Effect of Educational Guidelines on Anxiety and Self-Esteem among Women Undergoing Hysterectomy
DOI:
https://doi.org/10.31674/mjn.2026.v18i01.013Abstract
Background: Women undergoing hysterectomy frequently experienced anxiety because they worry about the procedure itself and losing their ability to conceive. Another important factor that is influenced by hysterectomy is self-esteem. When educational guidelines are used well, they can result in superior psychological results, such as decreased anxiety and increased self-esteem. Objectives: To evaluate the effect of educational guidelines on anxiety and self-esteem among women undergoing hysterectomy. Methods: A quasi-experimental research (pre-posttest) was utilized in the study. A purposive sample of 80 women underwent hysterectomy was enrolled. The study conducted at the Women Health Hospital's gynecological department at Assiut University. Three tools were used; a structured interview questionnaire, Zung Self-Rating Anxiety Scale to measure anxiety levels and Rosenberg Self-Esteem Scale to assess self- esteem level. Results: The study findings clarified that the majority (85%) of the studied women experience mild to moderate anxiety, only (30%) had high self-esteem before intervention while after intervention, both anxiety and self-esteem was significantly improved (P < 0.01). Conclusion: Women having hysterectomy saw a considerable and positive improvement in their self-esteem and decreased anxiety when educational guidelines were implemented. For women having a hysterectomy, it is crucial to incorporate educational guidelines into their regular preoperative and postoperative treatment.
Keywords:
Anxiety, Educational Guidelines, Hysterectomy and Self-esteemDownloads
References
Agüero‐Millan, B., Abajas‐Bustillo, R., & Ortego‐Maté, C. (2023). Efficacy of nonpharmacologic interventions in preoperative anxiety: a systematic review of systematic reviews. Journal of Clinical Nursing, 32(17-18), 6229-6242. https://doi.org/10.1111/jocn.16755
Ahmed, A. S., Hafez, A. M. M., Mustafa, M. F., Youness, E. M., & Hassan, M. M. (2023). The Effect of Implementing Evidence Based Practices Guidelines on Women's Knowledge and Practices Regarding Self-Care after Hysterectomy. Minia Scientific Nursing Journal, 13(1), 27-35. https://doi.org/10.21608/msnj.2023.190336.1049
Al-Amer, R., Atout, M., Malak, M. Z., Ayed, A., Othman, W. M., Saleh, M. Y., ... & Randall, S. (2025). Prevalence and predictors of anxiety and stress among Jordanian women following hysterectomy: an observational multicentre study. BMC Psychology, 13(1), 305. https://doi.org/10.1186/s40359-025-02623-1
Ali, F. K., Ramadan, E. A., & Afifi, O. A. W. (2024). Effect of Lamaze Technique on Pain, Anxiety, Sleep Disturbance and Quality of Recovery among Women Undergoing Hysterectomy. Menoufia Nursing Journal, 9(2), 151-176. https://doi.org/10.21608/menj.2024.373380
Alsufyani, F., Katooa, N., Al-Zahrani, A., Felemban, O., Badr, H., & Thabet, H. (2024). The impact of educational sessions on anxiety levels among women undergoing caesarean section: a quasi-experimental study. European Journal of Investigation in Health, Psychology and Education, 14(2), 324-338. https://doi.org/10.3390/ejihpe14020022
Chang, O. , Saldanha, I. , Encalada Soto, D., Jalloul, R. , Rozycki, S., Orlando, M., White, A., Yang, L. , Thompson, J., Nihira, M., Bretschneider, C., Jeppson, P., Balk, E., & Gupta, A. (2025). Associations between hysterectomy and pelvic floor disorders: A systematic review and meta analysis. American Journal of Obstetrics and Gynecology, 233(3), 141–151.e6. https://doi.org/10.1016/j.ajog.2025.03.018
Donati, S., Troìa, L., Alexander, S., Ventura, C. S., Kristufkova, A., Velebil, P., ... & Mahmood, T. (2026). Rising global incidence of Peripartum hysterectomy, how to address this challenge? An invited review by the European Board and College of Obstetrics and Gynaecology (EBCOG). European Journal of Obstetrics & Gynecology and Reproductive Biology, 115232. https://doi.org/10.1016/j.ejogrb.2026.115232
Hassan, H. E., Khalaf Gooda, W., RagabAhmed, T., & Shehta Said Farag, D. (2025). Marital, Sexual Satisfaction and Quality of Life among Post-hysterectomy Women: Impact of Nursing Counseling Guided by BETTER Model. Egyptian Journal of Health Care, 16(1), 99-116. https://doi.org/10.21608/EJHC.2025.402051
Farag, D. S. S., Khalaf Gouda, W., Nabil Malk, R., & Elzeblawy Hassan, H. (2024). Gynecological Nursing Care for women Undergoing Hysterectomy: Effect of an Educational program on Nurses' Knowledge and Practices. Egyptian Journal of Health Care, 15(3), 32-49. https://doi.org/10.21608/EJHC.2024.370388
Ghali, N. A., Al-Amer, R., Abuzied, Y., Aqel, A., Al-Rwashdih, R. W., Saleh, M. Y., ... & Dahmash, E. Z. (2025). Prevalence and predictors of depression in Jordanian women post-hysterectomy: A multi-centre cross-sectional study. Sexual & Reproductive Healthcare, 45, 101113. https://doi.org/10.1016/j.srhc.2025.101113
Ibrahim, W., & Mohammed, H. (2020). Effect of nursing instructional guideline on women’s quality of life after hysterectomy. International Journal of Novel Research in Healthcare and Nursing, 7(2), 439-451. https://www.noveltyjournals.com/upload/paper/paperpdf-1597666438.pdf
Kahlil, E. G. M., Elkhalek, N. K. A., Hanna, E. S. S., & Mohamed, E. L. (2024). Effect of Educational Guidelines about Coping Strategies on Anxiety and Depression among Women Post-Hysterectomy. Egyptian Journal of Health Care, 15(2), 418-433. https://doi.org/10.21608/ejhc.2024.353621.
Kallianidis, A. F., Rijntjes, D., Brobbel, C., Dekkers, O. M., Bloemenkamp, K. W., & Van Den Akker, T. (2023). Incidence, indications, risk factors, and outcomes of emergency peripartum hysterectomy worldwide: a systematic review and meta-analysis. Obstetrics & Gynecology, 141(1), 35-48. https://doi.org/10.1097/AOG.0000000000005022.
Kapesa, H., Manasyan, A., Muttau, N., Sinkey, R. G., Gallos, I., & Tembo, T. (2026). Availability, cost, and budget impact of lifesaving postpartum hemorrhage interventions in public hospitals in Zambia: A cross-sectional survey. International Journal of Gynecology & Obstetrics, 174(1), 353–362. https://doi.org/10.1002/ijgo.70812
Izurieta, M. I. L., Molina, A. A. S., -Barboza, V. V., & Saez-Carrillo, K. L. (2023). Nursing educational intervention in hysterectomized women: a mixed method study protocol. Revista Gaúcha de Enfermagem, 44, e20220177. https://doi.org/10.1590/1983-1447.2023.20220177.en
Meyer, R., McDonnell, J., Hamilton, K. M., Schneyer, R. J., Levin, G., Wright, K. N., & Siedhoff, M. T. (2025). Postoperative outcomes in minimally invasive total versus supracervical hysterectomy for endometriosis: a NSQIP study. Archives of Gynecology and Obstetrics, 311(3), 757-763. https://doi.org/10.1007/s00404-024-07749-y
Mohammed, G. F., Al-Dhubaibi, M. S., AbdElneam, A. I., Bahaj, S. S., & Al-Dhubaibi, A. M. (2025). Exploring female genital self-image: a psychological and sociocultural perspective. Sexual Medicine Reviews, 13(2), 256-266. https://doi.org/10.1093/sxmrev/qeaf006
Mohamed, S. H., Mohammed, R. F., Fahmei, T. B., Ali, N. H. M., Mohamed Awad, M. N. E. M., Elbosaty, L. M., Aldeeb, A. A. A., & Ahmed, M. R. (2022). Effect of social-platform nursing guidelines on emotional status among caregivers caring for elderly women undergoing hysterectomy. International Journal of Health Sciences, 6(S10), 2375–2401. https://sciencescholar.us/journal/index.php/ijhs/article/view/12753
Ojong, S. A., Temmerman, M., Nsahlai, C. J. F., Gidion, D., & Kihara, A. (2026). Why do cesarean delivery rates persistently rise despite evidence-based efforts to reduce them?. American Journal of Obstetrics and Gynecology, 233(6), S569-S580. https://doi.org/10.1016/j.ajog.2025.08.014.
Omar, H. K., Barakat, M. M., & Zeid, E. N. A. (2024). Relation between Body image, Self-esteem and Quality of Life among Women after Hysterectomy. Journal of Nursing Science Benha University, 5(2), 817-832. https://doi.org/10.21608/jnsbu.2024.367874
Rehan, M. K., Qasem, E. A., El Malky, M. E., & Elhomosy, S. M. (2023). Effect of psychological counseling program on quality of life among Post-Hysterectomy women. Menoufia Nursing Journal, 8(1), 81-93. https://doi.org/10.21608/menj.2023.288833.
Rosenberg, M. (1965). Rosenberg self-esteem scale (RSES)[Database record]. Apa Psyc Tests, 10. https://doi.org/10.1037/t01038-000
Sabra, A. I., & Hassan, L. A. A. (2020). Role of perceived social support on self-esteem and aggression among adolescents. Tanta Scientific Nursing Journal, 19(2), 174–191. https://doi.org/10.21608/tsnj.2020.131970
Samraz, Z., Dilshad, A., Dilshad, R., Farooq, A., & Nadeem, A. (2025). psychological impact of early menopause induced by hysterectomy among WOMEN. International Journal of Social Sciences Bulletin, 3(4), 763-773. https://doi.org/10.5281/zenodo.15301352
Shen, Y., Hu, J., Lv, F., Yu, C., Gong, Y., Wang, D., & Zeng, X. (2026). Deep neuromuscular blockade improves surgical conditions during laparoendoscopic single-site (LESS) surgery for total hysterectomy and reduces postoperative pain: a randomized controlled trial. Perioperative Medicine, 15(1), 31. https://doi.org/10.1186/s13741-026-00664-7
Thorn, H., & Uhrenfeldt, L. (2020). The effectiveness of preoperative individual information on reducing anxiety and pain after hysterectomy: A randomized controlled trial. Journal of Nursing Education and Practice, 10(1), 67-74. https://doi:org/10.5430/jnep.v10n1p67
Thomaidi, S., Sarantaki, A., Tzitiridou Chatzopoulou, M., Orovou, E., Jotautis, V., & Papoutsis, D. (2025). The rising global cesarean section rates and their impact on maternal and child health: A scoping review. Journal of Clinical Medicine, 14(22), 8102. https://doi.org/10.3390/jcm14228102
Tomescu-Stachie, S., Merwood, A., Sivyer, K., Caisley, S. N., & Al-Abbadey, M. (2025). The impact of psychosocial interventions on women with gynaecological cancers: a systematic review and meta-analysis. Health Psychology Review, 19(4), 781-819. https://doi.org/10.1080/17437199.2025.2525409
Zung, W. (1971). A rating instrument for anxiety disorders. Psychosomatics, 12(6), 371-379. https://doi.org/10.1016/S0033-3182(71)71479-0
Published
How to Cite
Issue
Section
License
Copyright (c) 2026 The Malaysian Journal of Nursing (MJN)

This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.


































