Duration of pain condition and physical pathology as determinants of nurses' assessments of patients in pain.

This article is based on an experiment that examined features distinguishing chronic from acute pain syndromes, and their influence on nurses' estimates of patient suffering, pain relief actions, and attitudes toward patients. Two hundred sixty-eight nurses received one-paragraph descriptions of patients complaining of severe pain. Descriptions varied on the dimensions of duration (acute vs. chronic), signs of physical pathology (positive vs. negative), signs of depression (positive vs. negative), and diagnostic category (low back vs. headache vs. joint pain). Subjects estimated the intensity of the hypothetical patient's suffering, indicated priorities for specific pain relief actions, and rated the patient on a series of trait dimensions. Subjects attributed less intense pain when the patient had no signs of pathology and when duration was long-termed and chronic. They also assigned lower priorities to medication-related nursing actions when signs of pathology were negative. Finally, more negative personality and behavioral traits were attributed to the patient when signs of pathology were negative. The results reflect a dichotomous, organic versus psychogenic model of pain on the part of health care staff. Since the data indicate the chronic pain sufferer is negatively stereotyped by staff, a need exists to develop and disseminate more integrative models of the pain experience.