Generic placeholder image

Current Women`s Health Reviews

Author(s): Minoo Ranjbar, Shirin Hasanpour*, Mojgan Mirghafourvand, Vahideh Rahmani and Soheila Bani

DOI: 10.2174/1573404820666230816141144

DownloadDownload PDF Flyer Cite As
A Comparison of Self-esteem, Body Image, and Depression in Hysterectomized and Non-hysterectomized Iranian Women: A Comparative Cross-sectional Study

Article ID: e160823219842 Pages: 8

  • * (Excluding Mailing and Handling)

Explore Articles
About Journal
For Authors
For Editors
For Reviewers

Abstract

Background: Hysterectomy is one of the factors that may affect women's body image and self-esteem and lead to serious psychological complications.

Objective: The study aimed to compare self-esteem, body image, and depression in hysterectomized and non-hysterectomized Iranian women.

Methods: In this cross-sectional comparative study, 140 women of the reproductive age, who have undergone hysterectomy with benign causes, were compared in terms of self-esteem, body image, and depression with 140 women receiving medical treatment due to abnormal bleeding in educational and medical centers in Tabriz, Iran. Sampling was conducted by convenience method. Self-esteem was assessed with the Rosenberg self-esteem questionnaire, body image was assessed with the multidimensional body-self relations questionnaire, and depression was assessed with the Beck II depression inventory. Data were analyzed by Pearson correlation test, independent t-test, chi-square test, and general linear model.

Results: The mean (standard deviation) of the body image in hysterectomized and nonhysterectomized women was 235.3 (28.5) and 250.1 (23.4) out of an achievable score of 69-395, respectively. The mean (standard deviation) self-esteem score for hysterectomized women was 20.4 (4.8) and it was 24.2 (3.4) in non-hysterectomized women (out of an achievable score of 0-30). The mean (standard deviation) depression score was 18.1 (9.7) and 5.5 (4.6) out of 0-63 in hysterectomized and non-hysterectomized women, respectively. The differences in self-esteem, body image, and depression variables were statistically significant in hysterectomized and non-hysterectomized women, respectively (P<0.001).

Conclusion: According to the results of the present study, the body image and self-esteem in hysterectomized women were low compared to non-hysterectomized women, while the level of depression was high, and this difference was statistically significant.

Keywords: Self-esteem, body image, depression, hysterectomy, women, reproductive system.

Graphical Abstract

[1]
Roch, J.A.; Jones, H.W. Tlindesoperatire Gynecology, (9th ed); Lippincott Williams & Wilkins: Philadelphia, 2015.
[2]
Merrill, R.M. Hysterectomy surveillance in the united states, 1997 through 2005. Med. Sci. Monit., 2008, 14(1), CR24-CR31.
[PMID: 18160941]
[3]
Saeidi, M.; Shamsalizadeh, N.; Yousefi, F. The effectiveness of cognitive behavior therapy on sexual dysfunction after hysterectomy in women referred to Besat hospital in Sanandaj. Shenakht J Psychol Psychiatry, 2017, 3(4), 39-47.
[4]
Farquhar, C.M.; Steiner, C.A. Hysterectomy rates in the United States 1990-1997. Obstet. Gynecol., 2002, 99(2), 229-234.
[PMID: 11814502]
[5]
Ahmadvand, A; Jamshidi, H. World Health Report 2002. Tehran: Avecinna Cultural Institute, 2002.
[6]
Banu, N.S.; Manyonda, I.T. Alternative medical and surgical options to hysterectomy. Best Pract. Res. Clin. Obstet. Gynaecol., 2005, 19(3), 431-449.
[http://dx.doi.org/10.1016/j.bpobgyn.2005.01.006] [PMID: 15985257]
[7]
Jelovsek, J.E.; Barber, M.D. Women seeking treatment for advanced pelvic organ prolapse have decreased body image and quality of life. Am. J. Obstet. Gynecol., 2006, 194(5), 1455-1461.
[http://dx.doi.org/10.1016/j.ajog.2006.01.060] [PMID: 16647928]
[8]
Wang, F.; Li, C-B.; Li, S.; Li, Q. Integrated interventions for improving negative emotions and stress reactions of young women receiving total hysterectomy. Int. J. Clin. Exp. Med., 2014, 7(1), 331-336.
[PMID: 24482729]
[9]
Cigdem, G.; Nuran, K. The relationship between self-esteem and self-care agency in hysterectomy patients. J Nurs Midwif Res, 2013, 2(7), 89-95.
[10]
Prütz, F; Knopf, H. [Prevalence of hysterectomy in women 18 to 79 years old: Results of the german health interview and examination survey for adults (DEGS1)]. Federal Health Sheet, 2013, 56(5-6), 716-22.
[http://dx.doi.org/10.1007/s00103-012-1660-7] [PMID: 23703490]
[11]
Alizadeh, T.; Farahani, M.N.; Shahraray, M.; Alizadegan, S. The relationship between self esteem and locus of control with infertility related stress of no related infertile men and women. J. Reprod. Infertil., 2005, 6(2)
[12]
Alipour, A. Effect of cognitive behavioral therapy in hastening recovery of women after hysterectomy surgery. Int J Behavioral Sci, 2010, 4(2), 91-95.
[13]
Anderson, B.; Lutgendorf, S. Quality of life as an outcome measure in gynecologic malignancies. Curr. Opin. Obstet. Gynecol., 2000, 12(1), 21-26.
[http://dx.doi.org/10.1097/00001703-200002000-00004] [PMID: 10752512]
[14]
Doğum, T.L.; Hemşireliği, K.S. System offset printing; , 2000. Available from: https://www.sistemofset.com.tr/
[15]
García, J.A.; y Olmos, F.C.; Matheu, M.L.; Carreñٌo, TP. Self esteem levels vs global scores on the Rosenberg self-esteem scale. Heliyon, 2019, 5(3), e01378.
[http://dx.doi.org/10.1016/j.heliyon.2019.e01378] [PMID: 30963120]
[16]
Jomeen, J.; Martin, C.R. Self-esteem and mental health during early pregnancy. Clin. Eff. Nurs., 2005, 9(1-2), 92-95.
[http://dx.doi.org/10.1016/j.cein.2004.09.001]
[17]
Grogan, S. Body image and health: Contemporary perspectives. J. Health Psychol., 2006, 11(4), 523-530.
[http://dx.doi.org/10.1177/1359105306065013] [PMID: 16769732]
[18]
Kamysheva, E.; Skouteris, H.; Wertheim, E.H.; Paxton, S.J.; Milgrom, J. Examination of a multi-factorial model of body-related experiences during pregnancy: The relationships among physical symptoms, sleep quality, depression, self-esteem, and negative body attitudes. Body Image, 2008, 5(2), 152-163.
[http://dx.doi.org/10.1016/j.bodyim.2007.12.005] [PMID: 18463009]
[19]
Moradi, A. Effectiveness of self-esteem, self-efficacy, and achievement motivation group trainings on self-esteem of physically disabled females. Psychol Except Individ, 2012, 2(5), 65-98.
[20]
Anisi, J.; Salimi, H.; Mirzamani, M.; Reisi, F.; Niknam, M. A survey study on behavioral problems in adolescence. J Res Behavioral Sci, 2007, 1(2), 163-170.
[21]
Beck, A.T.; Brown, G.K.; Steer, R.A.; Kuyken, W.; Grisham, J. Psychometric properties of the beck self-esteem scales. Behav. Res. Ther., 2001, 39(1), 115-124.
[http://dx.doi.org/10.1016/S0005-7967(00)00028-0] [PMID: 11125720]
[22]
Garrusi, B.; Shoraka, H.; Amirkafi, A. Review of body image and some of contributing factors in Iranian population. Int. J. Prev. Med., 2019, 10(1), 19.
[http://dx.doi.org/10.4103/ijpvm.IJPVM_293_18] [PMID: 30820306]
[23]
Bell, L.; Rushforth, J. Overcoming body image disturbance: A programme for people with eating disorders; Routledge: London, 2008, p. 160.
[http://dx.doi.org/10.4324/9780203931998]
[24]
David, D.E. Te Linde’s operative gynecology. JAMA, 1992, 267(21), 2961.
[http://dx.doi.org/10.1001/jama.1992.03480210123049]
[25]
Aquil, A.E.L.; Kherchi, O.E.L.; Azmaoui, N. Body image dissatisfaction and lower self-esteem as major predictors of poor sleep quality in gynecological cancer patients after surgery: Cross-sectional study. BMC Womens Health, 2021, 21(1), 229.
[http://dx.doi.org/10.1186/s12905-021-01375-5] [PMID: 34082733]
[26]
Mohamadnezhad, G.; Tadayon Najafabadi, M.; Komeilisani, H.; Haghighizadeh, M. Effect of counseling based on cognitive behavioral approach on self-esteem of hysterectomized women of reproductive ages. J. Mazandaran Univ. Med. Sci., 2019, 29(171), 67-80.
[27]
Yaman, Ş.; Ayaz, S. The effect of education given before surgery on self-esteem and body image in women undergoing hysterectomy. J Turk Soci Obstet Gynecol, 2015, 12(4), 211-214.
[http://dx.doi.org/10.4274/tjod.95770] [PMID: 28913071]
[28]
Supple, A.J.; Su, J.; Plunkett, S.W.; Peterson, G.W.; Bush, K.R. Factor structure of the Rosenberg self-esteem scale. J. Cross Cult. Psychol., 2013, 44(5), 748-764.
[http://dx.doi.org/10.1177/0022022112468942]
[29]
Mäkikangas, A; Kinnunen, U; Feldt, T. Self-esteem, dispositional optimism, and health: Evidence from cross-lagged data on employees. J. Res. Pers., 2004, 38(6), 556-575.
[http://dx.doi.org/10.1016/j.jrp.2004.02.001]
[30]
Rajabi, G.; Karjo, K.S. A study of confirmatory structure two-factor model of the persian version rosenberg self-esteem scale. Psychol Methods Models, 2012, 2(6), 33-43.
[31]
Cash, T.F. Multidimensional body-self relations questionnaire (MBSRQ); Author: Norfolk, VA, 2000.
[32]
Rahati, A. Evolutionary study of body image and its relationship with self-esteem based on comparison between adolescent, middle age and old people; Shahed University: Tehran, 2004, p. 34.
[33]
Beck, A.T.; Steer, R.A.; Brown, G.K. Beck depression inventory; , 1996. Available from: https://www.ismanet.org/doctoryourspirit/pdfs/Beck-Depression-Inventory-BDI.pdf
[34]
Rajabi, G.; Karjo, K.S. Psychometric properties of a Persian-language version of the beck depression inventory, 2nd ed; BDI-II-Persian, 2013.
[35]
Pinar, G.; Okdem, S.; Dogan, N.; Buyukgonenc, L.; Ayhan, A. The effects of hysterectomy on body image, self-esteem, and marital adjustment in Turkish women with gynecologic cancer. Clin. J. Oncol. Nurs., 2012, 16(3), E99-E104.
[http://dx.doi.org/10.1188/12.CJON.E99-E104] [PMID: 22641334]
[36]
Cohen, SM; Hollingsworth, AO; Rubin, M; Graff, BM; Thomas, JS; Welz, HK Psychosocial adaptation during recovery from hysterectomy. WebmedCentral Obstet Gynecol, 2011, 2(3), WMC001660.
[37]
Garry, R.; Fountain, J.; Brown, J. EVALUATE hysterectomy trial: A multicentre randomised trial comparing abdominal, vaginal and laparoscopic methods of hysterectomy. Health Technol. Assess., 2004, 8(26), 1-154.
[http://dx.doi.org/10.3310/hta8260] [PMID: 15215018]
[38]
Roussis, N.P.; Waltrous, L.; Kerr, A.; Robertazzi, R.; Cabbad, M.F. Sexual response in the patient after hysterectomy: Total abdominal versus supracervical versus vaginal procedure. Am. J. Obstet. Gynecol., 2004, 190(5), 1427-1428.
[http://dx.doi.org/10.1016/j.ajog.2004.01.074] [PMID: 15167858]
[39]
Schِönefuss, G; Hawighorst-Knapstein, S; Trautmann, K; Kِönig, Y; Knapstein, PG. Body image in gynecologic patients before and after radical surgery Zentralbl. Gynäkol., 2001, 123(1), 23-26.
[PMID: 11385907]
[40]
Flory, N.; Bissonnette, F.; Binik, Y.M. Psychosocial effects of hysterectomy. J. Psychosom. Res., 2005, 59(3), 117-129.
[http://dx.doi.org/10.1016/j.jpsychores.2005.05.009] [PMID: 16198184]
[41]
Raeisi, L.; Lamieian, M.; Hajizadeh, I. The effect of abdominal hysterectomy on women’s body image. Payesh, 2012, 11(5), 637-642.
[42]
Mohammadi-Zarghan, S.; Ahmadi, K. Marital adjustment, sexual function, and body image after hysterectomy. Shiraz E Med. J., 2021, 22(9)e107565
[http://dx.doi.org/10.5812/semj.107565]
[43]
Helmy, Y.A.; Hassanin, I.M.A.; Elraheem, T.A.; Bedaiwy, A.A.; Peterson, R.S.; Bedaiwy, M.A. Psychiatric morbidity following hysterectomy in Egypt. Int. J. Gynaecol. Obstet., 2008, 102(1), 60-64.
[http://dx.doi.org/10.1016/j.ijgo.2008.02.007] [PMID: 18384791]
[44]
Badakhsh, M; Taftachi, F The effect of hysterectomy in securing sexual desire and satisfaction., 2009.
[45]
Moorman, P.G.; Schildkraut, J.M.; Myers, E.R.; Wang, F. Reported symptoms before and one year after hysterectomy in African American and white women. J. Womens Health, 2011, 20(7), 1035-1042.
[http://dx.doi.org/10.1089/jwh.2010.2543] [PMID: 21671769]
[46]
Kjerulff, K.H.; Langenberg, P.W.; Rhodes, J.C.; Harvey, L.A.; Guzinski, G.M.; Stolley, P.D. Effectiveness of hysterectomy. Obstet. Gynecol., 2000, 95(3), 319-326.
[PMID: 10711536]
[47]
Rannestad, T. Hysterectomy: Effects on quality of life and psychological aspects. Best Pract. Res. Clin. Obstet. Gynaecol., 2005, 19(3), 419-430.
[http://dx.doi.org/10.1016/j.bpobgyn.2005.01.007] [PMID: 15985256]
[48]
Darwish, M.; Atlantis, E.; Mohamed-Taysir, T. Psychological outcomes after hysterectomy for benign conditions: A systematic review and meta-analysis. Eur. J. Obstet. Gynecol. Reprod. Biol., 2014, 174, 5-19.
[http://dx.doi.org/10.1016/j.ejogrb.2013.12.017] [PMID: 24398028]