JOURNAL OF WOMEN’S HEALTH & GENDER-BASED MEDICINE Volume 9, Supplement 2, 2000 Mary Ann Liebert, Inc. Decision Making, Beliefs, and Attitudes toward Hysterectomy: A Focus Group Study with Medically Underserved Women in Texas JANET Y. GROFF, M.D., Ph.D., 1 PATRICIA DOLAN MULLEN, Dr.P.H., 2 THERESA BYRD, R.N., Dr.P.H., 2 A.J. SHELTON, Ph.D., 2 EMILY LEES, Ph.D., 3 and JEANETTE GOODE, M.P.H. 2 ABSTRACT Variations in hysterectomy rates have been associated with assorted physician and patient characteristics, and the disproportionate rate of hysterectomies in African American women has been attributed to a higher prevalence of leiomyomas. The role of women’s beliefs and attitudes toward hysterectomy and participation in decision making for medical treatment has not been explored as a source of variance. The purposes of this qualitative study were to explore these constructs in a triethnic sample of women to understand beliefs, attitudes, and decision-making preferences among underserved women; to facilitate development of a quan- titative survey; and to inform development of interventions to assist women with such med- ical decisions. Twenty-three focus groups were conducted with 148 women from community sites and public health clinics. Thirteen self-identified lesbians participated in three groups. Analysis of audiotaped transcripts yielded four main themes: perceived outcomes of hys- terectomy, perceived views of men/partners, opinions about healthcare providers, decision- making process. Across groups, the women expressed similar expectations from hysterectomy, differing only in the degree to which dimensions were emphasized. The women thought men perceived women with hysterectomy as less desirable for reasons unrelated to childbearing. Attitudes toward physicians were negative except among Hispanic women. All women ex- pressed a strong desire to be involved in elective treatment decisions and would discuss their choice with important others. Implications for intervention development include enhancing women’s skills and confidence to evaluate treatment options and to interact with physi- cians around treatment choices and creation of portable educational components for impor- tant others. S-39 INTRODUCTION W OMEN, PHYSICIANS , AND POLICYMAKERS have voiced concern over the high rates of hys- terectomy in the United States, 1,2 This concern is accentuated by two factors: most hysterectomies are not performed for life-threatening condi- tions, 3,4 and elective hysterectomy is a high dis- cretion procedure. Although the incidence of hys- terectomy has declined steadily over the past The University of Texas-Houston Health Science Center 1 Medical School, 2 School of Public Health, and 3 Center on Aging, Houston, Texas. This work was funded by CDC grant U48/CCU609653-04 SIP25W.