Document Type : Scientific Research
Author
Associate Professor, Faculty of Psychology, Payame Noor University, Tehran, Iran
Abstract
Objective: Facial expression is one of the most important signs of pain, which is very effective in transmitting pain to others. The facial appearance of pain is directly related to the observers' direct perception of the presence or intensity of pain and is the result of the interaction between emotional, cognitive and sensory components. Pain perception is related to a set of attitudes, beliefs and also cognitive distortions of the observer. This issue is more important in medical environments. If patients are unable to express and convey their pain experiences; Or the caregivers and therapists are not able to identify and understand the pain experiences of the patients, the appropriate help or treatment may not be provided. In other words, understanding these biases in the treatment environment is very necessary and can help reduce the effects of bias and improve the quality of healthcare. Based on the available research literature, in previous researches, only the comparison of pain assessment by patients and experts has been examined, and no comparison was found regarding the effects of valuation and the resulting bias in therapeutic fields. Considering this research gap, the aim of the present study was to compare the effect of positive and negative evaluation of patients on pain assessment in nurses and normal people. Method: Sixty men & females (each group thirty) heard four pictured scenarios about 4 positive and 4 negative persons (half female). It should be noted that while reading the scenarios, the photos of the characters are also shown. These scenarios are expected to create a positive or negative perception of the characters. Then, thirty-two videos of dynamic facial expressions (one second long) of eight characters with four levels of pain expression (neutral, mild, moderate, and strong) were shown. The participants have to evaluated these pain expressions videos from 1 to 100. The data of the groups were compared by SPSS-21 software. Results: To deliberate the research hypothesis repeated measurement variance analysis 4×2 was used (four levels of pain intensity: neutral, mild, moderate, strong pain; two levels of characters' valence: positive vs. negative) as within‐subject factors. The results shown a significant main effect of pain intensity; as their evaluation for different pain levels are significantly different and high level of pain expressions received correctly higher estimations. Also, positive or negative impressions did not make a difference in nurses. Conclusion: These results are very important to indicated that the experience and professional knowledge of nurses in the field of treatment reduced the effect of evaluation bias in them. The alignment of information with the context increases the emotional understanding of other people's faces. For nurses, seeing the faces of people in pain is completely aligned with their information background; So, they have understood those images more accurately and with less effect of evaluation bias. Also, it is necessary to pay attention to the compatibility with pain empathy. In other words, since nurses are frequently and continuously exposed to the pain of others, and the diagnosis of pain is an important task for them, the level of empathy with the pain of others is often unconsciously reduced in them, and as a result, they underestimate the pain of others.
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