Ruben Mollie A, Hall Judith A
a Center for Healthcare Organization and Implementation Research , U.S. Department of Veterans Affairs.
b Department of Psychology , Northeastern University.
Health Commun. 2016 Aug;31(8):934-45. doi: 10.1080/10410236.2015.1020261. Epub 2016 Jan 11.
Two studies examined the expression and detection of suppressed, genuine, and exaggerated pain. In Study 1, videotaped participants underwent an acute laboratory pain stressor and completed pain ratings. In Study 2, the lens model examined the cues encoders displayed while in pain (facial expressions of pain and viewers' global impressions), the cues decoders used to infer pain in the videotaped encoders, and decoders' accuracy in making judgments of pain. Results revealed expression differences between the suppressed, genuine, and exaggerated pain such that exaggerated expressions contained more tightened facial expressions while genuine expressions of pain contained more open facial expressions of pain. Decoders were accurate at detecting pain only in the exaggerated pain expressions. These results highlight the need for improving providers' accuracy in detecting pain intensity for suppressed, genuine, and exaggerated pain displays. Trainings should focus on teaching providers that patients who appear more agitated and less composed may be suppressing pain, while patients who appear more tense and determined may be exaggerating pain. Finally, patients who seem to not be in that much pain because they are not showing tightened facial expressions may actually be experiencing higher intensities of genuine pain.
两项研究对压抑性疼痛、真性疼痛和夸大性疼痛的表达及检测进行了考察。在研究1中，对参与研究的人员进行录像，让他们承受急性实验室疼痛应激源并完成疼痛评级。在研究2中，透镜模型考察了编码者在疼痛时所表现出的线索（疼痛的面部表情及观察者的整体印象）、解码者用于推断录像中编码者疼痛的线索，以及解码者判断疼痛的准确性。结果显示，压抑性疼痛、真性疼痛和夸大性疼痛在表达上存在差异，即夸大性表情包含更多面部紧绷的表现，而真性疼痛表情则包含更多疼痛时面部放松的表现。解码者仅能准确检测出夸大性疼痛表情中的疼痛。这些结果凸显了提高医疗人员在检测压抑性、真性和夸大性疼痛表现时判断疼痛强度准确性的必要性。培训应着重教导医疗人员，那些看起来更激动、更不沉着的患者可能在压抑疼痛，而那些看起来更紧张、更坚定的患者可能在夸大疼痛。最后，那些似乎因未表现出面部紧绷而看起来疼痛程度不高的患者，实际上可能正经历着更高强度的真性疼痛。
