title: Preoperative coping strategies and distress predict postoperative pain and morphine consumption in women undergoing abdominal gynecologic surgery.
abstract: OBJECTIVE
  The aim of the present study was to predict postoperative pain and morphine consumption based on preoperative psychosocial factors.
  
  
  METHODS
  One hundred and twenty-two women completed measures of distress and coping 1 week before major abdominal gynecological surgery by laparotomy. Forty-eight hours after surgery, measures of pain and negative affect (NA) were completed, and morphine consumption was recorded from a patient-controlled analgesia pump. Four weeks after surgery, measures of pain and NA were completed.
  
  
  RESULTS
  Multivariate analyses revealed that preoperative self-distraction coping (P=.039) positively predicted postoperative pain levels in the hospital, after accounting for the effects of age, concurrent NA, and morphine consumption. Emotional support (P=.031) and religious-based coping (P=.036) positively predicted morphine consumption in the hospital, after accounting for the effects of age, concurrent NA, and pain levels. Preoperative distress (P<.04 to .008) and behavioral disengagement (P=.034), emotional support (P=.049), and religious-based coping (P=.001) positively predicted pain levels 4 weeks after surgery, after accounting for the effects of age and concurrent NA.
  
  
  CONCLUSIONS
  The results suggest that preoperative psychosocial factors are associated with postoperative pain and morphine consumption.
authors.affiliation: Department of Behavioral Science, The University of Texas, M.D. Anderson Cancer Center, Box 243, 1515 Holcombe Boulevard, Houston, TX 77030, USA. lcohen@mdanderson.org
authors.forename: Lorenzo
authors.initials: L
authors.lastname: Cohen
authors.forename: Rachel T
authors.initials: RT
authors.lastname: Fouladi
authors.forename: Joel
authors.initials: J
authors.lastname: Katz
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D000368:Aged; D016058:Analgesia, Patient-Controlled; D000701:Analgesics, Opioid / Q000627:therapeutic use*; D005260:Female; D013509:Gynecologic Surgical Procedures; D006801:Humans; D008297:Male; D008875:Middle Aged; D009020:Morphine / Q000627:therapeutic use*; D010147:Pain Measurement; D010149:Postoperative Pain / Q000188:drug therapy* / Q000517:prevention & control; D011300:Preoperative Care; D011795:Surveys and Questionnaires
chemical_list: D000701:Analgesics, Opioid; D009020:Morphine