Pain Research and Management

Pain Research and Management / 2009 / Article

Original Article | Open Access

Volume 14 |Article ID 343871 |

Paula C Miceli, Joel Katz, "The Influence of Addiction Risk on Nursing Students’ Expectations of Patients’ Pain Reports: A Clinical Vignette Approach", Pain Research and Management, vol. 14, Article ID 343871, 9 pages, 2009.

The Influence of Addiction Risk on Nursing Students’ Expectations of Patients’ Pain Reports: A Clinical Vignette Approach


OBJECTIVE: To examine the influence of addiction risk (substance abuse history [SAH]) and pain relief (PR) on nursing and non-nursing students’ perceptions of pain in a postoperative vignette patient.METHODS: Using a 2×2 design, the independent variables SAH (present/+, absent/–) and PR (adequate, little) were varied systematically to produce four vignettes. Participants were randomly assigned to receive one of the four vignettes that described a 45-year-old man after a total hip replacement. Participants rated the vignette patient’s experienced and reported pain intensity (PI) on a 0 mm to 100 mm visual analogue scale and addiction risk on a 0 mm to 100 mm visual analogue scale. A pain congruence (PC) score was calculated (PC = reported PI – experienced PI), and was interpreted as congruent (±2 mm) or incongruent (+2 mm to +100 mm for expected pain over-reporting; −2 mm to −100 mm for expected pain under-reporting).RESULTS: Responses from undergraduate nursing (n=89) and non-nursing (n=88) students were analyzed. The estimated addiction risk was significantly lower in nursing (14% to 45%) versus non-nursing students (50%). Nursing students’ mean PC scores were not significantly altered by SAH alone. Expectations of pain over-reporting were observed under conditions of SAH+/adequate PR, but not SAH+/little PR. In non-nursing students, SAH and PR were significant and independent factors influencing mean PC scores in the direction of pain over-reporting.CONCLUSION: Under most conditions, nursing students expected pain under-reporting by the postoperative vignette patient. However, nursing students did expect pain to be over-reported when addiction risk was high and PR was adequate. These data suggest that nursing students’ expectations regarding pain over- and under-reporting were sensitive to perceptions of addiction risk, but involved additional factors (eg, level of PR).

Copyright © 2009 Hindawi Publishing Corporation. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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