Surgery is stressful for children. How they cope with the experience is critical to their management and recovery. The purpose of the proposed research is to expand and extend previous research related to children's preoperative coping. In the proposed study the ways 100 children (8-17 years) cope with major orthopedic surgery will be examined in relation to their age, locus of control beliefs, and the amount of preoperative information given them by various sources. Parent anxiety also will be evaluated in order to determine the effect that anxiety has on the information variable, and on the child's preoperative coping strategy. The study will test a Coping Model that relates coping to two different postoperative outcomes anxiety on the second postoperative day, and return to normal activity at recovery. This research extends prior research in two ways. First, the proposed research adds both short-and long-term measures of the outcomes of coping. Second, in addition to identifying the child's avoidant-vigilant strategies, the coping interview measure also will be used to identify the characteristics of the stressful aspects of the surgery that children focus their attention on preoperatively and determine how this relates to the postoperative outcomes. The Coping Model will be tested twice: once with anxiety as the outcome and once with return to normal activity as the outcome. The model will be translated into structural equations and estimated using multiple regression analysis, and LISREL will be used to assess its overall goodness of fit. The relationship between attention focus and the postoperative outcomes will be evaluated using ANOVA. This research could help to identify and organize knowledge of children's coping with surgery and their postoperative outcomes. The findings from this research will be the basis for designing a study to test interventions for promoting children's coping and healthy postoperative outcomes in both the short- and long-terms.
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