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Objective: To investigate physician-patient communication in the context of hysterectomy decision making., Methods: A series of 17 focus groups with African American and white women (n=82) between the ages of 30 and 65 were run. Personal interviews with physicians (n=7) also were conducted. Transcripts were analyzed using NUD*IST software and note-based techniques., Results: For both patients and physicians, the optimal physician-patient interaction would be for the physician to provide plain, usable information to the patient allowing the patient to make the hysterectomy decision., Conclusions: The current state of physician-patient interaction represents collaboration but not a shared approach approximating the deliberative model.

Explores the perceptions of women on alternative therapies available for managing symptoms related to menopause and to the need for hysterectomy. Discussion of the Ethnicity, Needs and Decisions of Women project; Analysis of the emergent themes by race or surgery experience; List of possible alternatives for managing symptoms.

As part of the Ethnicity, Needs, and Decisions of Women (ENDOW) project, in-depth qualitative interviews and focus groups were conducted at four sites, Alabama, New Mexico, South Carolina, and Texas. In South Carolina and Alabama, African American and white women were interviewed. In Texas, African American, Caucasian, and Hispanic women were interviewed, and in New Mexico, focus groups with Caucasian, Hispanic, and Navajo women were conducted. The Texas site also conducted focus groups with lesbian women. Data were collected on women's experiences with and attitude toward menopause, hysterectomy, and hormone replacement therapy (HRT). Information also was gathered on women's concerns and what experiences they have had or expect to have with healthcare providers and what they perceive their friends', families', and sexual partners' attitudes are toward hysterectomy. Numerous commonalties of experience existed across racial and ethnic groups. Overall, the women who participated believed that doctors do not take the time to explain issues related to menopause, hysterectomy, and HRT. Most of the women who have had a hysterectomy were satisfied with the outcome of surgery, as painful symptoms were relieved. There are also several interesting differences among the groups. Decision-making patterns differed among the ethnic groups, as did experience with healthcare providers. Many women in the focus groups expressed mistrust of or negative opinions of healthcare providers. African Americans expressed mistrust of their motives for recommending surgery, as did several of the Caucasian, non-Hispanic women. Most of the Hispanic participants respected and trusted their providers. All groups said they would seek additional medical opinions if they could afford to do so. [ABSTRACT FROM AUTHOR]

Although hysterectomy is a frequently performed surgical procedure, little is known about how women make decisions regarding hysterectomy. This report details the women's perceptions of male partners' knowledge and attitudes about hysterectomy and the role women expect or allow men to play in their decision-making process. Seventeen focus groups were conducted with a total of 82 African American and Caucasian women aged 30-65 years in two coastal counties of South Carolina. Transcripts were coded and analyzed using the nonnumerical unstructured data indexing searching and theory building (QSR NUD*IST®) software program. Results indicate that women perceive men to be not well informed or knowledgeable about hysterectomy, to be concerned about the quality of sexual relations after hysterectomy, and, in some cases, to be neutral about hysterectomy. African American women reported that men hold more negative perceptions about hysterectomized women. Caucasian women stressed men's inability to understand what a woman is going through and men's concern with the hysterectomy's effect on their own egos. Nonhysterectomized women felt that men would be more bothered by a surgical procedure that left more visible effects (such as mastectomy). These women defined a limited role for men in their decision making regarding hysterectomy, consisting of discussion and offering of support/sympathy, but they reserved the actual decision for themselves. In a few instances, women accorded men a role in the hysterectomy decision based on a religious interpretation of marriage. Intervention programs are recommended that target women and their partners together, using hysterectomized women and their partners as peer educators. [ABSTRACT FROM AUTHOR]

This article presents information on a research study in a national project on decision making about hysterectomy and the use of hormone replacement therapy (HRT). ENDOW is a collaborative project funded by Centers for Disease Control and Prevention. The initial phase of ENDOW used focus group discussions to gain an understanding of women's experiences with and attitudes toward menopause, hysterectomy and HRT. This information was used to develop surveys for all four sites as well as a core questionnaire to which each site added questions that addressed the primary interests and concerns of that site. Focus group research has roots in two distinct disciplines, marketing, in which focus groups were used after World War II by researchers investigating motivation and psychology, in which focus groups stemmed from group therapy. Articles in this issue demonstrate the richness of the data obtained from focus groups and focused individual interviews. In the first article, an overview of issues related to hysterectomy decisions and the use of HRT is presented along with an introduction to the ENDOW project.