Clinical-Psychological Aspects Involved in Gynecological Surgery: Description of Peri-Operative Psychopathological Symptoms and Illness Behavior
Authors
Carlo Pruneti
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Simona Mortilla
Giuseppe Masellis
Chiara Caramuscio
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Guidotti, S., Pruneti, C. ., Mortilla, S. ., Masellis, . G. ., & Caramuscio, C. . (2023). Clinical-Psychological Aspects Involved in Gynecological Surgery: Description of Peri-Operative Psychopathological Symptoms and Illness Behavior. International Journal of Psychological Research, 16(1), 56–66. https://doi.org/10.21500/20112084.5981
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To give up copyright, the authors allow that, International Journal of Psychological Research, distribute the work more broadly, check for the reuse by others and take care of the necessary procedures for the registration and administration of copyright; at the same time, our editorial board represents the interests of the author and allows authors to re-use his work in various forms. In response to the above, authors transfer copyright to the journal, International Journal of Psychological Research. This transfer does not imply other rights which are not those of authorship (for example those that concern about patents). Likewise, preserves the authors rights to use the work integral or partially in lectures, books and courses, as well as make copies for educational purposes. Finally, the authors may use freely the tables and figures in its future work, wherever make explicit reference to the previous publication in International Journal of Psychological Research. The assignment of copyright includes both virtual rights and forms of the article to allow the editorial to disseminate the work in the manner which it deems appropriate.
The editorial board reserves the right of amendments deemed necessary in the application of the rules of publication.
Abstract
Background. Within the current literature concerning the gynecological surgery, there are only a few studies that focus on the psychological aspects that characterize the peri-operative period. In this research, the psychopathological symptoms and the illness behavior were assessed in order to confirm previous results about clinical variables such as the type and method of intervention, as well as psychological aspects regarding the positive anamnesis for mental disorders. Moreover, other factors including the desire for maternity and previous surgical interventions and pregnancies were also investigated. Methods. In this observational research, 58 women (age = 41.5±8.8), that undergone gynecological surgery (conservative and non-conservative) for benign pathologies, were consecutively recruited. Information on psychopathological symptoms was collected 15 days (T0) and one day before surgery
(T1), and at the time of discharge (T2) through the Symptom Questionnaire (SQ). At T2, the Illness Behavior Questionnaire (IBQ) was also administered. Results. The descriptive analyzes conducted on the total sample demonstrated that while anxious activation and
irritable mood decrease from T0 to T1, somatizations and depression mood increase between T1 and T2. Moreover, the comparisons between groups, dividing the sample according to the clinical-medical and psychological variables, highlighted that the type and modality of the intervention, as well as a positive history for the presence of psychological disorders, the desire for maternity, and previous surgical interventions and pregnancies, can influence the course of psychopathological symptoms. Conclusion. This study highlights the need to include a clinical-psychological evaluation and to pay attention to specific clinical variables regarding women that are undergoing a conservative or non-conservative gynecological surgery. Considering the psychological impact of these type of interventions, the clinical history of these women, as well as their fears and desires, could facilitate a better management of the patients in terms of well-being, adherence to treatment, and recovery
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References
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Berlit, S., Tuschy, B., Wuhrer, A., Jürgens, S., Buchweitz, O., Kircher, A.T., Sütterlin, M., Lis, S., Hornemann, A. (2018). Sexual functioning after total versus subtotal laparoscopic hysterectomy. Arch Gynecol Obstet, 298(2):337-344. doi: 10.1007/s00404-018-4812-7.
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Carter, J., Sonoda, Y., Baser, R.E., Raviv, L., Chi, D.S., Barakat. R.R., Iasonos, A., Brown, C.L., Abu-Rustum, N.R. (2010). A 2-year prospective study assessing the emotional, sexual and quality of life concerns of women undergoing radical hysterectomy versus radical trachelectomy for treatment of early-stage cervical cancer. Gynaecologic Oncology, 119:358-365.
Cosentino, C., Sgromo, D., Merisio, C., Berretta, R., Pruneti, C. (2018). Psychophysiological Adjustment to Ovarian Cancer: Preliminary Study on Italian Women Condition. Applied Psychophysiology and Biofeedback, 43(2):161-168. doi: 10.1007/s10484-018-9395-3.
Darwish, M., Atlantis, E., & Mohamed-Taysir, T. (2014). Psychological outcomes after hysterectomy for benign conditions: a systematic review and meta-analysis. Eur J Obstet Gynecol Reprod Biol, 174:5–19.
De Vincenzo, F., Cosentino, C., Quinto, R.M., Di Leo, S., Contardi, A., Guidotti, S., Iani, L., Pruneti, C. (2022). Psychological adjustment and heart rate variability in ovarian cancer survivors. Mediterranean Journal of Clinical Psychology, 10(1). https://doi.org/10.13129/2282-1619/mjcp-3318.
Etchegary, H., Dicks, E., Tamutis, L., Dawson, L. (2018). Quality of life following prophylactic gynecological surgery: experiences of female Lynch mutation carriers. Fam Cancer, 17(1): 53-61. doi: 10.1007/s10689-017-9997-6.
Fava, G.A., Bernardi, M., Pilowsky, I., Spence, N.D. (1982). Versione italiana dell’Illness Behaviour Questionnaire (IBQ) di Pilowsky e Spence. In: Canestrari R (Ed), Nuovi metodi in psicometria. Firenze: Organizzazioni Speciali; 1982.
Fava, G.A., Kellner, R., Perini, G.I., Fava, M., Michelacci, L., Munari, F., Pasquali Evangelisti, L., Grandi, S., Bernardi, M., Mastrogiacomo, I. (1983). Italian validation of the Symptom Rating Test (SRT) and Symptom Questionnaire (SQ). Canadian Journal of Psychiatry, 28:117–123.
Ferrandina, G., Corrado, G., Scambia, G. (2020). Minimally invasive surgery and quality of life in cervical cancer. Lancet Oncol, 21(6):746-748. doi: 10.1016/S1470-2045(20)30161-3.
Flory, N., Bissonnette, F., & Binik, Y.M. (2005). Psychosocial effects of hysterectomy: literature review. J Psychosom Res, 59(3):117–29.
Frumovitz, M., Obermair, A., Coleman, R.L., Pareja, R., Lopez, A., Ribero, R., Isla, D., Rendon, G., Bernardini, M.Q., Buda, A., Moretti-Marquez, R., Zevallos, A., Vieira, M.A., Zhu, T., Land, R.P., Nicklin, J., Asher, R., Robledo, K.P., Gebski, V., Ramirez, P.T. (2020). Quality of life in patients with cervical cancer after open versus minimally invasive radical hysterectomy (LACC): a secondary outcome of a multicentre, randomised, open-label, phase 3, non-inferiority trial. Lancet Oncol, 21(6):851-860. doi: 10.1016/S1470-2045(20)30081-4. Erratum in: Lancet Oncol., 21 (7): e341. PMID: 32502445
Hartmann, K.E., Ma, C., Lamvu, G.M., Langenberg, P.W., Steege, J.F., Kjerulff, K.H. (2004). Quality of life and sexual function after hysterectomy in women with preoperative pain and depression. Obstetrics and Gynecology, 104(4):701-9.
Helström, L., & Nilsson, B. (2005). Impact of vaginal surgery on sexuality and quality of life in women with urinary incontinence or genital descensus. Acta Obstetricia et Gynecologica Scandinavica, 84(1):79-84.
Khastgir, G., Studd, J.W., & Catalan, J. (2000). The psychological outcome of hysterectomy. Gynecol Endocrinol, 14(2):132–41.
Lilić, G., Živadinović, R., Petrić, A., Lilić, A. (2011). Preoperative Preparation of Patients for Gynecologic Surgery. Scientific Journal of the Faculty of Medicine in Niš, 28(2):125-133.
Mann, W.J.Jr, Falcone, T., & Eckler, K. (2020). Overview of preoperative evaluation and preparation for gynecologic surgery. https://www.uptodate.com/contents/overview-of-preoperative-evaluation-and- preparation-for-gynecologic-surgery.
Majumdar, A., & Saleh, S. Psychological Aspects of Hysterectomy & Postoperative Care. In: Al-Hendy, A., & Sabry, M. (2012). Hysterectomy. IntechOpen. Doi: 10.5772/1216.
Oates, M., & Gath, D. (1989). Psychological aspects of gynaecological surgery. Baillieres Clin Obstet Gynaecol, 3(4):729-49. doi: 10.1016/s0950-3552(89)80062-8.
Öztürk, R., Sevil, Ü., Sargin, A., Yücebilgin, M.S. (2018). The effects of reflexology on anxiety and pain in patients after abdominal hysterectomy: A randomised controlled trial. Complement Ther Med, 36:107-112. doi:10.1016/j.ctim.2017.12.005.
Pellegrini, J.E., Toledo, P., Soper, D.E., et al. (2017). Consensus Bundle on Prevention of Surgical Site Infections after Major Gynecologic Surgery. Obstet Gynecol, 129:50.
Persson, P., Brynhildsen, J., & Kjolhede, P. (2010). Hysterectomy Multicentre Study Group in South-East S. A 1-year follow up of psychological wellbeing after subtotal and total hysterectomy–a randomised study. BJOG, 117(4):479–87.
Pilowsky, I., & Spence, N.D. (1994). Manual for the illness behavior questionnaire (IBQ), (3rd Edn). Adelaide: University of Adelaide.
Pruneti, C., & Guidotti, S. Pain between Psyche and Soma in Uro-Andrology, International Journal of Pain Management, 1,2. https://doi.org/10.14302/issn.2688-5328.ijp-20-3386.
Salehi, S., Brandberg, Y., Åvall-Lundqvist, E., Suzuki, C., Johansson, H., Legerstam, B., Falconer, H. (2018). Long-term quality of life after comprehensive surgical staging of high-risk endometrial cancer-results from the RASHEC trial. Acta Oncol, 12:1671-1676. doi: 10.1080/0284186X.2018.1521987.
Selye, H. (1936). A Syndrome produced by Diverse Nocuous Agents. Nature, 138, 32. https://doi.org/10.1038/138032a0.
Theunissen, M., Peters, M. L., Schepers, J., Schoot, D. C., Gramke, H-F., & Marcus, M. A. (2017). Prevalence and predictors of depression and well-being after hysterectomy: an observational study. European Journal of Obstetrics & Gynecology and Reproductive Biology, 217, 94-100. https://doi.org/10.1016/j.ejogrb.2017.08.017.
Thornton, E.W., McQueen, C., Rosser, R., Kneale, T., Dixon, K. (1997). A prospective study of changes in negative mood states of women undergoing surgical hysterectomy: the relationship to cognitive predisposition and familial support. J Psychosom Obstet Gynaecol, 18(1):22–30.
Tiller, K., Meiser, B., Gould, L., Tucker, K., Dudding, T., Franklin, J., Friedlander, M., Andrews, L. (2005). Knowledge of risk management strategies and information and risk management preferences of women at increased risk for ovarian cancer. Psychooncology, 14:249–261.
Vandyk, A.D., Brenner, I., Tranmer, J., Van Den Kerkhof, E. (2011). Depressive symptoms before and after elective hysterectomy. J Obstet Gynecol Neonatal Nurs, 40(5):566–76.
Wechter, W.J., Geller, E., Nguyen, T., Visco, A. (2007). Hysterectomy rates in the United States. Obstetrics and Gynecology, 110:1091-5.
Yen, J.Y., Chen, Y.H., Long, C.Y., Chang, Y., Yen, C.F., Chen, C.C., et al. (2008). Risk factors for major depressive disorder and the psychological impact of hysterectomy: a prospective investigation. Psychosomatics, 49(2):137–42.
Aziz, A., Bergquist, C., Nordholm, L., Moller, A., Silfverstolpe, G. (2005). Prophylactic oophorectomy at elective hysterectomy: effects on psychological well-being at 1-year follow-up and its correlations to sexuality. Maturitas, 51(4):349– 57.
Berlit, S., Tuschy, B., Wuhrer, A., Jürgens, S., Buchweitz, O., Kircher, A.T., Sütterlin, M., Lis, S., Hornemann, A. (2018). Sexual functioning after total versus subtotal laparoscopic hysterectomy. Arch Gynecol Obstet, 298(2):337-344. doi: 10.1007/s00404-018-4812-7.
Bonadies, D., Moyer, A., & Matloff ,E. (2011). What I wish I’d known before surgery: BRCA carriers’ perspectives after bilateral salpingooophorectomy. Fam Cancer, 10:79–85.
Brain, K., Gravell, C., France, E., Fiander, A., Gray, J. (2004). An exploratory qualitative study of women’s perceptions of risk management options for familial ovarian cancer: implications for informed decision making. Gynecol Oncol, 92:905–913.
Carter, J., Sonoda, Y., Baser, R.E., Raviv, L., Chi, D.S., Barakat. R.R., Iasonos, A., Brown, C.L., Abu-Rustum, N.R. (2010). A 2-year prospective study assessing the emotional, sexual and quality of life concerns of women undergoing radical hysterectomy versus radical trachelectomy for treatment of early-stage cervical cancer. Gynaecologic Oncology, 119:358-365.
Cosentino, C., Sgromo, D., Merisio, C., Berretta, R., Pruneti, C. (2018). Psychophysiological Adjustment to Ovarian Cancer: Preliminary Study on Italian Women Condition. Applied Psychophysiology and Biofeedback, 43(2):161-168. doi: 10.1007/s10484-018-9395-3.
Darwish, M., Atlantis, E., & Mohamed-Taysir, T. (2014). Psychological outcomes after hysterectomy for benign conditions: a systematic review and meta-analysis. Eur J Obstet Gynecol Reprod Biol, 174:5–19.
De Vincenzo, F., Cosentino, C., Quinto, R.M., Di Leo, S., Contardi, A., Guidotti, S., Iani, L., Pruneti, C. (2022). Psychological adjustment and heart rate variability in ovarian cancer survivors. Mediterranean Journal of Clinical Psychology, 10(1). https://doi.org/10.13129/2282-1619/mjcp-3318.
Etchegary, H., Dicks, E., Tamutis, L., Dawson, L. (2018). Quality of life following prophylactic gynecological surgery: experiences of female Lynch mutation carriers. Fam Cancer, 17(1): 53-61. doi: 10.1007/s10689-017-9997-6.
Fava, G.A., Bernardi, M., Pilowsky, I., Spence, N.D. (1982). Versione italiana dell’Illness Behaviour Questionnaire (IBQ) di Pilowsky e Spence. In: Canestrari R (Ed), Nuovi metodi in psicometria. Firenze: Organizzazioni Speciali; 1982.
Fava, G.A., Kellner, R., Perini, G.I., Fava, M., Michelacci, L., Munari, F., Pasquali Evangelisti, L., Grandi, S., Bernardi, M., Mastrogiacomo, I. (1983). Italian validation of the Symptom Rating Test (SRT) and Symptom Questionnaire (SQ). Canadian Journal of Psychiatry, 28:117–123.
Ferrandina, G., Corrado, G., Scambia, G. (2020). Minimally invasive surgery and quality of life in cervical cancer. Lancet Oncol, 21(6):746-748. doi: 10.1016/S1470-2045(20)30161-3.
Flory, N., Bissonnette, F., & Binik, Y.M. (2005). Psychosocial effects of hysterectomy: literature review. J Psychosom Res, 59(3):117–29.
Frumovitz, M., Obermair, A., Coleman, R.L., Pareja, R., Lopez, A., Ribero, R., Isla, D., Rendon, G., Bernardini, M.Q., Buda, A., Moretti-Marquez, R., Zevallos, A., Vieira, M.A., Zhu, T., Land, R.P., Nicklin, J., Asher, R., Robledo, K.P., Gebski, V., Ramirez, P.T. (2020). Quality of life in patients with cervical cancer after open versus minimally invasive radical hysterectomy (LACC): a secondary outcome of a multicentre, randomised, open-label, phase 3, non-inferiority trial. Lancet Oncol, 21(6):851-860. doi: 10.1016/S1470-2045(20)30081-4. Erratum in: Lancet Oncol., 21 (7): e341. PMID: 32502445
Hartmann, K.E., Ma, C., Lamvu, G.M., Langenberg, P.W., Steege, J.F., Kjerulff, K.H. (2004). Quality of life and sexual function after hysterectomy in women with preoperative pain and depression. Obstetrics and Gynecology, 104(4):701-9.
Helström, L., & Nilsson, B. (2005). Impact of vaginal surgery on sexuality and quality of life in women with urinary incontinence or genital descensus. Acta Obstetricia et Gynecologica Scandinavica, 84(1):79-84.
Khastgir, G., Studd, J.W., & Catalan, J. (2000). The psychological outcome of hysterectomy. Gynecol Endocrinol, 14(2):132–41.
Lilić, G., Živadinović, R., Petrić, A., Lilić, A. (2011). Preoperative Preparation of Patients for Gynecologic Surgery. Scientific Journal of the Faculty of Medicine in Niš, 28(2):125-133.
Mann, W.J.Jr, Falcone, T., & Eckler, K. (2020). Overview of preoperative evaluation and preparation for gynecologic surgery. https://www.uptodate.com/contents/overview-of-preoperative-evaluation-and- preparation-for-gynecologic-surgery.
Majumdar, A., & Saleh, S. Psychological Aspects of Hysterectomy & Postoperative Care. In: Al-Hendy, A., & Sabry, M. (2012). Hysterectomy. IntechOpen. Doi: 10.5772/1216.
Oates, M., & Gath, D. (1989). Psychological aspects of gynaecological surgery. Baillieres Clin Obstet Gynaecol, 3(4):729-49. doi: 10.1016/s0950-3552(89)80062-8.
Öztürk, R., Sevil, Ü., Sargin, A., Yücebilgin, M.S. (2018). The effects of reflexology on anxiety and pain in patients after abdominal hysterectomy: A randomised controlled trial. Complement Ther Med, 36:107-112. doi:10.1016/j.ctim.2017.12.005.
Pellegrini, J.E., Toledo, P., Soper, D.E., et al. (2017). Consensus Bundle on Prevention of Surgical Site Infections after Major Gynecologic Surgery. Obstet Gynecol, 129:50.
Persson, P., Brynhildsen, J., & Kjolhede, P. (2010). Hysterectomy Multicentre Study Group in South-East S. A 1-year follow up of psychological wellbeing after subtotal and total hysterectomy–a randomised study. BJOG, 117(4):479–87.
Pilowsky, I., & Spence, N.D. (1994). Manual for the illness behavior questionnaire (IBQ), (3rd Edn). Adelaide: University of Adelaide.
Pruneti, C., & Guidotti, S. Pain between Psyche and Soma in Uro-Andrology, International Journal of Pain Management, 1,2. https://doi.org/10.14302/issn.2688-5328.ijp-20-3386.
Salehi, S., Brandberg, Y., Åvall-Lundqvist, E., Suzuki, C., Johansson, H., Legerstam, B., Falconer, H. (2018). Long-term quality of life after comprehensive surgical staging of high-risk endometrial cancer-results from the RASHEC trial. Acta Oncol, 12:1671-1676. doi: 10.1080/0284186X.2018.1521987.
Selye, H. (1936). A Syndrome produced by Diverse Nocuous Agents. Nature, 138, 32. https://doi.org/10.1038/138032a0.
Theunissen, M., Peters, M. L., Schepers, J., Schoot, D. C., Gramke, H-F., & Marcus, M. A. (2017). Prevalence and predictors of depression and well-being after hysterectomy: an observational study. European Journal of Obstetrics & Gynecology and Reproductive Biology, 217, 94-100. https://doi.org/10.1016/j.ejogrb.2017.08.017.
Thornton, E.W., McQueen, C., Rosser, R., Kneale, T., Dixon, K. (1997). A prospective study of changes in negative mood states of women undergoing surgical hysterectomy: the relationship to cognitive predisposition and familial support. J Psychosom Obstet Gynaecol, 18(1):22–30.
Tiller, K., Meiser, B., Gould, L., Tucker, K., Dudding, T., Franklin, J., Friedlander, M., Andrews, L. (2005). Knowledge of risk management strategies and information and risk management preferences of women at increased risk for ovarian cancer. Psychooncology, 14:249–261.
Vandyk, A.D., Brenner, I., Tranmer, J., Van Den Kerkhof, E. (2011). Depressive symptoms before and after elective hysterectomy. J Obstet Gynecol Neonatal Nurs, 40(5):566–76.
Wechter, W.J., Geller, E., Nguyen, T., Visco, A. (2007). Hysterectomy rates in the United States. Obstetrics and Gynecology, 110:1091-5.
Yen, J.Y., Chen, Y.H., Long, C.Y., Chang, Y., Yen, C.F., Chen, C.C., et al. (2008). Risk factors for major depressive disorder and the psychological impact of hysterectomy: a prospective investigation. Psychosomatics, 49(2):137–42.
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