Change Pattern and Influencing Variables of Self Image in Women after Hysterectomy: A Longitudinal Study

Friday, 3 August 2012: 8:50 AM

Ya-Ling Yang, RN, PhD
School of Nursing, National Taiwan University, Taipei, Taiwan

Learning Objective 1: understand the change pattern among the three aspects of the Self Image Scale was different. Feminine self is the less had been affected after hysterectomy.

Learning Objective 2: understand that a woman’s attitudes toward her uterus is more significantly influencing factor of the self image changing than other variables in hysterectomized woman.


This study aimed to explore the change pattern and influencing variables of self image over time in women with hysterectomy.


This was a concurrent prospective longitudinal study with four follow-up times. A total of 115 participants with benign gynecologic condition and scheduled surgery completed the required measurements. The instrument is the 13-item Self Image scale-Chinese version (SIS-C), a validated questionnaire with three-factor dimensions, was developed for this study. Higher scores indicated better perception of self image. The data were collected at 1 week, 1 month, 3 months, and 6 months after surgery in a medical center in the northern Taiwan. Marginal linear regression models using the generalized estimating equations method was applied to analyze the repeated measures data for estimating the effects of influencing variables on the change of self image over time after hysterectomy.


Some participants received laparoscopic hysterectomy (n = 59), whereas the others received abdominal hysterectomy (n = 56). There was no significant difference in the demographic and clinical characteristics between those two treatment groups before surgery. The mean age of all participant was 43.9 years. Most of them recognized uterus as an important symbol of femininity and as a functioning organ in childbearing. The mean total scores of SIS-C was significantly improved over time after hysterectomy. The change patterns of the three factor scores derived from the SIS-C over time were different. The surgical method only affected factor 1 (the reconfiguring of body image) of the SIS-C. The woman’s attitudes toward her uterus were crucial to affect the three dimensions of the SIS-C after hysterectomy.


Hysterectomy affected women’s self image. The major influencing variable was their attitudes toward the  uteri. This result was vital for the preoperative assessing and the postoperative counseling about the adjustment of self image in women contemplating hysterectomy.