Background: How children cope with minor or major surgery is influenced by
their attention focus appraisals. Although factors that predict children's
coping with surgery have been identified (i.e., age, locus of control, pare
nt-doctor information, worry), it still is not known whether the type of su
rgery per se affects the coping strategies used and influences previously e
stablished predictors of coping. Furthermore, questions remain concerning t
he relation among type of surgery, attention focus, and coping.
Objectives: The purpose of this study was to determine whether the type of
surgery (minor vs. major) would have a differential effect on coping, and w
hether coping can be predicted better if it is known what type of attention
focus (appraisal) the child has.
Methods: Data from three studies of children (n = 189) undergoing minor or
major surgery were combined to examine the effects that type of surgery and
attention have on coping. Measures included the Preoperative Mode of Copin
g Interview, Locus of Control Scale for Children, Parent-Doctor Information
Interview, and a measure for worry.
Results: The results showed that the factors previously found to predict co
ping were upheld in the combined sample and accounted for 50% of the varian
ce in coping. Type of surgery was significantly associated with coping: Chi
ldren undergoing minor surgery were somewhat more vigilant than children un
dergoing major surgery. The inclusion of attention in the analysis signific
antly improved the variance explained in coping (66%), and children who had
a concrete-objective focus of attention were found to be more vigilant. Si
gnificant interactions were found between attention focus and type of surge
ry, locus of control, and age. Type of surgery also had a significant inter
action with worry. Children who focused on the concrete-objective aspects o
f the situation were more vigilant if they were having minor rather than ma
jor surgery. Also, children who had an internal locus of control and a conc
rete-objective focus of attention were more vigilant in coping. Regardless
of age, children who had a concrete-objective focus of attention were more
vigilant. Furthermore, at low levels of worry, children undergoing major su
rgery were more vigilant than children undergoing minor surgery.
Conclusions: Coping with surgery is influenced by multiple factors. Childre
n's ability to focus attention on the concrete-objective aspects of surgery
may help to reduce feelings of threat that could impede their use of vigil
ant coping.