Emotional Distress Associated with Surgical Treatment and its Relationship with Coping Profiles Among Chronically ill Older Patients

The study determines the patterns of coping styles among older patients with hip osteoarthritis and assesses the derived profiles in terms of perceived stress and anxiety before and after arthroplasty. Sixty-one hospital patients (mean age 70.3 years) were analysed one day before arthroplasty and three months after. The participants were assessed with the Brief-COPE (coping style), PSS-10 (perceived stress) and STAI (anxiety) psychometric tests. Four coping patterns were yielded using data clustering: rational, enterprising (resourceful), potentially maladaptive and flexible. Repeated measures ANOVA indicated a main effect within subjects but did not indicate that decreases of stress and anxiety varied differently between groups. Cluster 1 (a coping profile characterised by high helplessness, low active coping, high avoidance) reported significantly greater stress and anxiety than all other groups before and after hip replacement, while clusters 2 (flexible), 3 (resourceful) and 4 (rational) were characterised by similar levels of anxiety and stress. Older patients with osteoarthritis might differ in terms of emotional response to surgical treatment. Screening for coping styles at admission to hospital may indicate more vulnerable individuals.