Paper
Thursday, July 22, 2004
Adolescents’ Coping With Surgery for Scoliosis: Effects of Recovery Over Time
Lynda L. LaMontagne, RN, DNSc and Michele H. Salisbury, RNC, PhD. School of Nursing, Vanderbilt University, Nashville, TN, USA
| Learning Objective #1: Describe long-term effects of coping over nine months of recovery after scoliosis surgery |
| Learning Objective #2: Describe changes in coping behaviors over time |
Objective: To determine the effects of avoidance/vigilance coping on long term (nine months) recovery outcomes of adolescents undergoing spinal surgery for scoliosis and identify if coping strategies change over time. Design: A prospective longitudinal design. Population, Sample, Setting, Years: 113 patients (11-18 years old) completed the study. Mean age was 13.9; 84% were Caucasian and 91 were female, which is consistent with the incidence of idiopathic scoliosis. Data collection occurred over 4 years in a medical center in the southeastern U. S.A. Concepts: Coping, activities (physical, social, academic). Methods: Adolescents who participated were enrolled one day before surgery when the Preoperative Coping Interview and the Youth Self Report of Activities were administered. The Postoperative Coping Interview assessed coping strategy at 4 days, one month, 3 months and 6 months after surgery. Activities were assessed at 1, 3, 6, and 9 months. Findings: More vigilant preoperative coping was a significant predictor of higher one month usual activities and new activities, six month new activities and six and nine month academic performance. Repeated measures ANOVA revealed a significant time effect for coping. Adolescents became significantly more avoidant from in-hospital coping to one month postsurgery. Conclusions: Results show that adolescents who cope more vigilantly preoperatively (e.g., seek information, problem solve and rely on others) have better long term activity outcomes. Becoming more avoidant postoperatively could be attributed to the overwhelming stressors during recovery and discouragement over the progress of recovery. Implications: Adolescents undergoing major spinal surgery need interventions to enhance their coping during recovery. Nurses should prepare patients to anticipate a long and challenging recovery and provide supportive information at specific times during recovery to help patients cope more actively.
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Sigma Theta Tau International
July 22-24, 2004