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Pain Research and Management
Volume 2016, Article ID 9267536, 11 pages
Research Article

Medical Evidence Influence on Inpatients and Nurses Pain Ratings Agreement

1University of Bologna, Department of Medicine and Surgery Sciences, Via Massarenti 9, 40138 Bologna, Italy
2Azienda Ospedaliera-Universitaria di Bologna Policlinico S. Orsola-Malpighi, Via Massarenti 9, 40138 Bologna, Italy
3University of Bologna, Post-Graduate School of Anaesthesia and Intensive Care, Via Massarenti 9, 40138 Bologna, Italy

Received 31 December 2014; Accepted 31 July 2015

Copyright © 2016 Boaz Gedaliahu Samolsky Dekel et al. 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.


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 inpatients’ self-reported pain and 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 ( 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.