Abstract
Accurate pain assessment is a joint function of both the judge perceiving correct (valid) cues of pain and targets displaying valid indicators of pain. The present research examined whether the judgeability of pain expressions could be altered by manipulating the nonverbal supportiveness of a videotaped physician who guided targets through an experimentally induced pain experience in the laboratory. Ten-s video clips of these targets during their pain experience were viewed by 95 naïve judges who assessed each target’s pain on an 11-point numeric rating scale. In addition, the video clips were rated by independent coders on 9-point scales (focused, calm, tense, distressed, composed, fidgety, determined, bored, and nervous). Judges’ pain assessment accuracy was calculated by correlating their inferred pain rating for each target with targets’ self-reported pain. Pain targets assigned to interact with the nonverbally supportive physician displayed more valid impressions of their pain and judges had higher pain assessment accuracy when viewing these targets compared to targets assigned to interact with the nonverbally unsupportive physician. Interventions for caregivers and healthcare providers that emphasize the importance of nonverbal behavior when interacting with pain sufferers are discussed.
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Notes
Although a power analysis was not done for planning purposes, a sample size of 95 yields power in excess of .80 for effects in the range obtained in the present study, with alpha = .05, two-tailed. For example, for the effect of viewing supported targets vs unsupported targets on judges’ pain assessment accuracy (d = .41), power exceeded .98 (Cohen 1966, p. 90).
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Acknowledgments
The authors would like to acknowledge the undergraduate research assistants whose hard work contributed to the completion of this research: Kailey Face, Amanda Falcon, Isabelle Nichols, Nicole Molnar, and Aria Rad.
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Appendix: Examples of Physician Script
Appendix: Examples of Physician Script
Introduction
Hello, I’m Dr. Smith. I’m a primary care physician at Newton General Hospital.
Health Questions for Eligibility
First, I need to ensure that you are eligible to participate in the study. I am going to ask you several questions pertaining to your health…Next, the physician’s assistant will take your blood pressure to ensure you’re eligible to participate in the study…According to your answers on the health questions and your blood pressure you are eligible to participate in the study.
Task Instructions
During the task you will get to a point where your arm begins to feel uncomfortable and hurt, please try to continue on past this point for as long as you can…When the physical discomfort has increased to the point where you cannot tolerate it for even one more second, then say out loud “I’m done” or “I want to stop.
Every 30-s Throughout Task
Rate your pain now on a scale of 1–10.
After Deflation of the Blood Pressure Cuff
It’s normal to feel numb or tingly sensations for about 15–20 min.
Closing
Next, you will fill out several questionnaires about yourself and your experience today on the computer in front of you.
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Ruben, M.A., Hall, J.A. Healthcare Providers’ Nonverbal Behavior can Lead Patients to Show Their Pain More Accurately: An Analogue Study. J Nonverbal Behav 40, 221–234 (2016). https://doi.org/10.1007/s10919-016-0230-3
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DOI: https://doi.org/10.1007/s10919-016-0230-3