A survey of gynecologists' attitudes regarding decision making in the management of non-cancerous conditions that frequently result in hysterectomy.
OBJECTIVE
To explore attitudes of practicing gynecologists regarding making treatment decisions for patients with benign uterine conditions frequently treated with hysterectomy.


METHODS
Mailed survey.


METHODS
66 gynecologists practicing in the Greater Rochester, New York, area.


METHODS
After reading brief vignettes, respondents indicated how they would treat patients with chronic pelvic pain, uterine leiomyomas, and abnormal uterine bleeding, and rated the importance of 24 considerations in making their treatment decisions on a 1-to-5 scale ranging from not important to extremely important.


RESULTS
Fourteen considerations (58%) had group mean importance ratings higher than 3. Exploratory factor analysis identified four factors that accounted for 96% of the variance. Respondent gender, practice type, graduation from a U.S. vs a non-U.S. medical school, and opinion regarding roles of doctor and patient in making treatment decisions were associated with significant differences in factor scores.


CONCLUSIONS
Gynecologists' attitudes toward hysterectomy decisions are complex, multifactorial, and variable. Depending on the extent to which these attitudes affect treatment decisions, differences among gynecologists in their clinical decision making processes could account for a substantial amount of the regional variability in hysterectomy use.
Dolan
J G
JG
Primary Care Institute, Highland Hospital of Rochester, Department of Medicine, New York 14620, USA. James_Dolan@URMC.Rochester.edu
Howard
F M
FM
D000368:Aged; D000704:Analysis of Variance; D001291:Attitude of Health Personnel; D003657:Decision Making; D004522:Educational Status; D005163:Factor Analysis, Statistical; D005260:Female; D006176:Gynecology; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007044:Hysterectomy; D008297:Male; D008875:Middle Aged; D009518:New York; D010358:Patient Participation; D018579:Patient Selection; D010819:Physician's Role; D010820:Physicians / Q000523:psychology*; D012737:Sex Factors; D011795:Surveys and Questionnaires; D014591:Uterine Diseases / Q000175:diagnosis / Q000601:surgery*