The experimental study is designed to test the effects of a structural discharge preparation program containing cognitive (sensory) and behavioral (coping) information on post-discharge outcomes among cancer patients who have undergone abdominal surgery. Post-discharge patient outcomes to be assessed include: perceived severity of physical symptoms, extent to which post-discharge experience is congruent with expectations, mood and anxiety, perceived uncertainty, and rate of return to normal levels of activity and personal functioning. Subjects will be 90 adults who have undergone major abdominal surgery for initial treatment of gastrointestinal or genitourinary cancer, randomly assigned to two experimental and one control group. The Sensory Preparation (E1) group will receive only sensory information detailing descriptively the physical symptoms expected during the first month following surgery. The combined Sensory-Behavioral Preparation (E2) group will receive both the sensory information and the behavioral information outlining coping behaviors which can be used to reduce symptom severity. The Behavioral Preparation (C) group will receive only the behavioral information. Baseline measures of mood, uncertainty, and expectations will be obtained prior to any of the treatments. Outcomes will be assessed at 10, 30, and 60 days following discharge using mailed questionnaires. It is hypothesized that the combined sensory-behavioral preparation, by providing a framework of expectations, will substantially reduce symptom distress, uncertainty about the meaning of post-operative sequellae, and time required for patients to return to maximal activity levels.
