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PubMed1985

Psychological aspects of female sterilisation--assessment of subsequent regret.

In order to study subsequent regret as a complication of female sterilisation, hospital records of women requesting reversal of their sterilisation were compared with women who had not requested a reversal. Regret was more likely in women sterilised at a younger age, but was not associated with lower parity. Women requesting reversal were interviewed to determine the psychosocial factors likely to produce later regret. The clinical implications are discussed.

Adult↗
PubMed1993

A model of pre-sterilization ambivalence and post-sterilization regret in married couples.

"We have presented a general theoretical perspective on couple decision-making and subsequent adaptation which serves as a framework for understanding the complex phenomenon commonly referred to as post-sterilization regret. We have anchored this framework by means of a series of specific hypotheses about ambivalence and post-sterilization regret among both tubal ligation and vasectomy married couples. Using our hypotheses, we constructed three models. These were tested on data gathered from 400 married couples.... The results, including unanticipated pathways and differences in specific areas of each model between sexes and method groups, not only provide a confirmation of our general theoretical perspective but also allow us to have insights and to speculate about the psychological and marital dynamics of sterilization decision-making and adaptation." Data are from a longitudinal study conducted in Santa Clara, California, in 1985.

Americas↗
PubMedDate not supplied

Sterilization regret in the Dominican Republic: looking for quality-of-care issues.

This report approaches the concept of quality of care by looking at the covariates of sterilization regret in the Dominican Republic according to the results from the 1991 Demographic and Health Survey. The main variables observed are the women's satisfaction with sterilization, their decisionmaking process, sterilization experience, use of family planning, and socioeconomic characteristics. The more detailed measurement and analysis of the outcomes of care point to a need for improvement in the public program effort with regard to sterilization. Substantial proportions of women were sterilized who were younger than 30, who had three or fewer living children, and who had the operation before they had used any other method of contraception. Because a greater proportion of sterilization regret is observed among these groups, women must be enabled to make a free and informed decision about sterilization by means of programs that offer a more balanced choice of methods, as well as better counseling, education, and access to high-quality services.

Adolescent↗
PubMed1994

[Vasectomy: who regrets it and why?].

In order to determine the real percentage of sterilised men who regretted their sterilisation and for which reasons, a retrospective questionnaire survey was conducted in 1990-1991 on 244 men sterilised between 1980 and 1983. Information was also collected from their case records. 7.4% of the sterilised men regretted their decision. Of these, 39% were younger than 30, and 94% had started a relation with another woman. The lower age limit for sterilisation according to the law is 25 years, 37% found this age limit too low and 6% found it too high. We conclude that it should be considered whether the legal lower age limit for sterilisation is too low. It is important to thoroughly inform the patient about problems in sexual relations and alternative methods of contraception before he decides on sterilisation.

Adult↗
PubMed2000

Regret and Responsibility: A Reply to Zeelenberg et al. (1998).

M. Zeelenberg, W. W. van Dijk, and A. S. R. Manstead (1998, Organizational Behavior and Human Decision Processes, 74, 254-272) recently reported an altered replication of our earlier study (T. Connolly, L. D. Ordóñez, & R. Coughlan, 1997, Organizational Behavior and Human Decision Processes, 70, 73-85) concerning the effects of decision agency on regret and outcome evaluation. Our earlier study had found no such effect, but Zeelenberg et al. did. In two new experiments, we have largely confirmed Zeelenberg et al.'s result but have shown that, contrary to most theory, regret (a) can appear even in the absence of decision agency, (b) can be unrelated to outcome evaluations, and (c) may be more influenced by the experience of gains or losses from the status quo than by any decisional responsibility for those changes. Copyright 2000 Academic Press.

Journal Article↗
PubMed2006

Siting and routing assessment for solid waste management under uncertainty using the grey mini-max regret criterion.

Solid waste management (SWM) is at the forefront of environmental concerns in the Lower Rio Grande Valley (LRGV), South Texas. The complexity in SWM drives area decision makers to look for innovative and forward-looking solutions to address various waste management options. In decision analysis, it is not uncommon for decision makers to go by an option that may minimize the maximum regret when some determinant factors are vague, ambiguous, or unclear. This article presents an innovative optimization model using the grey mini-max regret (GMMR) integer programming algorithm to outline an optimal regional coordination of solid waste routing and possible landfill/incinerator construction under an uncertain environment. The LRGV is an ideal location to apply the GMMR model for SWM planning because of its constant urban expansion, dwindling landfill space, and insufficient data availability signifying the planning uncertainty combined with vagueness in decision-making. The results give local decision makers hedged sets of options that consider various forms of systematic and event-based uncertainty. By extending the dimension of decision-making, this may lead to identifying a variety of beneficial solutions with efficient waste routing and facility siting for the time frame of 2005 through 2010 in LRGV. The results show the ability of the GMMR model to open insightful scenario planning that can handle situational and data-driven uncertainty in a way that was previously unavailable. Research findings also indicate that the large capital investment of incineration facilities makes such an option less competitive among municipal options for landfills. It is evident that the investment from a municipal standpoint is out of the question, but possible public-private partnerships may alleviate this obstacle.

Computer Simulation↗
PubMed2006

Regret after sex reassignment surgery in a male-to-female transsexual: a long-term follow-up.

This case report describes a four-decade presentation of a non-homosexual gender dysphoric male patient. The case material was collected from two main sources. One of the authors had weekly therapy sessions with the patient over a period of 2 years almost 15 years after sex reassignment surgery. Information was also gained from the patient's medical records covering the period from the early 1960s to the early 1990s. Over the years, the patient fulfilled the criteria for different diagnoses: overanxious reaction of childhood, fetishism and transvestism during adolescence, and transsexualism during adolescence and early adulthood. The purpose of this report was to shed light on aspects of regret, its manifestation in a male-to-female transsexual with psychiatric co-morbidity, and to show the complexity of the process of adjustment when regret is involved. The present case is an argument for a strict interpretation of the Standards of Care provided by the Harry Benjamin International Gender Dysphoria Association in terms of evaluating patients' mental health, apart from the evaluation of the gender identity disorder, and the patients' subsequent need for treatment interventions.

Adult↗
PubMed1988

Treatment planning using images of regret.

The lack of well-defined criteria for evaluating alternative treatment plans introduces a degree of subjectivity into the planning process. The complexity of conventional isodose charts causes further difficulty in making rapid and reliable evaluations of a plan. An objective method is described, using a prescription file to define the clinician's requirements in terms of the area of each organ which may be treated to predefined tolerance doses. The computer program OSCAR then compares the predicted dose distribution with the prescribed limits, and displays regions of noncompliance as colored "areas of regret." In addition, score functions are used to provide a quantitative measure of the acceptability of dose distributions within the target and each organ at risk. An example is described in which a plan for the treatment of ca esophagus is evaluated using both images of regret and score functions.

Esophageal Neoplasms↗
PubMed1989

The imperative character of medical technology and the meaning of "anticipated decision regret".

Medical-technical possibilities are often experienced as being strongly compelling. This imperative character of medical technology not only applies to the medical profession, but also to patients who frequently find it very difficult to refuse medical examinations or treatments. This article discusses the technological imperative with regard to patients. It attempts to discover relationships with decision theory, particularly concerning "anticipated decision regret." The fact that prevention of regret plays an important role in the use of medical technology is illustrated through a number of examples: liver transplantation, prenatal diagnosis, screening, and in vitro fertilization.

Decision Theory↗
PubMed2004

Reality compared with its alternatives: age differences in judgments of regret and relief.

Three experiments examined developmental change in children's understanding of regret and relief, two second-order emotions whose quality depends on a comparison between reality and "what might have been." In Experiment 1, participants 7 years of age and older, but not 5-year-olds, made regret-related emotion-response judgments that took into account a comparison of reality with its alternatives. In Experiment 2, 5-year-olds judged that an individual would feel better, rather than worse, when a counterfactual outcome was better than what actually occurred (the opposite of the pattern found with older children and adults). Experiment 3 focused on the understanding of relief. In contrast to the findings from Experiment I, the 7-year-olds in Experiment 3 made their judgments solely on the basis of what actually occurred.

Adult↗
PubMed2002

Risk factors for strong regret and subsequent IVF request after having tubal ligation.

OBJECTIVES: To identify and describe pre-sterilisation characteristics most consistently associated with intensive post-sterilisation regret and subsequent request for IVF. DESIGN: Case control study. SETTING: Fertility clinic in a tertiary referral urban hospital, Sydney, Australia. SAMPLE CASES: Ninety-seven sterilised women who underwent evaluation for IVF during the period 1986-1996; CONTROLS: 101 sterilised women who remained satisfied with their tubal ligation. MAIN OUTCOME MEASURES: Variables known at the time of sterilisation including age, number of living children, history of abortion, underlying medical diseases, marital status, race, education, and timing of sterilisation. RESULTS: In the multivariate analysis of data, age at the time of sterilisation had the most pronounced effect on strong regret. Women younger than 30 years old at the time of sterilisation were more likely to request IVF treatment than women 30 to 34 years old. A concurrent caesarean section was associated with a threefold risk (95% CI, 1.05-10.03) relative to an interval procedure. A strong protective effect (OR = 0.07; 95% CI, 0.01-0.65) was found for women with more than two children compared to childless women. The overwhelming reason stated by women requesting IVF was change in marital status, and the desire to have a child with the new partner. CONCLUSIONS: Women with such characteristics who are considering tubal ligation need further caution and counselling.

Adult↗
PubMed1989

Prediction of regrets in postoperative transsexuals.

This study investigated whether heterosexual males are more likely to regret sex reassignment surgery than homosexual males or females. Subjects were 111 postoperative transsexuals who had been surgically reassigned for at least one year, representing a follow-up rate of 84.1%. Subjects' feelings about surgery were assessed with self-administered questionnaires. None of the 61 homosexual females or 36 homosexual males consciously regretted surgery, compared to 4 of the 14 heterosexual males: a significant difference. This finding suggests that heterosexual applicants for sex reassignment should be evaluated with particular caution, although a heterosexual preference is not an absolute contraindication for surgery.

Adaptation, Psychological↗
PubMed2003

Acting on intentions: the role of anticipated regret.

Three studies tested the hypothesis that anticipated regret (AR) increases consistency between exercise intentions and behaviour. Study 1 employed a longitudinal survey design (N = 384). Measures specified by the theory of planned behaviour, past behaviour, and AR were used to predict self-reported exercise behaviour 2 weeks later. AR moderated the intention-behaviour relationship such that participants were most likely to exercise if they both intended to exercise and anticipated regret if they failed to exercise. Study 2 used an experimental design to examine the effect of focusing on AR prior to reporting intentions (N = 229). Exercise was measured 2 weeks later and the AR-focus manipulation was found to moderate the intention-behaviour relationship in a similar manner to that observed in Study 1. In Study 3 (N = 97), moderation was replicated and was shown to be mediated by the temporal stability of intention.

Adult↗
PubMed2006

Changes in family structure and regret following tubal sterilization.

Tubal sterilization is one of the contraceptive methods whose use has increased the most in Brazil, but a growing number of women have expressed regret after the procedure. A case-control study was conducted at the Centro Integrado de Saúde Amaury de Medeiros (CISAM), Recife, Pernambuco, Brazil, in 1997 to investigate the association between changes in family structure and request for or submittal to surgical reversal of tubal sterilization, comparing 304 sterilized women who had requested or submitted to reversal of tubal sterilization and 304 women who were also sterilized but had not requested, had not submitted to, and who did not wish to submit to reversal. The simple and adjusted odds ratios were estimated using logistic regression. The results of the current study showed that death of children, partners without children prior to the current union, and partner change after tubal sterilization were associated with the request for or submittal to reversal of tubal sterilization. More strict criteria are suggested in the indication of tubal sterilization, including an in-depth profile of the woman requesting tubal sterilization and identification of risk factors for future regret.

Adult↗
PubMed2002

Regret and psychological well-being among voluntarily and involuntarily childless women and mothers.

This study examines regret and psychological well-being among 72 middle-aged and older women who are either voluntarily childless, involuntarily childless, or mothers. Group comparisons indicate that, when compared to involuntarily childless women, voluntarily childless women show higher levels of overall well-being, rate themselves as more autonomous with greater environmental mastery, and are less likely to have a child-related regret. An unexpected finding is that about one-third of women categorized by researchers as involuntarily childless indicate that they are "childless by choice." These women report making an active decision to accept the childless lifestyle and focus on the future, in essence exerting control over their situations. Results from this small and selective sample should be interpreted cautiously. However, they do suggest that researchers' definitions of childlessness may not map directly onto those of participants, and they emphasize the importance of ascertaining respondents' perceptions of control over their situations.

Adaptation, Psychological↗
PubMed2000

[Regret after tubal sterilization].

OBJECTIVE: To examine thoroughly the profile and motivations of a group of women who regretted sterilization so much that they were prepared to undergo reversal microsurgery or in vitro fertilization treatment. MATERIAL: and methods. The study followed one hundred women from their first consultation for a period of 3 years in order to analyze the outcome of their initial decision. RESULTS: Analysis of the circumstances at the time of the sterilization indicate 3 main factors which later caused the women to regret the decision Three years after the initial consultation, 69% of the patients have withdrawn from further investigation and /or treatment for different reasons analyzed in this study. 17 of the patients have undergone reversal microsurgery and 14 have attempted one or more in vitro fertilization treatments. Of these 31 patients, 12 (38.7%) have given birth to at least one child. CONCLUSION: These results sufficiently prove that tubal sterilization is worthy of consideration as much by the patient as by the physician as a method of irreversible contraception despite the developments in tubal microsurgery or in medically assisted procreation.

Abortion, Therapeutic↗
PubMed1986

Presterilization counseling and women's regret about having been sterilized.

A study was designed to assess satisfaction with presterilization counseling, contentment with being sterilized and the effect of variables, such as age, number of children at the time of surgery and ethnic background, on the level of contentment with being sterilized. A total of 1,716 questionnaires were distributed at various hospitals and clinics. Questionnaires were collected from 492 women, who had ranged from 17 to 46 years of age at the time of sterilization. The majority of the women were married, and their average number of children was two. Of 487 women who replied, 30% did not receive any presterilization counseling from a physician; 15% of 480 women received their counseling from a nurse. Of 487 women, 2% fully regretted their sterilization, and the majority of them wanted more children. A positive correlation was found between the degree of satisfaction with presterilization counseling and the level of contentment with being sterilized. It was also found that 6 of the 53 women who were under 25 years of age at the time of surgery fully regretted their sterilization. The ethnic backgrounds of the women and their number of children at the time of surgery had no significant effect on their contentment with sterilization.

Adaptation, Psychological↗
PubMed1994

Burnout and career-choice regret among family practice physicians in early practice.

OBJECTIVE: Burnout and career-choice regret among physicians in early practice may contribute to physician impairment and attrition as well as patient dissatisfaction. METHOD: Fifty residency-trained family physicians in early practice completed the Maslach Burnout Inventory and a questionnaire on career-choice, demographics, and practice characteristics. RESULTS: The sample showed moderate burnout related to emotional exhaustion and depersonalization of patients but low burnout related to lack of personal accomplishment. Although only 52% reported that they would definitely choose a medical career again, 70% reported that they would definitely choose the specialty of family practice again. At the 0.01 level of significance, those who worked more hours were more emotionally exhausted, and those with children and those with more children under the age of 5 reported less depersonalization. CONCLUSIONS: This sample of physicians in early practice reported slightly less burnout and less specialty-choice regret than a comparable sample of family practice residents, suggesting possible attenuation of burnout with the transition from training to practice. Nonetheless, the importance of overwhelming time demands as a precipitant of exhaustion and potential physician impairment is noted.

Burnout, Professional↗