Coping variables as predictors of perioperative emotional states and adjustment

Abstract

Surgery, regardless of its kind and severity, can be regarded as a major stress situation for any patient. High preoperative emotional arousal may negatively influence adaptation during surgery and, consequently, rate of postoperative recovery. In a series of previous studies, our research group analyzed the influence of dispositional and actual coping on subjective and objective stress indicators before, during, and after surgery. The present study investigates the influence of the dispositional coping variables vigilance and cognitive avoidance on actual surgery-related coping, state anxiety, and indicators of intra- and postoperative adjustment. The sample consisted of 42 male and 42 female patients undergoing elective maxillofacial surgery under general anaesthesia. Dispositional coping was measured on the dimensions vigilance and cognitive avoidance with the Mainz Coping Inventory. Actual surgery-related coping was assessed by means of a newly constructed inventory containing items to measure the four dimensions avoidance, vigilance, positive restructuring, and seeking social support.

Self-reported state anxiety was differentiated according to the cognitive, affective, and somatic components. The patients' adaptation was assessed by measuring doses of the narcotic agents used for induction of anaesthesia, the intraoperative status, and the amount of postoperative (analgesic and psychotropic) medication. Significant effects of coping mode, gender, and time of measurement were observed on the cognitive, affective and somatic component of state anxiety, the indicators of intraoperative adaptation and on postoperative medication. Also, patients' actual coping behavior could partly be predicted by dispositional coping. Results indicate that actual coping behavior and gender should be taken into account when trying to predict adaptation and developing psychological preparatory intervention programs.