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Volume 58, Issue 2, Pages 201-209 (February 2005)


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Preoperative coping strategies and distress predict postoperative pain and morphine consumption in women undergoing abdominal gynecologic surgery

Lorenzo CohenaCorresponding Author Informationemail address, Rachel T. Fouladib, Joel Katzcdef

Received 18 September 2003; accepted 20 July 2004.

Abstract 

Objectives

The aim of the present study was to predict postoperative pain and morphine consumption based on preoperative psychosocial factors.

Methods

One hundred and twenty-two women completed measures of distress and coping 1 week before major abdominal gynecological surgery by laparotomy. Forty-eight hours after surgery, measures of pain and negative affect (NA) were completed, and morphine consumption was recorded from a patient-controlled analgesia pump. Four weeks after surgery, measures of pain and NA were completed.

Results

Multivariate analyses revealed that preoperative self-distraction coping (P=.039) positively predicted postoperative pain levels in the hospital, after accounting for the effects of age, concurrent NA, and morphine consumption. Emotional support (P=.031) and religious-based coping (P=.036) positively predicted morphine consumption in the hospital, after accounting for the effects of age, concurrent NA, and pain levels. Preoperative distress (P<.04 to .008) and behavioral disengagement (P=.034), emotional support (P=.049), and religious-based coping (P=.001) positively predicted pain levels 4 weeks after surgery, after accounting for the effects of age and concurrent NA.

Conclusion

The results suggest that preoperative psychosocial factors are associated with postoperative pain and morphine consumption.

Research was conducted at the Department of Psychology, York University, Toronto, ON, Canada.

a Department of Behavioral Science The University of Texas, M.D. Anderson Cancer Center, Box 243, 1515 Holcombe Boulevard, Houston, TX 77030, USA

b Department of Psychology, Simon Fraser University, Vancouver, BC, Canada

c Department of Psychology and School of Kinesiology and Health Science, York University, Toronto, ON, Canada

d Department of Anesthesia and Pain Management, Toronto General Hospital, Toronto, ON, Canada

e Mount Sinai Hospital, Toronto, ON, Canada

f Department of Anesthesia, University of Toronto, Toronto, ON, Canada

Corresponding Author InformationCorresponding author. Tel.: +1 713 745 4260; fax: +1 713 745 4286.

PII: S0022-3999(04)00548-3

doi:10.1016/j.jpsychores.2004.07.007


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