Lived Experiences of Middle-Aged Women After Bilateral Oophorectomy Before Menopause: Adaptation in the Lower Northern Community Context

Abstract

This qualitative study aimed to: 1) describe the experience of physiological changes; 2) describe experiences of identity and self-image perception; 3) describe experiences of role function and daily life adaptation; and 4) describe experiences of interdependence and use of sociocultural resources among middle-aged women following bilateral oophorectomy before menopause in the lower northern community context of Thailand. Interpretative Phenomenological Analysis (IPA) was employed as the methodological approach, guided by Roy's Adaptation Model (RAM). Twelve participants aged 35 to 55 years who had undergone bilateral oophorectomy before natural menopause at Uttaradit Hospital were recruited through purposive sampling. Data were collected via semi-structured in-depth interviews comprising four question clusters aligned with RAM's four adaptive modes. Content validity was verified by three experts one specialist in gynecological nursing and two in qualitative research methodology, yielding a Content Validity Index (CVI) of .89. Data were analyzed using IPA's six-step procedure until data saturation was achieved.

Four superordinate themes emerged. First, "An Unfamiliar Body" reflected abrupt physiological changes, particularly vasomotor symptoms and sleep disturbances. Second, "Am I Still a Woman?" captured the questioning of feminine identity and body image alongside an emergent process of self-redefinition. Third, "A World That Keeps Moving Without Asking If We Are Ready" illuminated the challenges of renegotiating roles within family and community settings. Fourth, "The Roots That Hold Us" revealed the vital role of spousal support, Buddhist beliefs, and local wisdom as spiritual resources sustaining adaptation.

Findings demonstrate that the cultural context of the lower northern community profoundly shapes women's lived experiences. These findings provide an evidence base for developing culturally congruent nursing practice guidelines. Future research should employ longitudinal qualitative designs and include spouses or family members as co-informants.