Factors Affecting Stress, Anxiety, Depression and Low Self-Esteem among Post-Hysterectomy Women

Background: Literature suggests that women with a hysterectomy suffer from many psychological and emotional problems that may have a significant impact on their mental well-being. In Pakistan, many ailments in females, both physical and mental, particularly those related to reproductive health, often go neglected due to various cultural and societal taboos attached with their reporting. It is therefore crucial to identify the factors contributing to their development in the first place. Objective: To determine the prevalence and associated factors of stress, anxiety, depression, and low self-esteem among post-hysterectomy women. Methods: A cross-sectional study was conducted at Baqai Institute of Health Sciences, Baqai Medical University, from October 2022 to March 2024. Women who had undergone a hysterectomy at least 3 months prior to the study were included in the study, using a non-probability consecutive sample technique. Data were collected by means of a questionnaire comprising the Depression Anxiety and Stress Scale-21 scale for assessing depression, anxiety, and stress; and the Rosenberg Self-Esteem scale to assess self-esteem. Data were analyzed using the Statistical Package for the Social Sciences (SPSS) version 20, and inferential analysis was performed using the multiple linear regression method. Results: A total of 601 women were included in the study. The mean age of the patients was 46.41±11.1 years, 480 (79.9%) of them were married, the mean number of children in the family was 4.0±1.3, 254 (42.3%), 414 (68.9%) of them lived in an extended family, 353 (58.7%) lived in a rented house whereas their mean duration since surgery was 2.6±1.5 years. The results showed that 25 (4.2%) of the patients had severe stress, 320 (53.2%) had extremely severe anxiety, whereas 47 (7.5%) had extremely severe depression. Multiple linear regression analysis revealed that patients’ age, number of children in family, education level, and type of residence were significant predictors of all of their stress, anxiety, and depression, as well as of their self-esteem. Conclusion: Many patient characteristics were significant predictors of their stress, anxiety, and depression levels as well as of their self-esteem score. It is therefore critical to consider these factors while treating post-hysterectomy women for any mental illness.