title: Medical Evidence Influence on Inpatients and Nurses Pain Ratings Agreement.
abstract: 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 n = 862 inpatients' self-reported pain and n = 115 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 (χ (2) 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.
authors.affiliation: University of Bologna, Department of Medicine and Surgery Sciences, Via Massarenti 9, 40138 Bologna, Italy; Azienda Ospedaliera-Universitaria di Bologna Policlinico S. Orsola-Malpighi, Via Massarenti 9, 40138 Bologna, Italy; University of Bologna, Post-Graduate School of Anaesthesia and Intensive Care, Via Massarenti 9, 40138 Bologna, Italy.
authors.forename: Boaz Gedaliahu
authors.initials: BG
authors.lastname: Samolsky Dekel
authors.affiliation: University of Bologna, Post-Graduate School of Anaesthesia and Intensive Care, Via Massarenti 9, 40138 Bologna, Italy.
authors.forename: Alberto
authors.initials: A
authors.lastname: Gori
authors.affiliation: University of Bologna, Post-Graduate School of Anaesthesia and Intensive Care, Via Massarenti 9, 40138 Bologna, Italy.
authors.forename: Alessio
authors.initials: A
authors.lastname: Vasarri
authors.affiliation: University of Bologna, Post-Graduate School of Anaesthesia and Intensive Care, Via Massarenti 9, 40138 Bologna, Italy.
authors.forename: Maria Cristina
authors.initials: MC
authors.lastname: Sorella
authors.affiliation: University of Bologna, Department of Medicine and Surgery Sciences, Via Massarenti 9, 40138 Bologna, Italy; Azienda Ospedaliera-Universitaria di Bologna Policlinico S. Orsola-Malpighi, Via Massarenti 9, 40138 Bologna, Italy; University of Bologna, Post-Graduate School of Anaesthesia and Intensive Care, Via Massarenti 9, 40138 Bologna, Italy.
authors.forename: Gianfranco
authors.initials: G
authors.lastname: Di Nino
authors.affiliation: University of Bologna, Department of Medicine and Surgery Sciences, Via Massarenti 9, 40138 Bologna, Italy; Azienda Ospedaliera-Universitaria di Bologna Policlinico S. Orsola-Malpighi, Via Massarenti 9, 40138 Bologna, Italy; University of Bologna, Post-Graduate School of Anaesthesia and Intensive Care, Via Massarenti 9, 40138 Bologna, Italy.
authors.forename: Rita Maria
authors.initials: RM
authors.lastname: Melotti
mesh_terms: D000700:Analgesics / Q000145:classification / Q000627:therapeutic use; D001364:Awareness; D005260:Female; D006801:Humans; D007297:Inpatients; D008297:Male; D009723:Nurse-Patient Relations; D009726:Nurses / Q000523:psychology*; D009733:Nursing Diagnosis; D010146:Pain / Q000175:diagnosis* / Q000188:drug therapy / Q000209:etiology; D010147:Pain Measurement / Q000379:methods*; D057566:Self Report; D013997:Time Factors
chemical_list: D000700:Analgesics