子宮切除後之心理調適

Psychological adjustment after hysterectomy

我國的子宮切除手術有日漸增多的趨勢，過去研究多半針對手術方式或短期住院期間適應情形探討，因此本文旨在探討長期子宮切除手術後婦女的心理適應情形。研究對象來自研究者過去社區婦女健康調查研究中切除子宮的婦女，已手術3年至15年，分別來自台北、新竹、花蓮、台南四地區，完成訪視的有80人，完訪率為58.8 %。由訪員至個案家中進行問卷訪談。重要的研究發現如下：1.的確有部份受訪者後悔作了手術、擔心與先生的性生活、有失去子宮失落感，或者擔心怕別人會笑她。2.術後心理不適反應發生率依序為記憶力減低、失眠、極度疲勞、對性無興趣、情緒不穩定、注意力不集中、憂鬱、焦慮、坐立不安、易哭、胃口不好。3.心理不適被婦女歸因為手術所引起的比率依序為極度疲勞、情緒不穩定、憂鬱、記憶力減低、對性無興趣、注意力不集中與失眠。4.心理不適的處置方式，多半是不理會，幾乎沒有看西醫，有少部份提及注意飲食與作運動。5.就醫與恢復的過程中，提供最大幫助的人以配偶最多，子女與母親其次。所提供的協助內容主要為心理支持與家事協助，結果發現子宮切除的心理影響不單只有負面意涵，文中並比較子宮切除術後長期與短期的心理適應，以及術後婦女採行的健康行為。

The prevalence rate of hysterectomy has shown an increasing tendency in Taiwan. Most studies have concentrated on operating techniques and the short-term effects of surgery. There is less knowledge about long-term effects on women or related health behaviors. We reported here on a retrospective study about 80 women, aged 40-60, who experienced hysterectomies three and fifteen years ago. Regarding the hysterectomy, some of the participants reported feeling regret, worried about sexual life with their husbands, felt the loss of their uterus and felt annoyed. They also reported discomforts after the hysterectomy of memory loss, insomnia, extreme tiredness, loss of libido, emotional instability, lack of concentration, depression, anxiety, frequent crying spells, irritation, and loss of appetites. Discomfort attributed to hysterectomy included extreme tiredness, emotional instability, depression, memory loss, loss of libido, lack of concentration, and insomnia. When asking about coping behaviors related to hysterectomy, most women reported no changes in their life style. Only 20% reported having taken action on their exercise and diet especially due to the hysterectomy. The results also show that the psychological effects of hysterectomy are not all negative. Discussion focuses on short versus long term adjustment, and implications for women's health and the promotion of healthy behaviors.