Skip to main content
Published Online:https://doi.org/10.1026/0943-8149.16.4.183

Zusammenfassung. In Studien zum Einfluss einer psychologischen Operationsvorbereitung auf den postoperativen Anpassungsstatus von Patienten wurde bislang einer möglichen Interaktion der Art der Vorbereitung mit Persönlichkeitsmerkmalen des Patienten nur wenig Beachtung geschenkt. Ziel der vorliegenden Arbeit ist die Analyse von Wechselwirkungen zwischen unterschiedlichen Formen der psychologischen Operationsvorbereitung und bestimmten Merkmalen des Patienten im Hinblick auf subjektive und objektive Indikatoren der perioperativen Patientenbelastung. In einer Untersuchung an 97 chirurgischen Patienten (Nasennebenhöhlen- oder Septumoperationen; 66 Männer und 31 Frauen) konnte nachgewiesen werden, dass die beiden Vorbereitungsprogramme „Information” und „Entspannung/Ablenkung” zusammen mit dem Geschlecht der Patienten sowie den Persönlichkeitsmerkmalen vigilante und kognitiv vermeidende Angstbewältigung eine Wechselwirkung auf perioperative Belastungsmerkmale (Angst, Genesungsfortschritt, Schmerzbelastung) ausübten. Die Ergebnisse werden auf dem Hintergrund des Modells der Bewältigungsmodi (Krohne, 2003) diskutiert.


Psychological preparation for surgery, coping, and perioperative adaptation

Abstract. In studies on the influence of psychological preparation for surgery on patients’ postoperative adaptation a possible interaction of the type of preparation and patient characteristics has received only scant attention. Therefore, the present study investigates possible interactions of types of psychological preparation and specific patient characteristics on subjective and objective indicators of the patient’s perioperative adaptation. Ninety seven patients (66 men and 31 women) undergoing nasal cavity or septum surgery were randomly assigned to an information, a relaxation-attentional diversion, or a control group. Results revealed significant interaction effects of the preparation program with patients’ gender and coping dispositions (vigilance, cognitive avoidance) on the adaptational status (anxiety, recovery, pain experience). Results are discussed with respect to the model of coping modes (Krohne, 2003).

Literatur

  • Auerbach, S. M. (1989). Stress management and coping research in the health care setting: An overview and methodological commentary. Journal of Consulting and Clinical Psychology, 57, 388–395. First citation in articleCrossrefGoogle Scholar

  • Bernstein, D. A. , Borkovec, T. D. (1982). Entspannungs-Training. Handbuch der progressiven Muskelentspannung (3. Auflage). München: Pfeiffer. First citation in articleGoogle Scholar

  • Borkovec, T. D. (1985). The role of cognitive and somatic cues in anxiety and anxiety disorders: Worry and relaxation-induced anxiety. In A. H. Tuma, J. Maser, (Eds.), Anxiety and the anxiety disorders (pp. 463–478). Hillsdale, NJ.: Erlbaum. First citation in articleGoogle Scholar

  • Breme, K. , Altmeppen, J. , Taeger, K. (2000). Patientenkontrollierte Analgesie: Psychologische Prädiktoren des postoperativen Schmerzerlebens, des Schmerzmittelverbrauchs und der Patientenzufriedenheit. Schmerz, 14, 137–145. First citation in articleCrossrefGoogle Scholar

  • Broadbent, E. , Petrie, K. J. , Alley, P. G. , Both, R. J. (2003). Psychological stress impairs early wound repair following surgery. Psychosomatic Medicine, 65, 865–869. First citation in articleCrossrefGoogle Scholar

  • Cohen, F. , Lazarus, R. S. (1973). Active coping processes, coping dispositions, and recovery from surgery. Psychosomatic Medicine, 35, 375–389. First citation in articleCrossrefGoogle Scholar

  • Cohen, S. , Wills, T. A. (1985). Stress, social support, and the buffering hypothesis. Psychological Bulletin, 98, 310–357. First citation in articleGoogle Scholar

  • Contrada, R. J. , Leventhal, E. A. , Anderson, J. R. (1994). Psychological preparation for surgery: marshalling individual and social resources to optimize self-regulation. In S. Maes, H. Leventhal, M. Johnston, (Eds.), International review of health psychology (pp. 219–266). Chichester, England: Wiley. First citation in articleGoogle Scholar

  • de Bruin, J. T. , Schäfer, M. K. , Krohne, H. W. , Dreyer, A. (2001). Preoperative anxiety, coping, and intraoperative adjustment: Are there mediating effects of stress-induced analgesia? Psychology and Health, 16, 253–271. First citation in articleCrossrefGoogle Scholar

  • Dick, W. , Kleinheisterkamp, U. (1987). Anästhesie-Merkbuch. Stuttgart: Wissenschaftliche Verlagsgesellschaft. First citation in articleGoogle Scholar

  • Dyson, M. et al. (2003). Wound healing assessment using 20 MHz ultrasound and photography. Skin Research and Technology, 9, 116–121. First citation in articleCrossrefGoogle Scholar

  • El-Giamal, M. , Krohne, H. W. , Kleemann, P. P. , Klimek, L. , Mann, W. (1997). Psychologische Operationsvorbereitung, Patientenmerkmale und perioperativer Anpassungsstatus. Zeitschrift für Gesundheitspsychologie, 5, 217–242. First citation in articleGoogle Scholar

  • Gaskey, N. J. (1987). Evaluation of the effect of a pre-operative anesthesia videotape. AANA Journal. American Association of Nurse Anesthetists, 55, 341–345. First citation in articleGoogle Scholar

  • George, J. M. , Scott, D. S. , Turner, S. P. , Gregg, J. M. (1980). The effects of psychological factors and physical trauma on recovery from oral surgery. Journal of Behavioral Medicine, 3, 291–310. First citation in articleCrossrefGoogle Scholar

  • Gould, T. H. et al. (1992). Policy for controlling pain after surgery: Effects of sequential changes in management. British Medical Journal, 305, 1187–1193. First citation in articleCrossrefGoogle Scholar

  • Höfling, S. (1988). Psychologische Vorbereitung auf chirurgische Operationen. Untersuchungen bei erwachsenen Patienten mit elektiven Eingriffen. Berlin: Springer. First citation in articleCrossrefGoogle Scholar

  • Holden-Lund, C. (1988). Effects of relaxation with guided imagery on surgical stress and wound healing. Research in Nursing & Health, 11, 235–244. First citation in articleCrossrefGoogle Scholar

  • Jage, J. (2004). Essentials der postoperativen Schmerztherapie. Ein Leitfaden für chirurgische Fächer. Stuttgart: Thieme. First citation in articleGoogle Scholar

  • Janis, I. L. (1958). Psychological stress: Psychoanalytic and behavioral studies of surgical patients. New York: Wiley. First citation in articleCrossrefGoogle Scholar

  • Johnston, M. (1986). Pre-operative emotional states and post-operative recovery. In F. G. Guggenheim, (Ed.), Advances in psychosomatic medicine: Vol. 15. Psychological aspects of surgery (pp. 1–22). Basel: Karger. First citation in articleCrossrefGoogle Scholar

  • Johnston, M. (1988). Impending surgery. In S. Fisher, J. Reason, (Eds.), Handbook of life stress, cognition, and health (pp. 79–100). Chichester, UK: Wiley. First citation in articleGoogle Scholar

  • Johnston, M. , Vögele, C. (1993). Benefits of psychological preparation for surgery: A meta-analysis. Annals of Behavioral Medicine, 15, 245–256. First citation in articleGoogle Scholar

  • Kaluza, G. , Basler, H.-D. (1991). Gelassen und sicher im Streß. Ein Trainingsprogramm zur Verbesserung des Umgangs mit alltäglichen Belastungen. Manual für Kursleiter. Berlin: Springer. First citation in articleGoogle Scholar

  • Kay, B. , Lehmann, K. A. (1990). Analgetika mit antipyretischer Wirkung. Klinische Erfahrungen. In K. A. Lehmann, (Ed.), Der postoperative Schmerz (pp. 132–142). Berlin: Springer. First citation in articleCrossrefGoogle Scholar

  • Kiecolt-Glaser, J. K. , Marucha, P. T. , Malarkey, W. B. , Mercado, A. M. , Glaser, R. (1998). Slowing of wound healing by psychological stress. Lancet, 346, 1194–1196. First citation in articleCrossrefGoogle Scholar

  • Kiecolt-Glaser, J. K. , Page, G. G. , Marucha, P. T. , MacCallum, R. C. , Glaser, R. (1998). Psychological influences on surgical recovery: Perspectives from psychoneuroimmunology. American Psychologist, 53, 1209–1218. First citation in articleCrossrefGoogle Scholar

  • Krohne, H. W. (1993). Vigilance and cognitive avoidance as concepts in coping research. In H. W. Krohne, (Ed.), Attention and avoidance. Strategies in coping with aversiveness (pp. 19–50). Seattle: Hogrefe & Huber. First citation in articleGoogle Scholar

  • Krohne, H. W. (1996). Angst und Angstbewältigung. Stuttgart: Kohlhammer. First citation in articleGoogle Scholar

  • Krohne, H. W. (2003). Individual differences in emotional reactions and coping. In R. J. Davidson, H. H. Goldsmith, K. R. Scherer, (Eds.), Handbook of affective sciences (pp. 698–725). New York: Oxford University Press. First citation in articleGoogle Scholar

  • Krohne, H. W. , de Bruin, J. T. (1998). Stress bei medizinischen Eingriffen: Kritischer Überblick über verschiedene Interventionsansätze. Zeitschrift für Medizinische Psychologie, 7, 3–39. First citation in articleGoogle Scholar

  • Krohne, H. W. , de Bruin, J. T. , El-Giamal, M. , Schmukle, S. C. (2000). The assessment of surgery-related coping: The Coping with Surgical Stress Scale (COSS). Psychology and Health, 15, 135–149. First citation in articleCrossrefGoogle Scholar

  • Krohne, H. W. , Egloff, B. (1999). Das Angstbewältigungs-Inventar (ABI). Frankfurt a.M.: Swets Test. First citation in articleGoogle Scholar

  • Krohne, H. W. , El-Giamal, M. (1999). Operativer Stress: Diagnose, Prävention, Intervention. Bericht über ein Forschungsprojekt (Mainzer Berichte zur Persönlichkeitsforschung No. 54). Mainz: Johannes Gutenberg-Universität, Psychologisches Institut. First citation in articleGoogle Scholar

  • Krohne, H. W. , El-Giamal, M. , Volz, C. (2003). Der Einfluss sozialer Unterstützung auf die prä- und postoperative Anpassung chirurgischer Patienten. Zeitschrift für Gesundheitspsychologie, 11, 132–142. First citation in articleLinkGoogle Scholar

  • Krohne, H. W. , Fuchs, J. , Slangen, K. E. (1994). Operativer Streß und seine Bewältigung. Zeitschrift für Gesundheitspsychologie, 2, 155–175. First citation in articleGoogle Scholar

  • Krohne, H. W. , Kleemann, P. P. , Hardt, J. , Theisen, A. (1990). Relations between coping strategies and presurgical stress reactions. In L. R. Schmidt, P. Schwenkmezger, J. Weinman, S. Maes, (Eds.), Theoretical and applied aspects of health psychology (pp. 423–429). London: Harwood. First citation in articleGoogle Scholar

  • Krohne, H. W. , Schmukle, S. C. (2006). Das Inventar State-Trait-Operations-Angst (STOA). Manual. Frankfurt a.M.: Harcourt Test Services. First citation in articleGoogle Scholar

  • Krohne, H. W. , Slangen, K. E. (2005). Influence of social support on adaptation to surgery. Health Psychology, 24, 101–105. First citation in articleCrossrefGoogle Scholar

  • Krohne, H. W. , Slangen, K. E. , Kleemann, P. P. (1996). Coping variables as predictors of perioperative emotional states and adjustment. Psychology and Health, 11, 315–330. First citation in articleCrossrefGoogle Scholar

  • Kulik, J. A. , Mahler, H. I. M. (1989). Social support and recovery from surgery. Health Psychology, 8, 221–238. First citation in articleCrossrefGoogle Scholar

  • Kulik, J. A. , Mahler, H. I. M. , Moore, P. J. (1996). Social comparison and affiliation under threat: effects on recovery from major surgery. Journal of Personality and Social Psychology, 71, 967–797. First citation in articleCrossrefGoogle Scholar

  • Leventhal, H. , Diefenbach, M. , Leventhal, E. A. (1992). Illness cognition: Using common sense to understand treatment adherence and affect cognition interactions. Cognitive Therapy and Research, 16, 143–163. First citation in articleCrossrefGoogle Scholar

  • Liebert, R. M. , Morris, L. W. (1967). Cognitive and emotional components of test anxiety: A distinction and some initial data. Psychological Reports, 20, 975–978. First citation in articleGoogle Scholar

  • Ludwick-Rosenthal, R. , Neufeld, R. W. J. (1988). Stress management during noxious medical procedures: An evaluative review of outcome studies. Psychological Bulletin, 104, 326–342. First citation in articleCrossrefGoogle Scholar

  • Ludwick-Rosenthal, R. , Neufeld, R. W. J. (1993). Preparation for undergoing on invasive medical procedure: Interaction effects of information and coping style. Journal of Consulting and Clinical Psychology, 61, 156–164. First citation in articleCrossrefGoogle Scholar

  • Martelli, M. F. , Auerbach, S. M. , Alexander, J. , Mercuri, L. G. (1987). Stress management in the health care setting: Matching interventions with patient coping styles. Journal of Consulting and Clinical Psychology, 55, 201–207. First citation in articleCrossrefGoogle Scholar

  • Mathews, A. , Ridgeway, V. (1981). Personality and surgical recovery: A review. British Journal of Clinical Psychology, 20, 243–260. First citation in articleCrossrefGoogle Scholar

  • Mathews, A. , Ridgeway, V. (1984). Psychological preparation for surgery. In A. Steptoe, A. Mathews, (Eds.), Health care and human behavior (pp. 231–259). London: Academic Press. First citation in articleGoogle Scholar

  • Melamed, B. G. , Siegel, L. J. (1975). Reduction of anxiety in children facing hospitalization and surgery by use of filmed modeling. Journal of Consulting and Clinical Psychology, 43, 511–521. First citation in articleCrossrefGoogle Scholar

  • Miller, S. M. (1992). Monitoring and blunting in the face of threat: Implications for adaptation and health. In L. Montada, S.-H. Filipp, M. J. Lerner, (Eds.), Life crises and experiences of loss in adulthood (pp. 255–273). Hillsdale, NJ: Erlbaum. First citation in articleGoogle Scholar

  • Miller, S. M. (1996). Monitoring and blunting of threatening information: Cognitive interference and facilitation in the coping process. In I. G. Sarason, G. R. Pierce, B. R. Sarason, (Eds.), Cognitive interference: Theories, methods, and findings (pp. 175–190). Mahwah, NJ: Erlbaum. First citation in articleGoogle Scholar

  • Miller, S. M. , Combs, C. , Stoddard, E. (1989). Information, coping and control in patients undergoing surgery and stressful medical procedures. In A. Steptoe, A. Appels, (Eds.), Stress, personal control and health (pp. 107–130). Chichester, UK: Wiley. First citation in articleGoogle Scholar

  • Miller, S. M. , Mangan, C. E. (1983). Interacting effects of information and coping style in adapting to gynecologic stress: Should the doctor tell all? Journal of Personality and Social Psychology, 45, 223–236. First citation in articleCrossrefGoogle Scholar

  • Montgomery, G. H. , Bovbjerg, D. H. (2004). Presurgery distress and specific response expectancies predict postsurgery outcomes in surgery patients confronting breast cancer. Health Psychology, 23, 381–387. First citation in articleCrossrefGoogle Scholar

  • Mumford, E. , Schlesinger, H. J. , Glass, G. V. (1982). The effects of psychological intervention on recovery from surgery and heart attacks: an analysis of the literature. American Journal of Public Health, 72, 141–151. First citation in articleCrossrefGoogle Scholar

  • Prokop, C. K. , Bradley, L. A. , Burish, T. G. , Anderson, K. O. , Fox, J. E. (1991). Psychological preparation for stressful medical and dental procedures. In C. K. Prokop, L. A. Bradley, (Eds.), Health psychology. Clinical methods and research (pp. 159–196). New York: Macmillan. First citation in articleGoogle Scholar

  • Rice, V. H. , Johnson, J. E. (1984). Preadmission self-instruction booklets, postadmission exercise performance and teaching time. Nursing Research, 33, 147–151. First citation in articleCrossrefGoogle Scholar

  • Saile, H. , Burgmeier, R. , Schmidt, L. R. (1988). A meta-analysis of studies on psychological preparation of children facing medical procedures. Psychology and Health, 2, 107–132. First citation in articleCrossrefGoogle Scholar

  • Schröder, H. , Schumacher, J. (1992). Bewältigung von chirurgischen Operationsanforderungen in differenzieller, subjektorientierter Sicht. In L. R. Schmidt, (Ed.), Jahrbuch der Medizinischen Psychologie: Bd. 7: Psychologische Aspekte medizinischer Maßnahmen (pp. 33–54). Berlin: Springer. First citation in articleCrossrefGoogle Scholar

  • Schultheis, K. , Peterson, L. , Selby, V. (1987). Preparation for stressful medical procedures and person x treatment interactions. Clinical Psychology Review, 7, 329–352. First citation in articleCrossrefGoogle Scholar

  • Schwerdtfeger, A. , Kohlmann, C.-W. (2004). Repressive coping style and the significance of verbal-autonomic response dissociations. In U. Hentschel, G. Smith, J. G. Draguns, W. Ehlers, (Eds.), Defense mechanisms. Theoretical, research and clinical perspectives (pp. 239–278). Amsterdam: Elsevier. First citation in articleCrossrefGoogle Scholar

  • Scott, L. E. , Clum, G. A. , Peoples, J. B. (1983). Preoperative predictors of postoperative pain. Pain, 15, 283–293. First citation in articleCrossrefGoogle Scholar

  • Slangen, K. , Krohne, H. W. , Stellrecht, S. , Kleemann, P. P. (1993). Dimensionen perioperativer Belastung und ihre Auswirkungen auf intra- und postoperative Anpassung von Chirurgiepatienten. Zeitschrift für Gesundheitspsychologie, 1, 123–142. First citation in articleGoogle Scholar

  • Stevens, J. O. (1975). Die Kunst der Wahrnehmung. München: Kaiser. First citation in articleGoogle Scholar

  • Tolksdorf, W. (1985). Der präoperative Streß. Heidelberg: Springer. First citation in articleGoogle Scholar

  • Vasey, M. W. , Thayer, J. F. (1987). The continuing problem of false positives in repeated measures ANOVA in psychophysiology: A multivariate solution. Psychophysiology, 24, 479–486. First citation in articleCrossrefGoogle Scholar

  • Vögele, C. (1988). Perioperativer Streß. Eine psychophysiologische Untersuchung zu prä- und postoperativen Reaktionen chirurgischer Patienten. Frankfurt a.M.: Peter Lang. First citation in articleGoogle Scholar

  • Vögele, C. (2004). Hospitalization and stressful medical procedures. In A. Kaptein, J. Weinman, (Eds.), Health Psychology (pp. 288–304). Malden, MA: BPS Blackwell. First citation in articleGoogle Scholar

  • Weidner, G. , Collins, R. L. (1993). Gender, coping, and health. In H. W. Krohne, (Ed.), Attention and avoidance. Strategies in coping with aversiveness (pp. 241–265). Seattle: Hogrefe & Huber. First citation in articleGoogle Scholar

  • Wolfer, J. A. , Davis, C. E. (1970). Assessment of surgical patients’ preoperative emotional condition and postoperative welfare. Nursing Research, 19, 402–414. First citation in articleCrossrefGoogle Scholar

  • Yang, J. C. , Clark, W. C. , Tsui, L. S. , Ng, K. F. , Clark, S. B. (2000). Preoperative Multidimensional Affect and Pain Survey (MAPS) scores predict postcolectomy analgesia requirement. The Clinical Journal of Pain, 16, 314–320. First citation in articleCrossrefGoogle Scholar

  • Yap, J. N.-K. (1988). A critical review of pediatric preoperative preparation procedures: Processes, outcomes, and future directions. Journal of Applied Developmental Psychology, 3, 359–389. First citation in articleCrossrefGoogle Scholar