Cultural factors and reaction to hysterectomy

Abstract

The role of cultural background in the etiology of depressive symptoms associated with hysterectomy has been rarely explored. However, the increasing interest in the transcultural aspects of psychiatry in the last decade gives a particular relevance to this subject. In the current study, 152 women underwent hysterectomy in a downtown hospital of a large city. The population under study consisted of women of various ethnic backgrounds, French Canadian (35%), English Canadian (29%), European (22%) and other (14%). The women completed the Zung self-rating depression scale (SDS) before the operation and six times after during a one year period. They also answered two questionnaires, the first before the operation and the last one a year after. These questionnaires explored the presence of fears, misconceptions, the attitudes toward the operation, the satisfaction regarding medical care and the general pre- and post-operative adjustment. English Canadian women reported the lowest scores on the SDS; they had few misconceptions and fears. They had the best post-operative adjustment of the three groups. French Canadian women showed intermediate scores on the SDS and expressed more misconceptions and feelings of mutilations pre-operatively. Women of European origin showed the highest scores on the SDS at all observations, expressed more regrets about the operation and had a more difficult post-operative adjustment than the other two groups. This study suggests that cultural factors may contribute to the reaction to hysterectomy in women of different ethnic backgrounds. Education, the type of society: patriarchal versus matriarchal, the emphasis on the women's reproductive ability in a particular culture, are among other factors that seem to play an important role.

Hysterectomy as Viewed by Mexican Women and Men

“…An additional or alternative explanation of the results from participants with a limited educational background is that the conjunction of unfavorable economic conditions and the fact of not having attended college put them at a disadvantage in obtaining information about the issue. In a previous study conducted in Canada, it was shown that women with limited educational backgrounds were those who exhibited more misconceptions regarding the function of the uterus and the consequences of hysterectomy (Lalinec-Michaud and Engelsmann 1989). Mexicans with a limited educational background have attitudes and beliefs regarding several reproductive health issues that differ from those of upper middle class people; they are more resistant to change in Table 4 Means (and Standard Deviations) for the positive adjectives that may describe a woman with hysterectomy for women (n=120) and men (n=135).…”

“…Furthermore, they also showed more fears and misconceptions related to hysterectomy. The authors concluded that sociocultural factors such as education and the concept of the feminine role held in a particular culture play an important role in the cognitive representations of hysterectomy (Lalinec-Michaud and Engelsmann 1989). Richter et al showed that African American women have more negative perceptions concerning hysterectomy than do European American women .…”

Psychiatric morbidity following hysterectomy in Egypt

“…Lalinec-Michaud and Engelsmann [24] suggested that cultural factors may contribute to the reaction to hysterectomy of women from different ethnic backgrounds, thereby influencing the findings across study populations. Fertility in women is valued highly in traditional Egyptian society and masculine roles are more dominant.…”

Risk of depressive disorders in women undergoing hysterectomy: A population-based follow-up study

“…These discrepancies may be due to differences in study design, length of follow-up, and selection of study population. Furthermore, most of these previous studies were conducted in patients of different ethnic backgrounds, and cultural factors may also contribute to this difference (Lalinec-Michaud and Engelsmann, 1989).…”

“…Therefore, the actual psychological outcomes following hysterectomy are still an unsolved issue. In addition, most of these previous studies were conducted in Western countries, and cultural factors may have an influence on the reactions to hysterectomy in women from different ethnic backgrounds (Lalinec-Michaud and Engelsmann, 1989); therefore, it is essential to conduct studies among people from different cultural backgrounds. Furthermore, only a few of these studies were conducted using a nationwide population dataset, which may limit the generalizability of the results reported (Gibson et al, 2012).…”