ANXIETY, PROBLEM-FOCUSED COPING STRATEGIES, DISFIGUREMENT/DYSFUNCTION AND POSTOPERATIVE COPING BEHAVIORS ASSOCIATED WITH HEAD AND NECK CANCER.
Contributors: New York University.
Published: 1994
Number of pages: 134
Subjects: Health Sciences, Nursing.
Description: This study was designed to investigate the relationship of anxiety and use of problem-focused coping strategies to self care and resocialization in individuals who sustain facial disfigurement/dysfunction associated with cancer surgery.

The theoretical framework underlying this study is the Stress-Coping Model (Scott, Oberst & Dropkin, 1980). This model expands upon Lazarus' theory of coping with stress (Lazarus & Folkman, 1984) in order to specifically address the problems of coping with cancer from a nursing perspective. Within this framework it was postulated that anxiety and use of problem-focused coping strategies prior to surgery would effect self care and resocialization after surgery. It was assumed that postoperative anxiety in relation to degree of disfigurement/dysfunction, would have a modulating effect.

The following hypotheses were generated for study: (1) There is a negative relationship between anxiety and use of problem-focused coping strategies prior to surgery. (2) Use of problem-focused coping strategies prior to surgery is positively related to self care and resocialization behaviors after surgery, independent of postoperative disfigurement and dysfunction. (3) There is a positive relationship between degree of disfigurement and dysfunction and postoperative anxiety. (4) Level of postoperative anxiety is negatively related to self care and resocialization behaviors. This negative correlation will decrease over postoperative days 4, 5, and 6.

The sample consisted of 75 adults (N = 75) who had sustained moderate to severe disfigurement/dysfunction associated with head and neck cancer surgery. There were 53 males (n = 53) and 22 females (n = 22) ranging in age from 37 to 82 years, with a mean age of 61. Anxiety was measured by the State Trait Anxiety Inventory; coping, by the Ways of Coping Questionnaire; disfigurement/dysfunction, by the Disfigurement/Dysfunction Scale; self care and resocialization, by the Coping Behaviors Score.

Hypotheses 1, 3, and 4 were analyzed using the Pearson product-moment correlation coefficient; Hypothesis 2 was analyzed by multiple regression analysis. Hypotheses 1, 2 and 3 did not reach statistical significance and were not supported. Hypothesis 4 was partially supported at the.05 level of significance. Total self care was inversely related to anxiety on POD 4 (r = $-$.3025; p $<$.05) and on POD 5 (r = $-$.3885; p $<$.01).

Ancillary analyses revealed a number of significant relationships between the study variables and demographic data. Preoperative anxiety was negatively correlated with age and positively correlated with postoperative anxiety. Use of problem-focused coping strategies was negatively associated with age and socioeconomic status. Postoperative self care was significantly related to being male, under the age of 55, and of lower socioeconomic status, with age being the strongest predicator. Finally, higher levels of anxiety were positively related to overall coping behaviors.
Notes: Source: Dissertation Abstracts International, Volume: 56-03, Section: B, page: 1345.

Thesis (PH.D.)--NEW YORK UNIVERSITY, 1994.

School code: 0146.