COPING VARIABLES AS PREDICTORS OF PERIOPERATIVE EMOTIONAL STATES AND ADJUSTMENT

Surgery, regardless of its kind and severity, can be regarded as a maj or stress situation for any patient. High preoperative emotional arous al may negatively influence adaptation during surgery and, consequentl y, rate of postoperative recovery. In a series of previous studies, ou r research group analyzed the influence of dispositional and actual co ping on subjective and objective stress indicators before, during, and after surgery. The present study investigates the influence of the di spositional coping variables vigilance and cognitive avoidance on actu al surgery-related coping, state anxiety, and indicators of intra- and postoperative adjustment. The sample consisted of 42 male and 42 fema le patients undergoing elective maxillofacial surgery under general an aesthesia. Dispositional coping was measured on the dimensions vigilan ce and cognitive avoidance with the Mainz Coping Inventory. Actual sur gery-related coping was assessed by means of a newly constructed inven tory containing items to measure the four dimensions avoidance, vigila nce, positive restructuring, and seeking social support. Self-reported state anxiety was differentiated according to the cognitive, affectiv e, and somatic components. The patients' adaptation was assessed by me asuring doses of the narcotic agents used for induction of anaesthesia , the intraoperative status, and the amount of postoperative (analgesi c and psychotropic) medication. Significant effects of coping mode, ge nder, and time of measurement were observed on the cognitive, affectiv e and somatic component of state anxiety, the indicators of intraopera tive adaptation and on postoperative medication. Also, patients' actua l coping behavior could partly be predicted by dispositional coping. R esults indicate that actual coping behavior and gender should be taken into account when trying to predict adaptation and developing psychol ogical preparatory intervention programs.