Differentielle Indikation psychologischer Operationsvorbereitung : bei knochenchirurgischen Wahleingriffen
The aim of the study was to analyse the importance of congruence between individual coping modes and specific methods of preparation for a surgical operation. The working assumption was that through a combination of 'vigilance and systematic information', 'cognitive avoidance and relaxation training', 'instrumental coping and therapeutic exercise treatment together with systematic breathing techniques' as well as 'instable coping and stress management' a fit between coping mode and treatment could be achieved. The hypothesis that individually oriented psychological treatments with respect to a range of criteria would yield better results than those forms of intervention which are not specifically adapted to the situation at hand was tested on 360 patients, who were undergoing elective bone surgery. Outcome variables used were anxiety, anger, psychological condition, a feeling of being down, hope and feeling of control. In addition were three further variables reflecting the doctor's assessment of recovery, copliance and mobility. Further, the study observed two physiological indicators of stress levels: intraoperative hemodynamics and reaction during anesthesia. Further parameters of convalescence were pain intensity, anxiety regarding pain, the need for analgesics and tranquilizers, the absolute and relative time of inpatient care, as well as the type and number of post-operative complications. For the majority of the variables the superiority of treatments specifically adapted to the coping modes compared with the other treatment constellations, as well as compared with placebo treatments and no treatment at all was clearly demonstrated.