Patterns of regret and associated factors in the 6 months after hysterectomy: A longitudinal cohort study.
Sangha R, Coleman C, Bossick A, Su W, Kassem Z, and Wegienka G. Patterns of regret and associated factors in the 6 months after hysterectomy: A longitudinal cohort study. J Minimally Invasive Gynecol 2018; 25(7):S57.
J Minimally Invasive Gynecol
Objective: To identify patterns of patient-reported regret after hysterectomy and examine factors associated with the patterns. Design: Prospective cohort study. Settings: Henry Ford Health System (HFHS), tertiary care university-affiliated community health system in Detroit, MI. Patients: Women who had a planned hysterectomy at HFHS for non-cancer reasons, December 2015 to September 2017. Interventions: Observational study of Hysterectomy any route. Measurements/Results: Participants completed questionnaires about their health and decision to have a hysterectomy within 14 days prior to surgery and at 6 weeks and 3, 6 and 12-months post-surgery. Data collection for the 12-month report is ongoing. Latent class analysis was used to classify patients into groups based on their overall regret scores (the Decision-Regret Scale) through 6 months after surgery. Three groups were identified by their patterns of repeated measures of self-reported regret scores after surgery: 1 “quickly achieved and maintained low regret scores”, n = 65 (14.2 %); group 2 “gradual improvement in regret scores”, n = 359 (78.2%); and group 3 “worsening of regret over time”, n = 35 (7.6%). Important differences were found between the groups with respect to the following characteristics: pain, surgery satisfaction, financial toxicity (financial burden due to surgery), insurance type and race. Those women in group 3 tended to have more pain, less satisfaction, worse financial toxicity scores, more public insurance and be African American. Differences were not found between the classes for the following characteristics: route of surgery, length of stay, complications, procedure duration, blood loss, uterine weight, concomitant oophorectomy and indication for surgery. Conclusions: Regret after hysterectomy was not associated with surgical factors such as indication or surgical route, but rather other factors including post-operative pain, financial toxicity and satisfaction.