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

• Published in: Journal of psychosomatic obstetrics and gynaecology 2003-06, Vol.24 (2), p.99-109
• Main Authors: Donoghue, A. P., Jackson, H. J., Pagano, R.
• Format: Article
• Language: English
• Subjects: Adaptation, Psychological; Adult; Affect; anxiety; Anxiety - psychology; appraisal; Biological and medical sciences; coping; depression; Depression - etiology; Depression - psychology; Female; Fundamental and applied biological sciences. Psychology; Humans; hysterectomy; Hysterectomy - psychology; Illness and personality; Illness, stress and coping; Middle Aged; Personality; Personality Inventory; Postoperative Care; Postoperative Complications; Preoperative Care; Psychology and medicine; Psychology. Psychoanalysis. Psychiatry; Psychology. Psychophysiology; stress; Stress, Psychological - psychology
• ISSN: 0167-482X; 1743-8942
• DOI: 10.3109/01674820309042807

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, OSS), 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.