Pain Rating Challenges and Patterns

Our long-term goal is to improve pain communication for patients' health. For this project, we seek information on patients' and health care nurses' (1) mental effort when choosing or understanding, respectively, pain intensity ratings, and (2) confidence in the accuracy of pain intensity rating patterns. This information will clarify the importance of mental effort from pain ratings and the probability of pain intensity rating patterns.

Our primary aim will compare patients' and nurses' perceptions of the mental effort of choosing (Aim 2a) and understanding (Aim 2b) pain intensity ratings. We hypothesize that patients will rate mental effort higher than nurses for choosing ratings and lower than nurses for understanding ratings. The results will inform future efforts to improve pain communication between patients and nurses.

Study Overview

• Status: Active, not recruiting
• Conditions: Chronic Pain
• Intervention / Treatment: Other: survey

Detailed Description

Our long-term goal is to improve pain communication for patients' health. For this project, we seek information on patients' and health care nurses' {1} mental effort when choosing or understanding, respectively, pain intensity ratings, and {2} confidence in the accuracy of pain intensity rating patterns. This information will clarify the importance of mental effort from pain ratings and the probability of pain intensity rating patterns.

Aim 1 {exploratory} will compare the mental effort of choosing {Aim 1a} and understanding {Aim1b different pain intensity rating scales. We hypothesize mental effort will be lower for {a} the "worst pain you have ever felt" scale than "worst pain you can think of" scale, {b} a 7-day recall period than a 1-month recall period, and {c} focus on one body area than summarizing across body areas. The results will clarify the impact of pain intensity scales' characteristics on mental effort.

Aim 2 {primary} will compare patients' and nurses' perceptions of the mental effort of choosing {Aim 2a} and understanding {Aim 2b} pain intensity ratings. We hypothesize that patients will rate mental effort higher than nurses for choosing ratings and lower than nurses for understanding ratings. The results will inform future efforts to improve pain communication between patients and nurses.

Aim 3 {exploratory} will determine the relationship between perceptions of mental effort and the importance of decreasing that mental effort for patients {Aim 3a} and nurses {Aim 3b}. We hypothesize perceptions of mental effort will positively correlate with the importance of decreasing mental effort. The results will clarify the importance of mental effort for pain intensity ratings.

Aim 4 {exploratory} will evaluate the equivalence of patients' and nurses' confidence in the accuracy of fictional pain intensity rating patterns. We hypothesize that patients' and nurses' confidence in the accuracy will be equally low because the patterns tested should be improbable. Future studies may investigate the ability of improbable pain intensity rating patterns to evaluate the usability and psychometrics of pain measures.

Aim 5 {exploratory} will test the relationship between confidence in the accuracy of fictional pain intensity rating patterns and the importance of increasing that confidence for patients {Aim 5a} and nurses {Aim 5b}. We hypothesize confidence will negatively correlate with the importance of increasing confidence. The results will clarify the importance of confidence in pain intensity rating accuracy.

• Study Type: Observational
• Enrollment (Estimated): 200

Contacts and Locations

Study Locations

• United States
  • Missouri
    • Columbia, Missouri, United States, 65211
      • University of Missouri - Columbia

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: No

• Sampling Method: Non-Probability Sample

Study Population

patients with chronic pain & nurses without chronic pain

Description

Our inclusion criteria for the patients are the following:

• 18 years old or older;
• currently being treated by a health care provider for a painful musculoskeletal condition;
• has felt a usual musculoskeletal pain intensity rating of "2" or higher on a "0" to "10" scale over the last 24 hours;
• has felt extreme pain that completely disappeared;
• has felt musculoskeletal pain on most days of the last 3 months;
• chronic musculoskeletal pain has increased and decreased during the last 3 months; and
• has felt musculoskeletal pain in more than one location on most days of the last 3 months.

Our exclusion criterion for the patients is:

• ever employed as a licensed health care provider.

Our inclusion criteria for the nurses are the following:

• 18 years old or older;
• currently employed as a licensed nurse; and
• current employment duties include routinely assessing the musculoskeletal pain of cognitively intact, adult outpatients.

Our exclusion criteria for the nurses are the following:

• currently managing a painful musculoskeletal condition; and
• has ever felt musculoskeletal pain on most days for 3 months or longer.

Study Plan

How is the study designed?

Number of groups / cohorts

2

Cohorts and Interventions

Group / Cohort	Intervention / Treatment
nurses; Our inclusion criteria for the nurses are the following: (1) 18 years old or older; (2) currently employed as a licensed nurse; and (3) current employment duties include routinely assessing the musculoskeletal pain of cognitively intact, adult outpatients. Our exclusion criteria for the nurses are the following: (1) currently managing a painful musculoskeletal condition; and (2) has ever felt musculoskeletal pain on most days for 3 months or longer.	Other: survey; survey
patients; Our inclusion criteria for the patients are the following: (1) 18 years old or older; (2) currently being treated by a health care provider for a painful musculoskeletal condition; (3) has felt a usual musculoskeletal pain intensity rating of "2" or higher on a "0" to "10" scale over the last 24 hours; (4) has felt extreme pain that completely disappeared; (5) has felt musculoskeletal pain on most days of the last 3 months; (6) chronic musculoskeletal pain has increased and decreased during the last 3 months; and (6) has felt musculoskeletal pain in more than one location on most days of the last 3 months. Our exclusion criterion for the patients is ever employed as a licensed health care provider.	Other: survey; survey

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
mental effort	ordinal self-report of expected amount of thought allocated to choosing a numeric pain intensity rating; higher scores mean more mental effort	baseline
importance of decreasing mental effort	ordinal self-report of importance of decreasing amount of thought allocated to choosing or understanding a numeric pain intensity rating; higher scores mean more importance	baseline

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
confidence in the accuracy of fictional pain intensity ratings	ordinal self-report of confidence in numeric pain intensity ratings; higher scores mean more confidence	baseline

Collaborators and Investigators

• Sponsor: University of Missouri-Columbia

Study record dates

Study Major Dates

• Study Start (Actual): March 21, 2023
• Primary Completion (Estimated): March 31, 2024
• Study Completion (Estimated): March 31, 2024

Study Registration Dates

• First Submitted: October 25, 2023
• First Submitted That Met QC Criteria: October 30, 2023
• First Posted (Actual): November 2, 2023

Study Record Updates

• Last Update Posted (Actual): February 5, 2024
• Last Update Submitted That Met QC Criteria: February 1, 2024
• Last Verified: February 1, 2024

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Pain; Neurologic Manifestations; Chronic Pain
• Other Study ID Numbers: 2091563

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: UNDECIDED

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No