A Pilot Study to Evaluate the Effectiveness of Preoperative Teaching Protocol on Selected Postoperative Outcomes in Terms of Anxiety and Depression Status Among Women undergone Hysterectomy

Background: The uterus contributes to a woman's sexual, reproductive and social identity. They are related to the concepts of feminity, sexuality, procreation and motherhood and are necessary part of a woman's body image. Hysterectomy is the second commonest operation in the women.

Objectives: 1.To assess and compare anxiety and depression scores between samples in control group and experimental group.2.To find association between pretest level of anxiety and depression scores of experimental group with selected demographic variables.

Design: Quantitative evaluative approach -Quasi experimental Nonequivalent before and after design

Setting: Pilot study was conducted in the Salem Polyclinic, Salem.

Participants: A Convenient sampling technique was used to select the samples. Inclusion criteria consist of women between the age group of 30-58 years, Women those who are living with partner, women at premenopausal/postmenopausal age, women who undergo abdominal/vaginal hysterectomy with or without salphingo oophorectomy for nonmalignant reasons. Exclusive criteria include women with debilitating illness and psychiatric illness, and women undergo hysterectomy for emergency reason. Equally 10 samples in control group and experimental group were selected for pilot study.

Methods: Three tools were used for data collection namely Proforma for Demographic data, State and trait Anxiety Inventory to identify anxiety status and Beck Depression inventory to assess depression status. Demographic data was collected on the preoperative period. State and Trait anxiety inventory and Beck Depression Inventory was assessed at preoperative period, at discharge and again 4 months after surgery. Preoperative teaching protocol was administered in 3 phased manner (preoperative period, at discharge and at 2 months after surgery) to experimental group.

Results: In Control group 80 % had mild anxiety at preoperative period, 50% had mild anxiety at discharge and at 4 months after surgery. But in experimental group 90% had mild anxiety at preoperative period which was reduced to 40% at discharge and further reduced to 20% at 4 months after surgery. There was statistically significant difference (P < 0.05) found between anxiety scores at discharge between control group and experimental group. In Control group 20 % had mild mood disturbance at preoperative period, discharge and at 4 months after surgery. But in experimental group 30% had mild mood disturbance at preoperative period which was reduced to 20% at discharge and further reduced to 10% at 4 months after surgery. There was no significant difference found between depression scores in control group and experimental group. There was no significant association found between the between pretest level of anxiety and depression scores of experimental group with selected socio-demographic variables (Age and Duration of illness).

Conclusion: Above study findings reflects the effectiveness of preoperative teaching protocol. Providing perioperative information in a structured manner will help the hysterectomy women to reduce anxiety and depression status after surgery