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Physical recovery in Arthroscopic knee surgery: unique contributions of coping behaviors to clinical outcomes and stress reactivity
Authors:Patricia H. Rosenberger  Jeannette R. Ickovics  Elissa S. Epel  Danielle D’Entremont  Peter Jokl
Affiliation:1. Department of Epidemiology and Public Health , Yale University School of Medicine;2. Department of Epidemiology and Public Health , Yale University School of Medicine;3. Department of Psychology , Yale University;4. Department of Psychiatry , University of California , San Francisco;5. Department of Orthopaedics and Rehabilitation Medicine , Yale University School of Medicine
Abstract:Few studies have examined whether certain coping behaviors are associated with physical outcomes following surgery. This prospective, longitudinal study investigated the effect of active and avoidant coping behaviors on two physical outcomes over time, pain and knee function, in a group of patients experiencing knee arthroscopic surgery (n = 81). Structured interviews and physician clinical assessments were conducted preoperatively and at 3 and 24 weeks postoperatively. Coping behavior was assessed during the preoperative interview, and patients were divided into high and low avoidant and active coping groups. Using repeated measures MANCOVA/ANCOVA, avoidant coping was significantly associated with knee pain and active coping was associated with knee function. Serum cortisol levels were available for a patient subset (n = 16); higher cortisol was related to both avoidant coping and poorer functioning during early recovery. Results suggest that these divergent coping behaviors are differentially associated with stress reactivity and physical outcomes in healthy patients undergoing minor knee surgery.
Keywords:Coping  Surgery  Recovery  Cortisol  Pain  Function
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