Negative attitudes and affect do not predict elective hysterectomy: a prospective analysis from the Study of XXXX 's Health Across the Nation.

@entity1 @entity308 @entity548 @entity1109 @entity148
OBJECTIVE: Cross-sectional studies suggest an association between hysterectomy and negative affect. Using prospective data, we examined the associations of negative affect, attitudes toward aging and menopause, @entity1109 , and vasomotor symptoms with elective hysterectomy in midlife. METHODS: Data were from the Study of @entity1 's Health Across the Nation, a multisite, community-based prospective cohort study of the menopausal transition (n = 2,818). Annually reported hysterectomy at visits 2 to 9 was verified with medical records when available (71%). @entity148 , perceived stress, @entity308 , attitudes toward aging and menopause, vasomotor symptoms, and @entity1109 were assessed at baseline using standardized questions. Cox proportional hazards models were used to relate these variables to subsequent elective hysterectomy. Covariates included demographic variables, @entity548 , body mass index, hormone levels, and self-rated health, also assessed at baseline. RESULTS: Elective hysterectomy was reported by 6% (n = 168) of @entity1 over an 8-year period. @entity1 with hysterectomy were not higher in negative affect or negative attitudes toward aging and menopause compared with @entity1 without hysterectomy. Vasomotor symptoms (hazard ratio [HR], 1.44; 95% CI, 1.03-2.01; P = 0.03) and positive attitudes toward aging and menopause (HR, 1.74; 95% CI, 1.04-2.93) at baseline predicted hysterectomy over the 8-year period, controlling for @entity548 , site, race/ethnicity, follicle-stimulating hormone, age, education, body mass index, and self-rated health. @entity548 at baseline were the strongest predictor of hysterectomy (HR, 4.30; 95% CI, 2.05-9.05). CONCLUSIONS: In this prospective examination, negative affect and attitudes were not associated with subsequent hysterectomy. @entity548 were the major determinant of elective hysterectomy.
