title: Coping with oral surgery by self-efficacy enhancement and perceptions of control.
abstract: Recent work has suggested that patients' coping could be improved in stressful dental situations if perceptions of self-efficacy and control could be enhanced. To test this hypothesis, 70 first-time third-molar extraction patients were randomly assigned to one of four surgery preparation conditions: standard preparation, oral premedication, relaxation, and a relaxation+efficacy-enhancing feed-back condition in which subjects were given false galvanic skin response (GSR) biofeedback leading them to believe that they were highly skilled at relaxing. Analyses indicated that: (1) all treatments were seen as equally credible (controlling for placebo effects); (2) a priori contrasts showed that both the relaxation-only treatment and the relaxation+efficacy-enhancement treatment were superior to the premedication and standard preparations in raising coping self-efficacy; (3) regardless of treatment condition, increase in reported coping self-efficacy was significantly correlated with pre-operative anxiety, with self-reported peri-operative distress, and with behavioral ratings of peri-operative distress; and (4) the relaxation treatments resulted in lower pre-operative anxiety than the other interventions, and linear contrasts showed significant trends in which the relaxation+efficacy-enhancing condition was superior to the relaxation-only condition, which was in turn superior to the medication condition and the standard preparation in reducing both pre-operative anxiety and behavioral ratings of peri-operative distress. It was concluded that thoughts related to self-confidence and control can be manipulated, and that these thoughts can in part determine how well a person copes in stressful dental situations.
authors.affiliation: Department of Behavioral Sciences and Community Health, University of Connecticut School of Dental Medicine, Farmington 06030.
authors.forename: M D
authors.initials: MD
authors.lastname: Litt
authors.forename: C
authors.initials: C
authors.lastname: Nye
authors.forename: D
authors.initials: D
authors.lastname: Shafer
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D000704:Analysis of Variance; D001521:Behavior Therapy / Q000379:methods*; D001676:Biofeedback, Psychology; D015928:Cognitive Behavioral Therapy; D016854:Dental Anxiety / Q000517:prevention & control*; D005260:Female; D005712:Galvanic Skin Response; D006801:Humans; D007389:Internal-External Control; D008140:Lorazepam / Q000627:therapeutic use; D008297:Male; D015999:Multivariate Analysis; D011229:Preanesthetic Medication; D012064:Relaxation Therapy; D012649:Self Concept; D012647:Self-Assessment; D013515:Surgery, Oral / Q000523:psychology*; D011795:Surveys and Questionnaires
chemical_list: D008140:Lorazepam