understood what patient and clinical factors are associated with a patient’s health-related quality of life before and after surgery. This thesis used a prospectively recruited cohort of patients scheduled for, or who had received, a hysterectomy for non-cancerous conditions to investigate: 1) the health of patients awaiting hysterectomy and factors associated with self-reported health, 2) patient and clinical factors associated with postoperative health, and 3) perceptions of shared decision-making and its association with postoperative health. These investigations were divided into three sub-studies. Patient-reported outcomes were used to measure pelvic floor health, sexual function, depression, and pain. Multi-variable regression analyses measured the association of age, comorbidities, socioeconomic factors, surgical approach, surgical indication, and shared decision-making with self-reported health. The first investigation found that participants that were younger, had more comorbidities, or had worse symptoms of pelvic health were more likely to report depression and pain before their surgery. The second investigation found that most participants reported improvements in health after their hysterectomy, however, those with lower socioeconomic status were more likely to report more pain. Participants that received a hysterectomy for their endometriosis or had received a hysterectomy through the abdominal approach, were more likely to report postoperative depressive symptoms. The last investigation found that almost half of hysterectomy patients reported less than optimal scores on their shared decision-making process with their surgeon before their hysterectomy. Those with lower scores were more likely to report poor pelvic health postoperatively.
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