Date of Conferral

2023

Degree

Ph.D.

School

Public Health

Advisor

Michael G. Schwab

Abstract

Black women are more likely than women of any other race in the United States to undergo an abdominal hysterectomy instead of a less invasive and less damaging laparoscopic or robotic procedure for benign fibroids. Although Black women are the population most disparately affected by benign fibroids, as evidenced by higher morbidity and mortality rates due to complications, they are often excluded in clinical research. The purpose of this qualitative phenomenological study was to explore the lived experiences of Black women who decided to undergo an invasive abdominal hysterectomy for benign fibroids. Semistructured interviews were conducted with 14 Black women, who were selected via purposeful sampling. The socioecological and health belief models provided a theoretical framework for understanding participants' decision-making. Hand coding and NVivo software were used to analyze the data. The eight emergent themes describe what treatment options participants were given, how much they knew about alternatives, and what influenced their treatment decisions (i.e., the desire to have children, access to social supports, the severity of symptoms, or family history of cancer). The findings illustrate the emotional stress participants experienced before surgery; the lack of knowledge they had about postsurgical effects; and, rarely mentioned in the research, the postsurgical psychosocial impacts they experienced. The study may contribute to positive social change by highlighting the need for (a) education programs targeted to Black women about minimally invasive treatment options and (b) more research about the use of counseling to improve the psychosocial impacts for women who had an abdominal hysterectomy.

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