Expressing pain: which patients do we trust?

November 14, 2016
 By Alyssa
November 14, 2016
 By Alyssa

Expressing pain: which patients do we trust?

The feel of pain varies from individuals and has many affecting factors such as sex, age, and ethnicity. This makes it difficult to rate pain for treatments involving opioids. A study done showed that females had a low score on pain than men. But many of the women’s reaction for high rated pain were discounted compared to men. There are parts of the study that needs to be revamped to obtain better data.

Key Takeaways:

  • Trustworthiness is one of those instant judgements we automatically make about other people, affecting our behaviour towards them [1]. We wanted to know whether clinicians’ judgements of patients’ trustworthiness affected their estimation of patients’ pain [2]. There seem to be so many grounds on which the complaint and expression of pain is met with scepticism, or is discounted – being old, young, female, or from an ethnic minority, for starters – but also degree of attractiveness and likeability [3].
  • We used brief videos of male and female patients’ faces during a painful movement (a great resource annotated for pain by facial action coding [4]), selecting those with equivalent levels of pain expression but rated (by a panel of trainee clinical psychologists) at the higher and lower ends of trustworthiness. We embedded videos in an online study which we distributed to UK pain doctors and medical students in their clinical years, to vary extent of experience with treating pain.
  • Each video (a randomly selected set across participants) had a brief vignette in the form of a referral letter that included a ‘back story’ on depression, but we were not confident that participants read it as we intended and understood depression either to precede pain onset or to follow it; we therefore did not analyse those data further.

“”Trustworthiness is one of those instant judgements we automatically make about other people, affecting our behaviour towards them””

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