Pre-Operative Anxiety and Coping Strategies in Relation to Post-Operative Recovery Management

Surgical procedures often elicit significant psychological responses among patients, which can influence their overall recovery experience and outcomes. This study examined the relationship between pre-operative anxiety, coping strategies, and post-operative recovery management among surgical patients, emphasizing how psychological responses prior to surgery and coping behaviors influence recovery outcomes such as pain management, physiological stability, complication prevention, and functional recovery. The study employed a descriptive-correlational research design and was conducted in a tertiary government hospital in Ozamiz City, Philippines. A total of 100 surgical patients undergoing elective procedures were purposively included in the study. Data were gathered through a researcher-made questionnaire and analyzed using the weighted mean, standard deviation, and Pearson’s Product-Moment Correlation Coefficient. Patients demonstrated extremely elevated pre-operative anxiety, highly utilized coping strategies, and excellent post-operative recovery management. Pre-operative anxiety does not directly influence post-operative recovery management, whereas coping strategies such as emotion-focused coping and cognitive reframing contribute in limited and specific ways, indicating that recovery outcomes are largely shaped by other clinical and supportive factors. Healthcare providers may integrate structured anxiety screening, coping interventions, and continuous clinical management to enhance both psychological support and post-operative recovery outcomes among surgical patients.

cognitive reframing, coping strategies, post-operative recovery, pre-operative anxiety, surgical patients

1. Akbari, A. (2025). The effects of preoperative education on postoperative outcomes in cardiac surgery patients. [Google Scholar] [Crossref]

2. Alanazi, A. H. K., Alhazmi, A. M., Alruwaili, F. B., Alenzi, R. R. S., Alhazmy, A. M., & Alshammari, N. S. M. (2024). NURSING CARE FOR PATIENTS BEFORE AND AFTER SURGERY: STRATEGIES TO ENSURE SAFE AND EFFECTIVE RECOVERY. Gland Surgery, 9(2), 478-484. [Google Scholar] [Crossref]

3. Ali, N. N. (2023). Assessment of preoperative anxiety, its contributing factors, and impact on immediate postoperative outcomes among cardiac surgery patients-A cross-sectional study. [Google Scholar] [Crossref]

4. Banasiewicz, T., Kobiela, J., Cwaliński, J., Spychalski, P., Przybylska, P., Kornacka, K., ... & Kłęk, S. (2023). Recommendations on the use of prehabilitation, ie comprehensive preparation of the patient for surgery. [Google Scholar] [Crossref]

5. Bates, A., West, M. A., Jack, S., & Grocott, M. P. (2024). Preparing for and not waiting for surgery. Current Oncology, 31(2), 629-648. [Google Scholar] [Crossref]

6. Bondarchuk, O., Balakhtar, V., Pinchuk, N., Pustovalov, I., & Pavlenok, K. (2023). Adaptation of coping strategies to reduce the impact of stress and lonelines on the psychological well-being of adults. Journal of Law and Sustainable Development, 10(11). [Google Scholar] [Crossref]

7. Bondarchuk, O., Balakhtar, V., Pinchuk, N., Pustovalov, I., & Pavlenok, K. (2024). Coping with stressfull situations using coping strategies and their impact on mental health. Multidisciplinary Reviews, 7, 2024spe034. [Google Scholar] [Crossref]

8. Chen, L. (2025). Perioperative Inflammation and Immune Response in Anesthesia: Implications for Recovery and Postoperative Outcomes. Journal of Cardiothoracic and Vascular Anesthesia. [Google Scholar] [Crossref]

9. Chen, Y. Y. K., Soens, M. A., & Kovacheva, V. P. (2022). Less stress, better success: a scoping review on the effects of anxiety on anesthetic and analgesic consumption. Journal of anesthesia, 36(4), 532-553. [Google Scholar] [Crossref]

10. Folkman, S. (2023). Stress, coping, and health outcomes in medical populations: A 2023 perspective. Journal of Health Psychology, 28(2), 145–159. [Google Scholar] [Crossref]

11. Folkman, S., & Lazarus, R. S. (1980). An analysis of coping in a middle-aged community sample. Journal of Health and Social Behavior, 21(3), 219–239. [Google Scholar] [Crossref]

12. Garza-Ulloa, J. (2024). Theory for Anxiety Disorders. Anxiety and Anguish-Psychological Explorations and Anthropological Figures: Psychological Explorations and Anthropological Figures, 49. [Google Scholar] [Crossref]

13. Ghobadi, A., Moradpoor, H., Sharini, H., Khazaie, H., & Moradpoor, P. (2024). The effect of virtual reality on reducing patients’ anxiety and pain during dental implant surgery. BMC Oral Health, 24(1), 186. [Google Scholar] [Crossref]

14. Giordano, N. A., Kent, M. L., Kroma, R. B., Rojas, W., Lindl, M. J., Lujan, E., ... & Highland, K. B. (2023). Acute postoperative pain impact trajectories and factors contributing to trajectory membership. Pain Medicine, 24(7), 829-836. [Google Scholar] [Crossref]

15. Giusti, E. M., Lacerenza, M., Gabrielli, S., Manzoni, G. M., Manna, C., D’Amario, F., ... & Castelnuovo, G. (2022). Psychological factors and trajectories of post‐surgical pain: a longitudinal prospective study. Pain Practice, 22(2), 159-170. [Google Scholar] [Crossref]

16. Godor, B. P., van der Horst, F. C., & Van der Hallen, R. (2024). Unravelling the roots of emotional development: Examining the relationships between attachment, resilience and coping in young adolescents. The Journal of Early Adolescence, 44(4), 429-457. [Google Scholar] [Crossref]

17. Hinds, J. A., & Sanchez, E. R. (2022). The role of the hypothalamus–pituitary–adrenal (HPA) axis in test-induced anxiety: assessments, physiological responses, and molecular details. Stresses, 2(1), 146-155. [Google Scholar] [Crossref]

18. Hudson, G., Fung, C., Sureshkumar, D. S., Gómez-Restrepo, C., Uribe-Restrepo, J. M., Ariza-Salazar, K., ... & Kirkbride, J. B. (2025). Do coping mechanisms moderate the effect of stressful life events on depression and anxiety in young people? A case–control study from Latin America. BMJ Mental Health, 28(1). [Google Scholar] [Crossref]

19. Ivascu, R., Torsin, L. I., Hostiuc, L., Nitipir, C., Corneci, D., & Dutu, M. (2024). The surgical stress response and anesthesia: a narrative review. Journal of Clinical Medicine, 13(10), 3017. [Google Scholar] [Crossref]

20. Johnston, M. (2025). Perioperative models of care. Medicine, 53(1), 1-4. [Google Scholar] [Crossref]

21. Krupic, F., Krupic, M., Dervisevic, E., Kovacevic, M., & Bujakovic, T. (2025). Preoperative information as predictor of the patient’s fear and anxiety before surgery Systematic review of qualitative and quantitative literature. Saudi Journal of Anaesthesia, 19(4), 487-493. [Google Scholar] [Crossref]

22. Kumar, R., Sharma, P., & Gupta, N. (2023). Postoperative recovery management and its impact on surgical outcomes. International Journal of Surgery, 110, 106734. https://doi.org/10.1016/j.ijsu.2023.106734 [Google Scholar] [Crossref]

23. Lazarus, R. S., & Folkman, S. (1984). Stress, appraisal, and coping. New York, NY: Springer. [Google Scholar] [Crossref]

24. Lee, H., & Kim, S. (2023). Coping strategies and anxiety among caregivers of hospitalized patients: A transactional perspective. Journal of Nursing Research, 31(1), e182. [Google Scholar] [Crossref]

25. Lee, H., Kim, S., & Park, J. (2022). Application of Orem’s self-care deficit nursing theory in post-operative orthopedic care. Journal of Clinical Nursing, 31(15–16), 2500–2512. [Google Scholar] [Crossref]

26. Leis, O., Sharpe, B. T., Pelikan, V., Fritsch, J., Nicholls, A. R., & Poulus, D. (2024). Stressors and coping strategies in esports: A systematic review. International review of sport and exercise psychology, 1-31. [Google Scholar] [Crossref]

27. Loriga, L. (2025). Pre-operative Risk Assessment and Post-operative Risk Behaviours. In Body Integrity Dysphoria and the Ethical Dilemma of On-Demand Amputation: Redefining Wholeness: Identity, Autonomy, and the Moral Boundaries of the Human Body (pp. 49-57). Cham: Springer Nature Switzerland. [Google Scholar] [Crossref]

28. Lu, Y. J., Lee, M. C., Chen, C. Y., Liang, S. Y., Li, Y. P., & Chen, H. M. (2022). Effect of guided imagery meditation during laparoscopic cholecystectomy on reducing anxiety: a randomized controlled trial. Pain Management Nursing, 23(6), 885-892. [Google Scholar] [Crossref]

29. Majumdar, J. R., Barton-Burke, M., Gilliland, J. L., & Jairath, N. N. (2025). Coping strategies and psychological distress in postoperative recovery: A repeated-measures study in women undergoing breast-conserving surgery. Asia-Pacific Journal of Oncology Nursing, 12, 100674. [Google Scholar] [Crossref]

30. Ni, K., Zhu, J., & Ma, Z. (2023). Preoperative anxiety and postoperative adverse events: A narrative overview. Anesthesiology and Perioperative Science. [Google Scholar] [Crossref]

31. Niyonkuru, E., Iqbal, M. A., Zhang, X., & Ma, P. (2025). Complementary approaches to postoperative pain management: a review of non-pharmacological interventions. Pain and therapy, 14(1), 121-144. [Google Scholar] [Crossref]

32. Oh, J., Lee, W., Ki, S., Suh, J., & Hwang, S. (2024). Assessment of preoperative anxiety and influencing factors in patients undergoing elective surgery. Medicina (Kaunas), 60(3), 403. [Google Scholar] [Crossref]

33. Oliveira, P., Pires, R., Silva, R., & Sequeira, C. (2024). Design of a nursing psychoeducation program to reduce preoperative anxiety in adults. Frontiers in Public Health, 12, 1391764. [Google Scholar] [Crossref]

34. Oliveira, P., Porfírio, C., Pires, R., Silva, R., Carvalho, J. C., Costa, T., & Sequeira, C. (2022). Psychoeducation programs to reduce preoperative anxiety in adults: a scoping review. International journal of environmental research and public health, 20(1), 327. [Google Scholar] [Crossref]

35. Oorthuys, A. O., Ross, M., Kreukels, B. P., Mullender, M. G., & van de Grift, T. C. (2022, December). Identifying coping strategies used by transgender individuals in response to stressors during and after gender-affirming treatments—an explorative study. In Healthcare (Vol. 11, No. 1, p. 89). MDPI. [Google Scholar] [Crossref]

36. Orem, D. E. (2001). Nursing: Concepts of practice (6th ed.). St. Louis, MO: Mosby. [Google Scholar] [Crossref]

37. Oubaid, V. (2023). Psychological stress and the autonomic nervous system. In Primer on the Autonomic Nervous System (pp. 301-304). Academic Press. [Google Scholar] [Crossref]

38. Patel, R., & Kumar, S. (2023). Enhancing self-care in post-cardiac surgery patients: Application of Orem’s theory. Nursing Practice Today, 10(2), 45–53. [Google Scholar] [Crossref]

39. Reza, T., Grezenko, H., Barker, C., Bakht, D., Faran, N., Yahya, N. A., ... & ALMADHOUN, M. K. I. K. (2023). Emotional stress and immune response in surgery: a psychoneuroimmunological perspective. Cureus, 15(11). [Google Scholar] [Crossref]

40. Saiwan, M. J., & Al-showaily, J. S. (2025). Psycho-educational programs: Enhancing coping strategies and mitigating anxiety in chemotherapy patients. Babcock University Medical Journal, 8(2), 360-377. [Google Scholar] [Crossref]

41. Salazar Maya, Á. M. (2022). Nursing care during the perioperative within the surgical context. Investigacion y educacion en enfermeria, 40(2). [Google Scholar] [Crossref]

42. Samadi, S. (2024). The effect of preoperative education on preoperative anxiety in patients waiting for surgery: a literature review. [Google Scholar] [Crossref]

43. Shebl, M. A., Toraih, E., Shebl, M., & Tolba, A. (2025). Preoperative anxiety and its impact on surgical outcomes: A systematic review and meta analysis. Journal of Clinical and Translational Science, 9(1), e33. [Google Scholar] [Crossref]

44. Silva, F., Santos, L., & Oliveira, R. (2024). Physiological stability and enhanced recovery in postoperative patients: Evidence from tertiary care hospitals. Frontiers in Public Health, 12, 1432156. https://doi.org/10.3389/fpubh.2024.1432156 [Google Scholar] [Crossref]

45. Silvetti, S., Aloisio, T., & Bertini, P. (2024). Post-operative Implications. In Fast-Track in Cardiac Anesthesia: Cardiac Surgery in the Era of ERAS (pp. 229-237). Cham: Springer Nature Switzerland. [Google Scholar] [Crossref]

46. Syed, A., Menezes, T., Bisenius, A., Sic, A., & Knezevic, N. N. (2026). The Burden of Preoperative Stress: Biological Mechanisms and Postoperative Outcomes. Brain Sciences, 16(2), 219. [Google Scholar] [Crossref]

47. Tadesse, M., Ahmed, S., Regassa, T., Girma, T., Hailu, S., Mohammed, A., & Mohammed, S. (2022). Effect of preoperative anxiety on postoperative pain on patients undergoing elective surgery: Prospective cohort study. Annals of medicine and surgery, 73, 103190. [Google Scholar] [Crossref]

48. Weinerman, J., Vazquez, A., Schurhoff, N., Shatz, C., Goldenberg, B., Constantinescu, D., & Hernandez, G. M. (2023). The impacts of anxiety and depression on outcomes in orthopaedic trauma surgery: a narrative review. Annals of medicine and surgery, 85(11), 5523-5527. [Google Scholar] [Crossref]

49. Zhang, Y., Li, Q., & Wang, H. (2023). Postoperative pain management and recovery outcomes in elective surgery: A multicenter study. Pain Management Nursing, 24(3), 224–232. https://doi.org/10.1016/j.pmn.2023.05.007 [Google Scholar] [Crossref]

50. Zhuo, Q., Ma, F., Cui, C., Bai, Y., Hu, Q., Hanum, A. L., ... & Liang, H. (2023). Effects of pre-operative education tailored to information-seeking styles on pre-operative anxiety and depression among patients undergoing percutaneous coronary intervention: A randomized controlled trial. International Journal of Nursing Sciences, 10(2), 174-181. [Google Scholar] [Crossref]

• Assessment of the Role of Artificial Intelligence in Repositioning TVET for Economic Development in Nigeria
• Teachers’ Use of Assure Model Instructional Design on Learners’ Problem Solving Efficacy in Secondary Schools in Bungoma County, Kenya
• “E-Booksan Ang Kaalaman”: Development, Validation, and Utilization of Electronic Book in Academic Performance of Grade 9 Students in Social Studies
• Analyzing EFL University Students’ Academic Speaking Skills Through Self-Recorded Video Presentation
• Major Findings of The Study on Total Quality Management in Teachers’ Education Institutions (TEIs) In Assam – An Evaluative Study