Surgery-Related Coping in Surgery Patients with Intracranial Tumors.

Abstract

Neurosurgical brain tumor removal poses a unique threat for patients while also minimizing instrumental control. Thus, psychological processes used by patients to cope with surgery-related anxiety are of utmost importance. This is the first study to assess both nature and effectiveness of surgery-related coping efforts in neuro-oncological patients. We included 70 inpatients with an intracranial tumor before neurosurgical treatment. For assessment of patients' coping efforts, we used the Coping with Surgical Stress Scale, which includes the 5 subscales: Rumination, Optimism and Trust, Turning to Social and Religious Resources, Threat Avoidance, and Information Seeking. The extent of operation-specific anxiety was assessed via the State-Trait-Operational-Anxiety Inventory. Effectiveness of coping efforts was assessed via relations to other areas of psychosocial well-being (e.g., depression or health-related quality of life). All patients reported using a variety of coping strategies, most frequently from the area of Optimism and Trust, which was associated with less surgery-related anxiety and better emotional well-being. By contrast, Rumination was positively correlated with surgery-related anxiety and psychiatric morbidity. Mediator analyses supported a model in which surgery-related anxiety initiates coping efforts, which then distinctively mediates the influence of patients' anxiety on psychosocial well-being. Neuro-oncologic patients undertake considerable psychological effort to cope with surgery-related anxiety. The majority of patients use coping strategies facilitating emotional adjustment. A minority of patients, however, report extensive rumination, which negatively influences psychosocial well-being. Our results stress the importance of the doctor-patient relationship and offer implications for targeted interventions.