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PubMed1998

[Regret by women following sterilization]

Female sterilization is the most widely used contraceptive method among Brazilian women, although it has not been provided by the National Health System. Due to its legal ambiguity, it has not been recommended by Medical Boards as an ethical procedure. A study in which 3,149 women were asked about contraceptive use was carried out in the Greater São Paulo Metropolitan Area between March and July 1992. A total of 407 women under 40 years of age who had been submitted to sterilization at least one year prior to the interview were asked about their adjustment after the operation. Fifteen in-depth interviews with regretful women were analyzed in order to elucidate the nature of such feelings. The results include: adjustment after sterilization, provision of the sterilization procedure, knowledge of contraceptive methods, previous use of methods among sterilized women, and factors associated with regret. The qualitative results focus on the misinformation of sterilized women. Results indicate a need for regulating the procedure in order to ensure women's health, reproductive rights, and the fundamental principles of medical ethics.

Journal Article↗
PubMedDate not supplied

Regret of laparoscopic sterilization.

A follow-up study with questionnaires was performed 4-8 years after laparoscopic sterilization. The follow-up questionnaires were answered for 90.5%. The study revealed that 7.1% of the women were dissatisfied at some stage with the decision to undergo sterilization. However, only 1.8% requested reversal of the sterilization. 40% of the dissatisfied women were between 25-29 years of age, and every fifth sterilized woman in this age group regretted the sterilization.

Adult↗
PubMed1998

First sexual intercourse: age, coercion, and later regrets reported by a birth cohort.

OBJECTIVES: To investigate how age at first sexual intercourse is related to the reported circumstances and to determine how these corresponded to views in early adulthood about its timing. DESIGN: Cross sectional study within a birth cohort using a questionnaire presented by computer. SETTING: Dunedin, New Zealand in 1993-4. SUBJECTS: 477 men and 458 women enrolled in the Dunedin Multidisciplinary Health and Development Study, comprising 92% of survivors of the cohort. RESULTS: The median age at first intercourse was 17 years for men and 16 years for women. Only one man (0.2%) but 30 (7%) women reported being forced to have intercourse on the first occasion. For women, there were increasing rates of coercion with younger age at first intercourse. More men than women reported that they and their partner were equally willing (77% (316/413) v 53% (222/419)). Mutual willingness of both partners was greater for those who reported that it was also the first time for their partner. Timing of first intercourse was considered about right by 49% (200/411) of men and 38% (148/388) of women. Many women (54% (211/388) reported that they should have waited longer, and this rose to 70% (90/129) for women reporting intercourse before age 16. CONCLUSIONS: Most women regretted having sexual intercourse before age 16. First intercourse at younger ages is associated with risks that are shared unequally between men and women. This information is important to young people themselves.

Adult↗
PubMed2006

Estimation of optimal dynamic anticoagulation regimes from observational data: a regret-based approach.

A complication of long-term anticoagulation is that the optimal dose level varies not only between patients but over time within patients, in response to short-term changes in lifestyle. Consequently, doseage needs to be adaptive but there are as yet no accepted decision rules. Since anticoagulant use is increasing worldwide there is a need for more objective and routine procedures. In this paper, we describe an analysis of observational longitudinal anticoagulant data, aimed at determining an optimal reactive dose-changing strategy. We use the regret parameterization approach advocated by Murphy (J. R. Stat. Soc. Ser. B 2003; 65:331-366). Practical problems encountered in the implementation of the approach are discussed and illustrated.

Algorithms↗
PubMed1997

Regret and Responsibility in the Evaluation of Decision Outcomes

The negative affect associated with bad decision outcomes is often thought to involve feelings of remorse or self-blame. For example, studies showing greater regret associated with active than with passive choice are interpreted as the active chooser piling self-recrimination on top the disappointment of a poor outcome. Corresponding rejoicing is postulated for active choice that leads to good outcomes. The five experiments reported here challenge such a view. In each, hypothetical individuals experienced identical gains or losses, some as a result of their own choice, others as a result of an external, arbitrary process. Though evaluations of final outcomes were heavily influenced by the paths by which the outcomes were reached, and by the comparison levels that were evoked, in no case was decision agency a significant influence. In these experiments, then, the "active chooser" effect appears more a matter of change than of choice, of the route taken rather than whether one is the driver or the passenger. Further research will be needed to establish the circumstances under which different salient comparisons are evoked.

Journal Article↗
PubMed2005

Risk factors for tubal ligation: regret and psychological effects impact of Beck Depression Inventory.

OBJECTIVE: To investigate the relation of sterilization and depression in association with Beck Depression Inventory (BDI) and to analyze whether preoperative BDI scores have predictive value on satisfaction. METHODS: One hundred sixty-two women who had laparoscopic surgical sterilization were recruited into the study. Patients identified to have an intra-abdominal disease such as pelvic inflammatory disease, endometriosis or adnexal lesions, myoma uteri and previous cesarean delivery were excluded from the study. Women were administered the BDI 1 week prior to the operation and 1 year after the procedure, and patients were asked if they were satisfied with their new state of fertility. RESULTS: Mean BDI scores were 10.1+/-2.7 and 12.9+/-4.0, preoperatively and postoperatively, respectively (p<.001). The difference between preoperative and postoperative BDI scores was affected by age and satisfaction status; younger patients had significantly increased postoperative scores. Dissatisfied women had higher pre- and postoperative BDI scores (p<.001). The difference between pre- and postoperative scores was increased significantly in the dissatisfied group. Preoperative BDI score was found to be a significant predictor of satisfaction status 1 year after the operation. CONCLUSION: Preoperative application of BDI can identify women who are at greater risk for regret and dissatisfaction.

Adult↗
PubMed2002

Locked into gambling: anticipatory regret as a motivator for playing the National Lottery.

Four hundred and eighty-five people were asked about their intentions to play the National Lottery in England a week prior to the introduction of a new midweek draw. We predicted that those people who played the Saturday game with a regular set of numbers would be more inclined to play the new midweek game than those who had not established a routine of using the same set of numbers. We further predicted that their motivation to play would derive from a feeling of 'anticipatory regret'--a sense that they would find it intolerable to discover their regular numbers had been drawn when they hadn't purchased a ticket. Results supported both of these predictions, and an interpretation of the data is given in terms of the circumstances most likely to trigger such counterfactual reasoning.

Adult↗
PubMed2006

Supplication and appeasement in conflict and negotiation: The interpersonal effects of disappointment, worry, guilt, and regret.

This study examined the social effects of emotions related to supplication and appeasement in conflict and negotiation. In a computer-simulated negotiation, participants in Experiment 1 were confronted with a disappointed or worried opponent (supplication), with a guilty or regretful opponent (appeasement), or with a nonemotional opponent (control). Compared with controls, participants conceded more when the other experienced supplication emotions and conceded less when the other experienced appeasement emotions (especially guilt). Experiment 2 replicated the effects of disappointment and guilt and showed that they are moderated by the perceiver's dispositional trust: Negotiators high in trust conceded more to a disappointed counterpart than to a happy one, but those with low trust were unaffected. In Experiment 3, trust was manipulated through information about the other's personality (cooperative vs. competitive), and a similar moderation was obtained.

Anxiety↗
PubMed2000

Kidney donors don't regret: follow-up of 370 donors in Stockholm since 1964.

BACKGROUND: The aim of the study was to present the views of our kidney donors since 1964, at the time of donation, as well as later on--and to assess their current subjective health. METHODS: A total of 451 living-donor nephrectomies were performed on Swedish residents in Stockholm from April 1964 until the end of 1995. A questionnaire with 11 questions about the donation and a standardized health form (SF-36) were sent to all donors alive in 1997 (n=403). RESULTS: The mean age (+/-SD) of the donors was 61+/-14 years at follow-up and the time-since-donation was 12.5+/-7.7 years. The response rate was very good (92%). Current health, as assessed by form SF-36, was satisfactory. Donors scored somewhat better than those reported in a random sample of the Swedish population. The decision to donate had been easy: 86% made the decision themselves, without being pushed. Twenty-three percent thought that the nephrectomy had been troublesome. A higher percentage of young donors had felt that the postoperative period was difficult. Most donors (56%) stated that it had taken more than 2 months before they returned to a "normal" life, and 5% felt that they never completely recovered. Less than 1% of the donors regretted the donation. The commonest current medical prescription was antihypertensives (15%). The actual mean serum creatinine was 103+/-22 (range 48-219) micromol/L. CONCLUSIONS: The results indicate that the degree of health is at least as high as in the general population. The decision to donate was easy for most of the donors, but surgery and the recovery period were troublesome and lasted longer than expected. Kidney function was acceptable.

Adult↗
PubMed2005

Risk, rationality, and regret: responding to the uncertainty of childhood food anaphylaxis.

Risk and uncertainty are unavoidable in clinical medicine. In the case of childhood food allergy, the dysphoric experience of uncertainty is heightened by the perception of unpredictable danger to young children. Medicine has tended to respond to uncertainty with forms of rational decision making. Rationality cannot, however, resolve uncertainty and provides an insufficient account of risk. This paper compares the medical and parental accounts of two peanut allergic toddlers to highlight the value of emotions in decision making. One emotion in particular, regret, assists in explaining the actions taken to prevent allergic reactions, given the diffuse nature of responsibility for children. In this light, the assumption that doctors make rational judgments while patients have emotion led preferences is a false dichotomy. Reconciling medical and lay accounts requires acknowledgement of the interrelationship between the rational and the emotional, and may lead to more appropriate clinical decision making under conditions of uncertainty.

Anaphylaxis↗
PubMed2004

Deciding to exercise: the role of anticipated regret.

OBJECTIVES: Two studies tested (a) whether anticipated regret (AR) qualifies as an additional predictor of intentions to engage in a health-enhancing behaviour (exercise) after variables from the Theory of Planned Behaviour (TPB) and past behaviour have been controlled, and (b) whether a manipulation that induces participants to focus on AR causes stronger intentions to exercise. DESIGN: Study 1 employed a cross-sectional questionnaire design; Study 2 employed a between-participants experimental design (AR focus vs. no AR focus). METHOD: Participants (N = 385) completed standard, multi-item, reliable measures of TPB constructs and AR and also reported their past behaviour (Study 1). Participants in Study 2 (N = 70) completed measures of AR and intention; salience of AR was manipulated by means of item order. RESULTS: Study 1 showed that even though TPB variables and past behaviour were reliable predictors of intention, and explained 51% of the variance, AR contributed a substantial increment in the variance (5%) even after these predictors had been taken into account. Study 2 showed that participants who were induced to focus on AR prior to intention formation had significantly stronger intentions to exercise compared to controls. CONCLUSION: The findings indicate that AR predicts a health-enhancing behaviour (as well as the health-risk behaviours examined in previous research) and that effects of AR are independent of TPB variables and past behaviour. The findings also indicate that a simple and inexpensive manipulation of the salience of AR can be used to promote exercise intentions.

Adolescent↗
PubMed1996

Risk factors for tubal sterilization regret, detectable before surgery.

Brazil has one of the highest prevalence rates of female surgical sterilization in the world. At the same time there is an increased demand for sterilization reversal. In order to understand which women tend to later request reversal of the procedure, a case-control study was carried out comparing 216 women who requested reversal with sterilized women who did not, paired by year of surgery. The relative risk of requesting reversal for women sterilized before age 25 was 18 times that of women sterilized after age 29. The elevated risk remained even after controlling for a number of variables present at the time of surgery. Multiple regression analysis showed that request for reversal was associated with younger age, less information about the procedure, and fewer contraceptive methods known before sterilization. These results support the recommendation that women should be fully informed about the tubal ligation procedure and have access to other contraceptive options before being sterilized.

Adult↗