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Surgical patients with similar medical problems differ greatly in their rate of postoperative recovery. This study investigated the relationship between the mode of coping with preoperative stress and recovery from surgery. Sixty-one preoperative surgical patients were interviewed and classified into three groups based on whether they showed avoidance, vigilance, or both kinds of coping behavior, concerning their surgical problem. Coping dispositions referring to the same dimension, preoperative anxiety, and previous life stress were also measured. The five recovery variables included days in hospital, number of pain medications, minor medical complications, negative psychological reactions, and the sum of these. Results showed that the vigilant group had the most complicated postoperative recovery, although only two recovery variables (days in hospital and minor complications) were statistically significant. Coping dispositions, anxiety, and life stress showed no clear or consistent relationships with recovery. Ways in which mode of coping may have influenced recovery are discussed.
Clinical workers have long observed that surgical patients under roughly comparable medical conditions differ greatly in the course of postsurgical recovery. One of the psychological explanations of this variation is based on personality-related and hospital-induced differences in the modes of coping with stress (1-5). Questions about the role of coping have major theoretical as well as practical implications. From the practical standpoint, knowledge about the relevant coping processes, and the personality factors associated with them, could ultimately contribute greatly to improved patient care; for example, it may be possible to intervene selectively with suitable communications designed to facilitate coping.
From the theoretical standpoint, we must consider, among other things, the mechanisms by which coping styles and the course of recovery from surgery might be linked. One such link is via the relations between coping and stress or emotion. Some types of coping activities reduce or short-circuit stress reactions by modifying stress-induced threat appraisals (6) (see also, Lazarus, Averill, and Opton (7) for a recent review), and others presumably provide an opportunity for anticipatory coping, that is, for working out prior to an impending crisis the harms and threats to be faced (1,8). It is assumed in such analyses that the course of postsurgical recovery would be related to the increase or decrease of psychological stress during this period.