Styles of adjustment to coronary graft surgery

Using Herzlich's descriptions of styles of adaptation to illness a conceptual scheme is offered which sets out four potential modes of adjustment to illness (ACCOMMODATION, ACTIVE-DENIAL, RESIGNATION, SECONDARY GAIN). A study is reported in which a group of 40 patients attending for CABGS were interviewed to assess their adjustment style, their expectations of surgery and their pattern of activities. A second group of 40 patients who had received CABGS approx. 11 months previously were also interviewed regarding their course of recovery, activity pattern and style of adjustment to illness. Results indicate that the same adjustment styles may not be employed prior to surgery as are adopted during recovery. Specific findings indicate that different styles of adjustment are consistent with different expectations of surgery; with changes in patterns of activity; and with particular courses of recovery. These differences were not explicable in terms of the degree of angina reported by patients either prior to or following CABGS. Discussion of these and related findings point to the explanatory potential of the conceptual system outlined in the paper, within which scheme further questions of adjustment to illness can be addressed.