Histerektomi ameliyatı olan kadınlara ameliyat öncesi ve sonrası verilen danışmanlık hizmetinin yaşam kalitesi ve cinsel sorunlara etkisi
The effect of preoperative and postoperative counselling for patients undergoing hysterectomy on quality of life and sexual problems
Yazar: MELAHAT SAYLAM
Danışman: Y.DOÇ.DR. FÜSUN TERZİOĞLU
Hacettepe Üniversitesi / Sağlık Bilimleri Enstitüsü / Doğum ve Kadın Hastalıkları Hemşireliği Ana Bilim Dalı
Derece: Yüksek Lisans, 2005
Konu: Hemşirelik = Nursing

Özet:
ÖZETSAYLAM M., Histerektomi Ameliyatı Olan Hastalara Ameliyat Öncesi Ve Sonrası verilenDanışmanlık Hizmetinin Yaşam Kalitesi Ve Cinsel Sorunlara Etkisi, Hacettepe ÜniversitesiSağlık Bilimleri Enstitüsü Kadın Sağlığı ve Hastalıkları Hemşireliği Programı, DoktoraTezi, Ankara 2005. Araştırma histerektomi ameliyatı yapılan hastalara ameliyat öncesi vesonrası verilen danışmanlık hizmetinin yaşam kalitesi ve cinsel sorunlara etkisini saptamakamacıyla tanımlayıcı ve analitik olarak yapılmıştır. Araştırmanın evrenini 1 yıl içinde HacettepeErişkin Hastanesi Jinekoloji Servisinde benign nedenlerle histerektomi ameliyatı olan hastalaroluşturmuştur. Araştırmaya alınan 60 hastanın 30'u kontrol grubu, 30'u ise deney grubu olarakörneklem kapsamına alınmıştır. Veriler, ameliyat öncesi veri formu, SF-36 yaşam kalitesi ölçeğive cinsel öykü formu kullanılarak toplanmıştır. Kontrol grubundaki hastalar normal tedavisürecine bırakılmış ve toplam 3 kez görüşme yapılmıştır. Deney grubundaki hastalara isearaştırmacı tarafından ameliyat öncesi yatış için geldikleri günden başlanarakplanlı danışmanlıkhizmeti verilmiş ve 6-8 kez görüşme yapılmıştır. Deney ve kontrol grubundaki hastalarahisterektomi ameliyatından 7,5 ay sonra ikinci rutin kontrole geldikleri gün SF-36 yaşam kalitesiölçeği ve cinsel öykü formu tekrar uygulanmıştır. Verilerin analizinde sayı, yüzdelik, Mann-Whitney U testi, Wilcoxon eşleştirilmiş iki örnek testi ve ki kare önemlilik testleri kullanılmıştır.Araştırmanın sonucunda deney grubundaki hastaların ameliyat sonrası tüm yaşam kalitepuanlarının kontrol grubuna göre daha yüksek olduğu belirlenmiştir. Deneygrubundaki hastalarınameliyat sonrası fonksiyonel durum ( X :83.16), esenlik ( X :56.10), ve global yaşam kalitesi( X :66.66) ortalama puanlarının ameliyat öncesine göre yükseldiği saptanmıştır (p<0.05).Kontrol grubundaki hastaların ise; ameliyat sonrası fonksiyonel durum ( X :55.10) ve globalyaşam kalitesi ( X :48.33) ortalama puanlarının ameliyat öncesine göre yükseldiği, (p<0.05)fakat esenlik ( X :46.10) ve genel sağlık anlayışı ( X :24.33) ortalama puanlarının ise düştüğü(p>0.05) belirlenmiştir. Deney (%73.3) ve kontrol (%66.7) grubundaki hastaların yarısındanfazlası ameliyat öncesi cinsellikle ilgili herhangi bir problem yaşamadıklarını ifade etmişlerdir.Ameliyat öncesi cinsel problem yaşadığını belirten hastaların ameliyat sonrası da cinselsorunlarının devam ettiği saptanmıştır.Cinsellikle ilgili araştırmacı tarafından verilen danışmanlık hizmetinin cinsel problemlerinçözümünde yeterli olmadığı belirlenmiştir.Araştırmadan elde edilen sonuçlar doğrultusundahisterektomi ameliyatından önce bu araştırma kapsamında geliştirilen ?danışmanlık hizmetmodelinin? uygulamaya konulması, cinsellikle ilgili konularda uzman bir hemşirenin ameliyatöncesi ve sonrası danışmanlığı sürdürmesi önerilerinde bulunulmuştur.vAnahtar Kelimeler: Histerektomi, Yaşam Kalitesi, Cinsellik, Hemşirelik, DanışmanlıkABSTRACTSAYLAM M., The Effect of Preoperative and Postoperative Counselling for PatientsUndergoing Hysterectomy on Quality of Life and Sexual Problems, Hacettepe UniversityInstitute of Health Sciences Obstetrics and Gynecology Nursing Program, DoctorateThesis, Ankara 2005. The study was performed on a descriptive and analytical basis in order todetermine the effect of preoperative and postoperative counselling for Patients UndergoingHysterectomy on quality of life and sexual problems. The universe of the study is composed ofpatients undergoing hysterectomy due to benign causes during 1 year in Hacettepe UniversityHospital Gynecology Ward. Among 60 patients involved in the study, 30 were sampled as thecontrol group, whereas another 30 formed the study group. The data were obtained by usingPreoperative Data Form, SF-36 Life Quality Scale and Sexual History Form. The patients in thecontrol group were followed through the routine treatment process and interviewed 3 timestotally. The patients in the study group underwent a planned counselling program provided bythe researcher starting from the day of admission preoperatively and were interviewed 6-8times. SF-36 Life Quality Scale and Sexual History Form were reapplied to patients in bothgroups during their second routine control visit at 7.5 months following the surgery. Number,Percentage, Mann-Whitney U Test, Wilcoxon Matched Double Sample Test and Chi SquareSignificance Tests were used for the analysis of the data. At the end of the study it wasdetermined that all of the postoperative life quality points of the patients in the study groupwere higher when compared to the control group. It was also determined that average points forpostoperative function status (Ï:83,16), soundness (Ï:56,10) and global life quality increased inthe study group when compared to the preoperative state. Whereas, for the patients in thecontrol group , average points for post operative functional status (Ï:55,10) and global lifequality (Ï:48,33) increased (p<0,05) but those for soundness (Ï:46,10) and overall healthperception (Ï:24,33) decreased (p>0,05). More than half of the patients in both groups(study:73,3%; control:66,7%)declared that they had no preoperative sexual problems. It wasdetermined that sexual problems of the patients, who had declared to have sexual problems,continued postoperatively. It was also determined that sexual counselling provided by theresearcher was not sufficient in resolving sexual problems.According to the results obtainedfrom the study, It was suggested that before hysterectomy the ?counselling model? which hasbeen developed through the study program has to be put into practice and a specialized nurseupon sexual issues has to mantain pre and postoperative counselling.Key Words: Hysterectomy, Quality of Life, Sexuality, Nursing, Counsellingvi

Abstract:
Anahtar Kelimeler: Histerektomi, Yaşam Kalitesi, Cinsellik, Hemşirelik, DanışmanlıkABSTRACTSAYLAM M., The Effect of Preoperative and Postoperative Counselling for PatientsUndergoing Hysterectomy on Quality of Life and Sexual Problems, Hacettepe UniversityInstitute of Health Sciences Obstetrics and Gynecology Nursing Program, DoctorateThesis, Ankara 2005. The study was performed on a descriptive and analytical basis in order todetermine the effect of preoperative and postoperative counselling for Patients UndergoingHysterectomy on quality of life and sexual problems. The universe of the study is composed ofpatients undergoing hysterectomy due to benign causes during 1 year in Hacettepe UniversityHospital Gynecology Ward. Among 60 patients involved in the study, 30 were sampled as thecontrol group, whereas another 30 formed the study group. The data were obtained by usingPreoperative Data Form, SF-36 Life Quality Scale and Sexual History Form. The patients in thecontrol group were followed through the routine treatment process and interviewed 3 timestotally. The patients in the study group underwent a planned counselling program provided bythe researcher starting from the day of admission preoperatively and were interviewed 6-8times. SF-36 Life Quality Scale and Sexual History Form were reapplied to patients in bothgroups during their second routine control visit at 7.5 months following the surgery. Number,Percentage, Mann-Whitney U Test, Wilcoxon Matched Double Sample Test and Chi SquareSignificance Tests were used for the analysis of the data. At the end of the study it wasdetermined that all of the postoperative life quality points of the patients in the study groupwere higher when compared to the control group. It was also determined that average points forpostoperative function status (Ï:83,16), soundness (Ï:56,10) and global life quality increased inthe study group when compared to the preoperative state. Whereas, for the patients in thecontrol group , average points for post operative functional status (Ï:55,10) and global lifequality (Ï:48,33) increased (p<0,05) but those for soundness (Ï:46,10) and overall healthperception (Ï:24,33) decreased (p>0,05). More than half of the patients in both groups(study:73,3%; control:66,7%)declared that they had no preoperative sexual problems. It wasdetermined that sexual problems of the patients, who had declared to have sexual problems,continued postoperatively. It was also determined that sexual counselling provided by theresearcher was not sufficient in resolving sexual problems.According to the results obtainedfrom the study, It was suggested that before hysterectomy the ?counselling model? which hasbeen developed through the study program has to be put into practice and a specialized nurseupon sexual issues has to mantain pre and postoperative counselling.Key Words: Hysterectomy, Quality of Life, Sexuality, Nursing, Counsellingvi