Women's decision making regarding hysterectomy.

OBJECTIVE

To describe the decision-making process of women who choose hysterectomy for treatment of benign disease or distressing symptoms.

DESIGN

Qualitative design based on grounded theory, using semistructured interviews.

SETTING

Participants were interviewed in their homes or at their place of employment.

PARTICIPANTS

Ten women who were premenopausal prior to hysterectomy.

RESULTS

Decision making began when the women recognized abnormal body changes or bothersome symptoms. Four major processes were identified. "Seeking Solutions" was characterized by information seeking, information processing, and utilization of pharmacologic and nonpharmacologic treatments in an attempt to cure the disease and/or alleviate symptoms. "Holding On" included managing symptoms, rearranging activities of daily living to accommodate symptoms, and waiting. "Changing Course" was characterized by an abrupt change from Holding On to focusing on hysterectomy as the solution to the distressing symptoms. During "Taking Charge," the women displayed purposeful actions directed at arranging and preparing for surgery.

CONCLUSIONS

Understanding the process of decision making will enable nurses to provide support for women who choose hysterectomy for treatment of benign gynecologic diseases and/or distressing gynecologic symptoms. Nurses' support of women's decision making should include referrals, education, and emotional support. In addition, nurses can help these women improve their quality of life by assisting them with symptom management.