title: Health care professionals' reactions to patient pain: impact of knowledge about medical evidence and psychosocial influences.
abstract: This study examined the impact of evidence concerning the presence of 1) a biomedical basis for pain and 2) psychosocial influences on practitioner appraisals of patient pain experiences. Furthermore, the potential moderating role of patient pain behavior was examined. In an online study, 52 general practitioners and 46 physiotherapists viewed video sequences of 4 patients manifesting pain, with accompanying vignettes describing presence or absence of medical evidence and psychosocial influences. Participants estimated pain intensity, daily interference, sympathy felt, effectiveness of pain medication, self-efficacy, their likability, and suspicions of deception. Primary findings indicated lower perceived pain and daily interference, less sympathy, lower expectations of medication impact, and less self-efficacy when medical evidence was absent. The same results were found when psychosocial influences were present, but only when the patient displayed higher levels of pain behavior. Furthermore, absence of medical evidence was related to less positive evaluations of the patients and to higher beliefs in deception in both professions. The presence of psychosocial influences was related to less positive evaluations and higher beliefs in deception in both professions. In sum, a range of contextual factors influence health care practitioner responses to patient pain. Implications for caregiving behavior are discussed.
  
  
  CONCLUSIONS
  The present study indicates that in the absence of clear medical evidence and in the presence of psychosocial influences, patient pain might be taken less seriously by health care practitioners. These findings are important to further understand the difficulties that relate to the clinical encounter between pain patients and health care practitioners.
authors.affiliation: Department of Experimental-Clinical and Health Psychology, Ghent University, Ghent, Belgium. Electronic address: Lies.DeRuddere@ugent.be.
authors.forename: Lies
authors.initials: L
authors.lastname: De Ruddere
authors.affiliation: Department of Experimental-Clinical and Health Psychology, Ghent University, Ghent, Belgium.
authors.forename: Liesbet
authors.initials: L
authors.lastname: Goubert
authors.affiliation: Department of Experimental Psychology, Ghent University, Ghent, Belgium.
authors.forename: Michaël André Louis
authors.initials: MA
authors.lastname: Stevens
authors.affiliation: Department of General Practice and Primary Health Care, Ghent University, Ghent, Belgium.
authors.forename: Myriam
authors.initials: M
authors.lastname: Deveugele
authors.affiliation: Department of Psychology, University of British Columbia, Vancouver, British Columbia, Canada.
authors.forename: Kenneth Denton
authors.initials: KD
authors.lastname: Craig
authors.affiliation: Department of Experimental-Clinical and Health Psychology, Ghent University, Ghent, Belgium.
authors.forename: Geert
authors.initials: G
authors.lastname: Crombez
mesh_terms: D000328:Adult; D000368:Aged; D001291:Attitude of Health Personnel; D017281:Cost of Illness; D008192:Deception; D004645:Empathy; D005260:Female; D058005:General Practitioners / Q000523:psychology*; D006801:Humans; D020407:Internet; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000188:drug therapy / Q000503:physiopathology* / Q000523:psychology*; D010147:Pain Measurement; D010361:Patients; D010465:Perception; D059825:Physical Therapists / Q000523:psychology*; D011795:Surveys and Questionnaires; D014741:Video Recording; D055815:Young Adult
keywords: Pain; health care practitioner responses; medical evidence; psychosocial influences