Skip to main content
Top
Gepubliceerd in: Journal of Behavioral Medicine 1/2010

01-02-2010

Taking into account the observers’ uncertainty: a graduated approach to the credibility of the patient’s pain evaluation

Auteurs: Patrice Rusconi, Paolo Riva, Paolo Cherubini, Lorenzo Montali

Gepubliceerd in: Journal of Behavioral Medicine | Uitgave 1/2010

Log in om toegang te krijgen
share
DELEN

Deel dit onderdeel of sectie (kopieer de link)

  • Optie A:
    Klik op de rechtermuisknop op de link en selecteer de optie “linkadres kopiëren”
  • Optie B:
    Deel de link per e-mail

Abstract

This article presents two experiments aiming to investigate the adoption of a graduated measure to describe credibility attribution by observers who evaluate patients’ pain accounts. A total of 160 medical students were required to express a credibility judgment on the pain intensity level of hypothetical patients. We used 16 vignettes based on a factorial mixed-design. Within-participants factors were the reported pain, the presence of a physical sign, the patient’s facial expression and the patient’s gender, and between-groups factors were the patient’s age and the geographical distribution of the patient’s name. Results confirm the well-established tendency not to believe patients’ self-reports and provide information regarding the evaluators’ uncertainty. The findings suggest that a graduated measure is useful for assessing the degree of uncertainty of the observers and subtle effects of different factors upon the judgment of patient’s pain.
Bijlagen
Alleen toegankelijk voor geautoriseerde gebruikers
Voetnoten
1
The latter factor was introduced on the basis of a preliminary qualitative study in which it emerged that healthcare professionals were influenced by the patients’ place of origin (Montali et al. 2009). Hence, in order to further test this aspect we decided to take into account the geographical distribution of the patients’ names instead of tackling the better known ethnic disparities (Edwards et al. 2001a, b; Cintron and Morrison 2006).
 
2
In these analyses and in all the subsequent non-parametric analyses we performed a series of Wilcoxon tests when considering the within-participants variables, while we used the Mann–Whitney test when examining the between-groups factors.
 
3
The effect size r was computed, in these analyses and in all the subsequent non-parametric analyses, as follows:
\( r = Z/\surd N \), where N is the total number of observations (Field 2005).
 
4
When the n hypotheses are equiprobable the entropy reduces to the log2(n).
 
5
In keeping with this reading, the literature on interval estimates indicates that a wide interval is less informative than a narrow interval (e.g., Yaniv and Foster 1995, 1997; McKenzie et al. 2008).
 
6
These two values are analog to the surface (i.e., the integral) to the right and left of the mode of a probability distribution; in this context, they correspond to the overall amount of trust allocated to the right and to the left of the most trusted value.
 
Literatuur
go back to reference Bell, F. (2000). A review of the literature on the attitudes of nurses to acute pain management. Journal of Orthopaedic Nursing, 4, 64–70.CrossRef Bell, F. (2000). A review of the literature on the attitudes of nurses to acute pain management. Journal of Orthopaedic Nursing, 4, 64–70.CrossRef
go back to reference Breivik, H. H., Collett, B. B., Ventafridda, V. V., Cohen, R. R., & Gallacher, D. D. (2006). Survey of chronic pain in Europe: Prevalence, impact on daily life, and treatment. European Journal of Pain, 10(4), 287–333.CrossRefPubMed Breivik, H. H., Collett, B. B., Ventafridda, V. V., Cohen, R. R., & Gallacher, D. D. (2006). Survey of chronic pain in Europe: Prevalence, impact on daily life, and treatment. European Journal of Pain, 10(4), 287–333.CrossRefPubMed
go back to reference Chibnall, J. T., Dabney, A., & Tait, R. C. (2000). Internist judgments of chronic low back pain. Pain Medicine, 1(3), 231–237.CrossRefPubMed Chibnall, J. T., Dabney, A., & Tait, R. C. (2000). Internist judgments of chronic low back pain. Pain Medicine, 1(3), 231–237.CrossRefPubMed
go back to reference Chibnall, J. T., & Tait, R. C. (1995). Observer perceptions of low back pain: Effects of pain report and other contextual factors. Journal of Applied Social Psychology, 25(5), 418–439.CrossRef Chibnall, J. T., & Tait, R. C. (1995). Observer perceptions of low back pain: Effects of pain report and other contextual factors. Journal of Applied Social Psychology, 25(5), 418–439.CrossRef
go back to reference Chibnall, J. T., & Tait, R. C. (2004). Comment on Marquie L. et al. Pain rating by patients and physicians: Evidence of systematic pain miscalibration (Pain 2003; 102:289–96). Pain, 107, 192–193.CrossRef Chibnall, J. T., & Tait, R. C. (2004). Comment on Marquie L. et al. Pain rating by patients and physicians: Evidence of systematic pain miscalibration (Pain 2003; 102:289–96). Pain, 107, 192–193.CrossRef
go back to reference Chibnall, J. T., Tait, R. C., & Ross, L. R. (1997). The effects of medical evidence and pain intensity on medical student judgments of chronic pain patients. Journal of Behavioral Medicine, 20(3), 257–271.CrossRefPubMed Chibnall, J. T., Tait, R. C., & Ross, L. R. (1997). The effects of medical evidence and pain intensity on medical student judgments of chronic pain patients. Journal of Behavioral Medicine, 20(3), 257–271.CrossRefPubMed
go back to reference Cintron, A., & Morrison, R. S. (2006). Pain and ethnicity in the United States: A systematic review. Journal of Palliative Medicine, 9(6), 1454–1473.CrossRefPubMed Cintron, A., & Morrison, R. S. (2006). Pain and ethnicity in the United States: A systematic review. Journal of Palliative Medicine, 9(6), 1454–1473.CrossRefPubMed
go back to reference Clarke, K. A., & Iphofen, R. (2005). Believing the patient with chronic pain: A review of the literature. British Journal of Nursing, 14(9), 490–493.PubMed Clarke, K. A., & Iphofen, R. (2005). Believing the patient with chronic pain: A review of the literature. British Journal of Nursing, 14(9), 490–493.PubMed
go back to reference Clarke, K. A., & Iphofen, R. (2008). The effects of failing to believe patients’ experience of chronic pain. Nursing Times, 104(8), 30–31. Clarke, K. A., & Iphofen, R. (2008). The effects of failing to believe patients’ experience of chronic pain. Nursing Times, 104(8), 30–31.
go back to reference Craig, K. D., Hyde, S. A., & Patrick, C. J. (1991). Genuine, suppressed and faked facial behavior during exacerbation of chronic low back pain. Pain, 46, 161–171.CrossRefPubMed Craig, K. D., Hyde, S. A., & Patrick, C. J. (1991). Genuine, suppressed and faked facial behavior during exacerbation of chronic low back pain. Pain, 46, 161–171.CrossRefPubMed
go back to reference Edwards, R. R., Doleys, D. M., Fillingim, R. B., & Lowery, D. (2001a). Ethnic differences in pain tolerance: Clinical implications in a chronic pain population. Psychosomatic Medicine, 63, 316–323.PubMed Edwards, R. R., Doleys, D. M., Fillingim, R. B., & Lowery, D. (2001a). Ethnic differences in pain tolerance: Clinical implications in a chronic pain population. Psychosomatic Medicine, 63, 316–323.PubMed
go back to reference Edwards, C. L., Fillingim, R. B., & Keefe, F. (2001b). Race, ethnicity and pain. Pain, 94, 133–137.CrossRefPubMed Edwards, C. L., Fillingim, R. B., & Keefe, F. (2001b). Race, ethnicity and pain. Pain, 94, 133–137.CrossRefPubMed
go back to reference Elander, J., Marczewska, M., Amos, R., Thomas, A., & Tangayi, S. (2006). Factors affecting hospital staff judgments about sickle cell disease pain. Journal of Behavioral Medicine, 29(2), 203–214.CrossRefPubMed Elander, J., Marczewska, M., Amos, R., Thomas, A., & Tangayi, S. (2006). Factors affecting hospital staff judgments about sickle cell disease pain. Journal of Behavioral Medicine, 29(2), 203–214.CrossRefPubMed
go back to reference Field, A. (2005). Discovering statistics using SPSS (2nd ed.). London: Sage. Field, A. (2005). Discovering statistics using SPSS (2nd ed.). London: Sage.
go back to reference Iafrati, N. S. (1986). Pain on the burn unit: Patient versus nurse perceptions. Journal of Burn Care and Rehabilitation, 7, 413–416.CrossRefPubMed Iafrati, N. S. (1986). Pain on the burn unit: Patient versus nurse perceptions. Journal of Burn Care and Rehabilitation, 7, 413–416.CrossRefPubMed
go back to reference Igier, V., Mullet, E., & Sorum, P. C. (2007). How nursing personnel judge patients’ pain. European Journal of Pain, 11(5), 542–550.CrossRefPubMed Igier, V., Mullet, E., & Sorum, P. C. (2007). How nursing personnel judge patients’ pain. European Journal of Pain, 11(5), 542–550.CrossRefPubMed
go back to reference Jacques, A. (1992). Do you believe I’m in pain? Professional Nurse, 7(4), 249–251. Jacques, A. (1992). Do you believe I’m in pain? Professional Nurse, 7(4), 249–251.
go back to reference Kappesser, J., Williams, A. C. d. C., & Prkachin, K. (2004). What makes clinicians underestimate pain? The Journal of Pain, 5(3, Supplement), S128.CrossRef Kappesser, J., Williams, A. C. d. C., & Prkachin, K. (2004). What makes clinicians underestimate pain? The Journal of Pain, 5(3, Supplement), S128.CrossRef
go back to reference Kappesser, J., & Williams, A. C. d. C. (2008). Pain judgements of patients’ relatives: Examining the use of social contract theory as theoretical framework. Journal of Behavioral Medicine, 31, 309–317.CrossRefPubMed Kappesser, J., & Williams, A. C. d. C. (2008). Pain judgements of patients’ relatives: Examining the use of social contract theory as theoretical framework. Journal of Behavioral Medicine, 31, 309–317.CrossRefPubMed
go back to reference Kappesser, J., Williams, A. C. d. C., & Prkachin, K. M. (2006). Testing two accounts of pain underestimation. Pain, 124, 109–116.CrossRefPubMed Kappesser, J., Williams, A. C. d. C., & Prkachin, K. M. (2006). Testing two accounts of pain underestimation. Pain, 124, 109–116.CrossRefPubMed
go back to reference Kendrick, D. B., & Strout, T. D. (2005). The minimum clinically significant difference in patient-assigned numeric scores for pain. The American Journal of Emergency Medicine, 23(7), 828–832.CrossRefPubMed Kendrick, D. B., & Strout, T. D. (2005). The minimum clinically significant difference in patient-assigned numeric scores for pain. The American Journal of Emergency Medicine, 23(7), 828–832.CrossRefPubMed
go back to reference Loveman, E., & Gale, A. (2000). Factors influencing nurses’ inferences about patient pain. British Journal of Nursing, 9(6), 334–337.PubMed Loveman, E., & Gale, A. (2000). Factors influencing nurses’ inferences about patient pain. British Journal of Nursing, 9(6), 334–337.PubMed
go back to reference Lunney, G. H. (1970). Using analysis of variance with a dichotomous dependent variable: An empirical study. Journal of Educational Measurement, 7(4), 263–269.CrossRef Lunney, G. H. (1970). Using analysis of variance with a dichotomous dependent variable: An empirical study. Journal of Educational Measurement, 7(4), 263–269.CrossRef
go back to reference MacLeod, F. K., LaChapelle, D. L., Hadjistavropoulos, T., & Pfeifer, J. E. (2001). The effect of disability claimants’ coping styles on judgments of pain, disability, and compensation: A vignette study. Rehabilitation Psychology, 46(4), 417–435.CrossRef MacLeod, F. K., LaChapelle, D. L., Hadjistavropoulos, T., & Pfeifer, J. E. (2001). The effect of disability claimants’ coping styles on judgments of pain, disability, and compensation: A vignette study. Rehabilitation Psychology, 46(4), 417–435.CrossRef
go back to reference Mader, T. J., Blank, F. S. J., Smithline, H. A., & Wolfe, J. M. (2003). How reliable are pain scores? A pilot study of 20 healthy volunteers. Journal of Emergency Nursing, 29(4), 322–325.CrossRefPubMed Mader, T. J., Blank, F. S. J., Smithline, H. A., & Wolfe, J. M. (2003). How reliable are pain scores? A pilot study of 20 healthy volunteers. Journal of Emergency Nursing, 29(4), 322–325.CrossRefPubMed
go back to reference Marks, R. M., & Sachar, E. J. (1973). Undertreatment of medical inpatients with narcotic analgesics. Annals of Internal Medicine, 78, 173–181.PubMed Marks, R. M., & Sachar, E. J. (1973). Undertreatment of medical inpatients with narcotic analgesics. Annals of Internal Medicine, 78, 173–181.PubMed
go back to reference Marquié, L., Raufaste, E., Lauque, D., Mariné, C., Ecoiffier, M., & Sorum, P. (2003). Pain rating by patients and physicians: Evidence of systematic pain miscalibration. Pain, 102(3), 289–296.CrossRefPubMed Marquié, L., Raufaste, E., Lauque, D., Mariné, C., Ecoiffier, M., & Sorum, P. (2003). Pain rating by patients and physicians: Evidence of systematic pain miscalibration. Pain, 102(3), 289–296.CrossRefPubMed
go back to reference Marquié, L., Raufaste, E., Lauque, D., Mariné, C., Ecoiffier, M., & Sorum, P. (2004). Further results about pain rating by patients and physicians: Reply to Chibnall and Tait. Pain, 107, 194–195.CrossRef Marquié, L., Raufaste, E., Lauque, D., Mariné, C., Ecoiffier, M., & Sorum, P. (2004). Further results about pain rating by patients and physicians: Reply to Chibnall and Tait. Pain, 107, 194–195.CrossRef
go back to reference Marquié, L., Sorum, P. C., & Mullet, E. (2007). Emergency physicians’ pain judgments: Cluster analyses on scenarios of acute abdominal pain. Quality of Life Research, 16(7), 1267–1273.CrossRefPubMed Marquié, L., Sorum, P. C., & Mullet, E. (2007). Emergency physicians’ pain judgments: Cluster analyses on scenarios of acute abdominal pain. Quality of Life Research, 16(7), 1267–1273.CrossRefPubMed
go back to reference McCaffery, M., Rolling Ferrell, B., & Pasero, C. (2000). Nurses’ personal opinions about patients’ pain and their effect on recorded assessments and titration of opioid doses. Pain Management Nursing, 1(3), 79–87.CrossRefPubMed McCaffery, M., Rolling Ferrell, B., & Pasero, C. (2000). Nurses’ personal opinions about patients’ pain and their effect on recorded assessments and titration of opioid doses. Pain Management Nursing, 1(3), 79–87.CrossRefPubMed
go back to reference McKenzie, C. R. M., Liersch, M. J., & Yaniv, I. (2008). Overconfidence in interval estimates: What does expertise buy you? Organizational Behavior and Human Decision Processes, 107(2), 179–191.CrossRef McKenzie, C. R. M., Liersch, M. J., & Yaniv, I. (2008). Overconfidence in interval estimates: What does expertise buy you? Organizational Behavior and Human Decision Processes, 107(2), 179–191.CrossRef
go back to reference Montali, L., Colombo, M., & Riva, P. (2009). Theories and practices in pain management: A research on doctors’ representations. Psicologia della Salute, 1, 33–56. Montali, L., Colombo, M., & Riva, P. (2009). Theories and practices in pain management: A research on doctors’ representations. Psicologia della Salute, 1, 33–56.
go back to reference Peabody, J. W., Luck, J., Glassman, P., Dresselhaus, T. R., & Lee, M. (2000). Comparison of vignettes, standardized patients, and chart abstraction. A prospective validation study of 3 methods for measuring quality. The Journal of the American Medical Association, 283(13), 1715–1722.CrossRef Peabody, J. W., Luck, J., Glassman, P., Dresselhaus, T. R., & Lee, M. (2000). Comparison of vignettes, standardized patients, and chart abstraction. A prospective validation study of 3 methods for measuring quality. The Journal of the American Medical Association, 283(13), 1715–1722.CrossRef
go back to reference Pesudovs, K., & Noble, B. A. (2005). Improving subjective scaling of pain using rasch analysis. The Journal of Pain, 6(9), 630–636.CrossRefPubMed Pesudovs, K., & Noble, B. A. (2005). Improving subjective scaling of pain using rasch analysis. The Journal of Pain, 6(9), 630–636.CrossRefPubMed
go back to reference Prkachin, K. M., Solomon, P. E., & Ross, J. (2007). Underestimation of pain by health-care providers: Towards a model of the process of inferring pain in others. Canadian Journal of Nursing Research, 39(2), 88–106.PubMed Prkachin, K. M., Solomon, P. E., & Ross, J. (2007). Underestimation of pain by health-care providers: Towards a model of the process of inferring pain in others. Canadian Journal of Nursing Research, 39(2), 88–106.PubMed
go back to reference Puntillo, K., Neighbor, M., & Nixon, R. (2003). Accuracy of emergency nurses in assessment of patients’ pain. Pain Management Nursing, 4(4), 171–175.CrossRefPubMed Puntillo, K., Neighbor, M., & Nixon, R. (2003). Accuracy of emergency nurses in assessment of patients’ pain. Pain Management Nursing, 4(4), 171–175.CrossRefPubMed
go back to reference Saxey, S. (1986). The nurse’s response to postoperative pain. Nursing: The Add on Journal of Clinical Nursing, 3(10), 377–381. Saxey, S. (1986). The nurse’s response to postoperative pain. Nursing: The Add on Journal of Clinical Nursing, 3(10), 377–381.
go back to reference Scott, I. (1992). Nurses’ attitudes to pain control and the use of pain assessment scales. British Journal of Nursing, 2(1), 11–14.PubMed Scott, I. (1992). Nurses’ attitudes to pain control and the use of pain assessment scales. British Journal of Nursing, 2(1), 11–14.PubMed
go back to reference Shannon, C. E. (1948). A mathematical theory of communication. The Bell System Technical Journal, 27(379–423), 623–656. Shannon, C. E. (1948). A mathematical theory of communication. The Bell System Technical Journal, 27(379–423), 623–656.
go back to reference Solomon, P. (2001). Congruence between health professionals’ and patients’ pain ratings: A review of the literature. Scandinavian Journal of Caring Sciences, 15(2), 174–180.CrossRefPubMed Solomon, P. (2001). Congruence between health professionals’ and patients’ pain ratings: A review of the literature. Scandinavian Journal of Caring Sciences, 15(2), 174–180.CrossRefPubMed
go back to reference Strout, T. D., & Burton, J. H. (2004). Clinically significant change in physician-assigned numeric pain rating scale scores. American Journal of Emergency Medicine, 22(3), 243–244.CrossRefPubMed Strout, T. D., & Burton, J. H. (2004). Clinically significant change in physician-assigned numeric pain rating scale scores. American Journal of Emergency Medicine, 22(3), 243–244.CrossRefPubMed
go back to reference Tait, R. C., & Chibnall, J. T. (1994). Observer perceptions of chronic low back pain. Journal of Applied Social Psychology, 24(5), 415–431.CrossRef Tait, R. C., & Chibnall, J. T. (1994). Observer perceptions of chronic low back pain. Journal of Applied Social Psychology, 24(5), 415–431.CrossRef
go back to reference Thorn, M. (1997). A survey of nurses’ attitudes towards the assessment and control of postoperative pain. Journal of Orthopaedic Nursing, 1, 30–38.CrossRef Thorn, M. (1997). A survey of nurses’ attitudes towards the assessment and control of postoperative pain. Journal of Orthopaedic Nursing, 1, 30–38.CrossRef
go back to reference Visentin, M., Zanolin, E., Trentin, L., Sartori, S., & de Marco, R. (2005). Prevalence and treatment of pain in adults admitted to Italian hospitals. European Journal of Pain, 9, 61–67.CrossRefPubMed Visentin, M., Zanolin, E., Trentin, L., Sartori, S., & de Marco, R. (2005). Prevalence and treatment of pain in adults admitted to Italian hospitals. European Journal of Pain, 9, 61–67.CrossRefPubMed
go back to reference Waterhouse, M. (1996). Why pain assessment must start with believing the patient. Nursing Times, 92(38), 42–43.PubMed Waterhouse, M. (1996). Why pain assessment must start with believing the patient. Nursing Times, 92(38), 42–43.PubMed
go back to reference Yaniv, I., & Foster, D. P. (1995). Graininess of judgment under uncertainty: An accuracy-informativeness trade-off. Journal of Experimental Psychology: General, 124(4), 424–432.CrossRef Yaniv, I., & Foster, D. P. (1995). Graininess of judgment under uncertainty: An accuracy-informativeness trade-off. Journal of Experimental Psychology: General, 124(4), 424–432.CrossRef
go back to reference Yaniv, I., & Foster, D. P. (1997). Precision and accuracy of judgmental estimation. Journal of Behavioral Decision Making, 10, 21–32.CrossRef Yaniv, I., & Foster, D. P. (1997). Precision and accuracy of judgmental estimation. Journal of Behavioral Decision Making, 10, 21–32.CrossRef
go back to reference Yates, P., Dewar, A., Edwards, H., Fetiman, B., Najman, J., Nash, R., et al. (1998). The prevalence and perception of pain amongst hospital in-patients. Journal of Clinical Nursing, 7, 521–530.CrossRefPubMed Yates, P., Dewar, A., Edwards, H., Fetiman, B., Najman, J., Nash, R., et al. (1998). The prevalence and perception of pain amongst hospital in-patients. Journal of Clinical Nursing, 7, 521–530.CrossRefPubMed
Metagegevens
Titel
Taking into account the observers’ uncertainty: a graduated approach to the credibility of the patient’s pain evaluation
Auteurs
Patrice Rusconi
Paolo Riva
Paolo Cherubini
Lorenzo Montali
Publicatiedatum
01-02-2010
Uitgeverij
Springer US
Gepubliceerd in
Journal of Behavioral Medicine / Uitgave 1/2010
Print ISSN: 0160-7715
Elektronisch ISSN: 1573-3521
DOI
https://doi.org/10.1007/s10865-009-9232-5

Andere artikelen Uitgave 1/2010

Journal of Behavioral Medicine 1/2010 Naar de uitgave