Prkachin Kenneth M, Solomon Patricia E, Ross Joan
University of Northern British Columbia, Prince George, Canada.
Can J Nurs Res. 2007 Jun;39(2):88-106.
Health professionals are routinely exposed to evidence of pain in others. It is important that the processes by which they evaluate pain be understood. The purposes of this article are to review and synthesize recent research on how health professionals judge the pain of others and to present a conceptual model of this process. Methodological and conceptual issues in the conduct of pain judgement studies are addressed. Research in this field over the last 40 years has indicated that, when compared with the pain judgements of patients themselves, health professionals tend to underestimate pain. The authors review the relation of this underestimation bias to such variables as the nature of the patient's pain and the clinical experience of the judge. They also review experiential and cognitive-perceptual variables found to influence the degree of underestimation bias, such as the amount of exposure to evidence of pain and suspicion about the motivations of the patient. A model of the pain decoding process is presented. The issue of whether underestimation has implications for treatment outcome is addressed and priorities for future research are identified.
医疗专业人员经常会接触到他人疼痛的证据。了解他们评估疼痛的过程很重要。本文的目的是回顾和综合近期关于医疗专业人员如何判断他人疼痛的研究，并提出这一过程的概念模型。文中讨论了疼痛判断研究中的方法学和概念性问题。过去40年该领域的研究表明，与患者自身对疼痛的判断相比，医疗专业人员往往会低估疼痛。作者回顾了这种低估偏差与患者疼痛性质和判断者临床经验等变量之间的关系。他们还回顾了发现会影响低估偏差程度的经验性和认知感知变量，如接触疼痛证据的量以及对患者动机的怀疑。文中提出了一个疼痛解码过程的模型。讨论了低估是否对治疗结果有影响这一问题，并确定了未来研究的重点。
