The proposed study will examine the effects of two types of cognitive and affective interventions upon the psychological and behavioral response of patients following periodontal surgery -- an elective, non-life-threatening procedure which typically involves both physical and psychological stress and discomfort. It is designed as an experiment to compare the effects of interventions consisting of (a) enhancement of positive affect toward the surgery and its long-term outcomes and (b) enhancement of feelings of self-efficacy about managing the immediate post-surgical outcomes and the long-term course of the disease. The investigation will employ a factorial design, comparing positive affect enhancement, self-efficacy enhancement, a combined positive affect/self-efficacy condition, and a control group condition consisting of patients receiving usual care and instructions from their periodontists. The experimental interventions will be carried out in a two stage program. Interventions will precede each of two periodontal operative sessions in order to assess the possible cumulative effect of previous coping with the first surgery upon the second operation. In addition, the research will examine the relationship between periodontal surgery behavioral response and selected pre-operative characteristics of the patients, including anxiety, previous experience in coping with medical surgery, peer group support and modeling, and demographic variables. The outcome variables will consist of short-term, post-surgery responses (such as reported pain, use of analgesics, work disability, disability days at home) and subsequent behaviorial response (level of compliance with the periodontal home care regimen at 6 months post-surgery). A study population of 120 patients will participate, with 30 assigned randomly to each experimental cell. Data will be collected through interviews with patients, questionaire assessments by their periodontists, and by oral examination of dental plaque status as a measure of periodontal home care compliance.
| Baume, R M; Croog, S H; Nalbandian, J (1995) Pain perception, coping strategies, and stress management among periodontal patients with repeated surgeries. Percept Mot Skills 80:307-19 |
