Psychological predictors of surgical outcome: anxiety and active coping

Abstract

The underlying purpose of this study was to identify presurgical predictors of surgical recovery. The psychological variables of interest were trait and state anxiety and active coping style.

An examination was made of a multifactor trait anxiety scale, the S-R Inventory of General Trait Anxiousness. Specific emphasis was on the subscale related to anxiety aroused in physical danger situations, its relationship to presurgical state anxiety, and to surgical recovery. Two other anxiety measures, as well as a measure of active coping style, were also included as potential predictors of recovery.

Responses to the S-R Inventory of General Trait Anxiousness (S-R GTA), the Present Affect Reactions Questionnaire (PARQ), and the Fear of Surgery Scale (FSS) were obtained from 48 patients on the day prior to their surgery and on the fifth day after surgery. A rating of the patient's active coping style was obtained from an interview taped during the presurgical testing session. The dependent measures were the five individual components of a Recovery Index.

Based on a multiple regression analysis, the Fear of Surgery Scale (FSS) was the most efficient predictor of the indices of recovery. There was no support for the hypothesis that active coping style would be an important predictor of recovery. Despite expectations to the contrary, the subscale of the S-R Inventory of General Trait Anxiousness (S-R GTA-PD) which measures anxiety in physical danger situations was not a reliable predictor of recovery nor was it the best of the five subscales in predicting state anxiety in the surgical situation.

The recommendation was made that the Fear of Surgery Scale be employed to enable early identification of patients with potentially high state anxiety in the surgical situation in order to make interventions in such a way as to reduce that anxiety and foster a smooth recovery. Various concepts of intervention were discussed as well as recommendations concerning the indices to be considered in evaluating recovery.