title: The integration of a woman's perspective in hysterectomy decisions.
abstract: It has been argued, based on a limited amount of research data, that patient participation in decision-making regarding surgery, results not only in more patient satisfaction, but also in better surgery outcomes. Especially in a procedure such as hysterectomy, with far-reaching consequences and many potential side effects, it may therefore be relevant to promote an active role of the patient in the decision-making process. The article identifies contextual elements that might promote this active role. Subsequently a model of participative, informed decision-making is outlined. The model entails that clinical guidelines should be adjusted to the particular situation at hand and that patients should be fully informed about hysterectomy-involved risks. An overview of the various guidelines and risks is provided. Proper counseling in the decision-making phase as well as in the post-hysterectomy period is advocated. Throughout the article attention is paid to documented and undocumented ethnic differences regarding various aspects of hysterectomy, particularly differences in patient participation around the world.
authors.affiliation: Leiden University Medical Center, The Netherlands.
authors.forename: Rianne
authors.initials: R
authors.lastname: De Gelder
authors.forename: Annemiek
authors.initials: A
authors.lastname: Richters
authors.forename: Lex
authors.initials: L
authors.lastname: Peters
mesh_terms: D001294:Attitude to Health; D003469:Culture; D003657:Decision Making; D005260:Female; D017408:Guidelines as Topic; D006801:Humans; D007044:Hysterectomy / Q000523:psychology*; D010819:Physician's Role; D010817:Physician-Patient Relations; D011184:Postoperative Period; D012307:Risk Factors; D012725:Sexual Behavior