Chibnall J T, Tait R C, Ross L R
Department of Psychiatry, Saint Louis University, School of Medicine, Missouri 63104, USA.
J Behav Med. 1997 Jun;20(3):257-71. doi: 10.1023/a:1025504827787.
This study examined symptom judgments made by medical students of hypothetical chronic low back pain patients. Eight vignettes were varied as to the pain intensity reported by the hypothetical patient (low vs. moderate vs. high vs. very high) and the availability of medical evidence supportive of the pain report (present vs. absent). Ninety-five subjects read vignettes and made judgments of patient emotional distress, pain intensity, and pain-related disability. Subjects significantly discounted pain level when intensity was high but slightly augmented pain level when intensity was low. Judgments of pain and disability were higher for patients for whom medical evidence was present compared to those for whom it was absent. The results support and extend previous research on the effects of situational and patient variables on observer pain judgments. Future research should examine the influence of these biasing variables on the assessment and treatment of chronic pain patients.
本研究考察了医学生对假设的慢性下腰痛患者症状的判断。八个案例在假设患者报告的疼痛强度（低、中、高、非常高）以及支持疼痛报告的医学证据的可得性（有、无）方面有所不同。95名受试者阅读案例并对患者的情绪困扰、疼痛强度和与疼痛相关的残疾进行判断。当疼痛强度高时，受试者显著低估疼痛程度；而当强度低时，他们会略微高估疼痛程度。与没有医学证据的患者相比，有医学证据的患者的疼痛和残疾判断更高。这些结果支持并扩展了先前关于情境和患者变量对观察者疼痛判断影响的研究。未来的研究应考察这些偏差变量对慢性疼痛患者评估和治疗的影响。
