Samolsky Dekel Boaz Gedaliahu, Gori Alberto, Vasarri Alessio, Sorella Maria Cristina, Di Nino Gianfranco, Melotti Rita Maria
University of Bologna, Department of Medicine and Surgery Sciences, Via Massarenti 9, 40138 Bologna, Italy; Azienda Ospedaliera-Universitaria di Bologna Policlinico S. Orsola-Malpighi, Via Massarenti 9, 40138 Bologna, Italy; University of Bologna, Post-Graduate School of Anaesthesia and Intensive Care, Via Massarenti 9, 40138 Bologna, Italy.
University of Bologna, Post-Graduate School of Anaesthesia and Intensive Care, Via Massarenti 9, 40138 Bologna, Italy.
Pain Res Manag. 2016;2016:9267536. doi: 10.1155/2016/9267536. Epub 2016 Apr 28.
Biased pain evaluation due to automated heuristics driven by symptom uncertainty may undermine pain treatment; medical evidence moderators are thought to play a role in such circumstances. We explored, in this cross-sectional survey, the effect of such moderators (e.g., nurse awareness of patients' pain experience and treatment) on the agreement between n = 862 inpatients' self-reported pain and n = 115 nurses' pain ratings using a numerical rating scale. We assessed the mean of absolute difference, agreement (κ-statistics), and correlation (Spearman rank) of inpatients and nurses' pain ratings and analyzed congruence categories' (CCs: underestimation, congruence, and overestimation) proportions and dependence upon pain categories for each medical evidence moderator (χ (2) analysis). Pain ratings agreement and correlation were limited; the CCs proportions were further modulated by the studied moderators. Medical evidence promoted in nurses overestimation of low and underestimation of high inpatients' self-reported pain. Knowledge of the negative influence of automated heuristics driven by symptoms uncertainty and medical-evidence moderators on pain evaluation may render pain assessment more accurate.
