title: Reasons for middle-aged women in Taiwan to choose hysterectomy: a qualitative study using the bounded rationality perspective.
abstract: OBJECTIVE
  To explore women's perspectives on deciding to undergo hysterectomy for benign conditions based on physicians' recommendations and the women's own judgement.
  
  
  BACKGROUND
  Hysterectomy is the second most common surgical procedure worldwide. Although most hysterectomies are elective, physicians may recommend treatment that involves a loss of sexuality or ovary removal, creating a difficult choice for women.
  
  
  METHODS
  Qualitative, in-depth interview
  
  
  METHODS
  A purposive sample of 17 women was recruited. The women had decided to undergo hysterectomy after the diagnosis of uterine fibroids. All these women had already decided not to have more children. Data were collected by in-depth interviewing, and content analysis was used to analyse the data.
  
  
  RESULTS
  Our study revealed five themes: release from stress, inescapable fate, positive support, hoping for peace of mind and sense of trust.
  
  
  CONCLUSIONS
  The participants felt that mental and physical health were the most important considerations, noting that when women no longer want children, a uterus is useless. The women believed that they retained their womanhood, even without a uterus, and were satisfied with the outcomes of their hysterectomy decisions.
  
  
  CONCLUSIONS
  Our findings might serve as educational and counselling reference materials for healthcare providers, ensuring that women receive appropriate care quality and have their needs met. Healthcare providers can then maximise women's empowerment, deepen their awareness of body image and their concept of self-care and help them to clearly perceive their own concerns and needs so that they can make suitable decisions.
authors.affiliation: Department of Nursing, Chang Gung University of Science and Technology, Tao-Yuan, Taiwan.
authors.forename: Shu-Mei
authors.initials: SM
authors.lastname: Wu
authors.forename: Hui-Ling
authors.initials: HL
authors.lastname: Lee
authors.forename: Mei-Yu
authors.initials: MY
authors.lastname: Yeh
authors.forename: Hui-Lian
authors.initials: HL
authors.lastname: Che
mesh_terms: D000328:Adult; D003657:Decision Making; D005260:Female; D006801:Humans; D007044:Hysterectomy; D007407:Interviews as Topic; D007889:Leiomyoma / Q000451:nursing / Q000601:surgery*; D008875:Middle Aged; D017060:Patient Satisfaction; D013624:Taiwan; D014594:Uterine Neoplasms / Q000451:nursing / Q000601:surgery*
keywords: bounded rationality; decision-making; hysterectomy; nursing; qualitative study