Surgery-Related Coping in Surgery Patients with Intracranial Tumors.

BACKGROUND

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.

METHODS

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).

RESULTS

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.

CONCLUSIONS

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.