Difference in perception of and morphine dose administered to the patient's self-reported pain according to the patient's facial expression in Korea

Abstract

Purpose: This study aimed to compare the nurses' perception, recording, and treatment of the patient's self-reported pain according to the patient facial expression. Methods: It is a descriptive cross-sectional survey. Participants were 482 nurses working at a tertiary hospital in Seoul, Korea. The self-reporting questionnaire required nurses to answer the pain intensity, records, and medication for a smiling patient complaining of acute post-surgical pain and a grimacing cancer-pain patient. Results: The pain intensity perceived by nurses in grimacing patients was significantly higher than that for smiling patients (P < 0.001). The score of pain recording was significantly higher for grimacing patients than for smiling patients (P < 0.001). There was a significant difference in the amount of morphine chosen by the nurses for pain intervention in smiling and grimacing patients (P=0.040). Higher perceived pain intensities and scores reflected in the pain record resulted in greater administered doses of morphine. Conclusion: These findings suggest that the nurses might be affected by a patient's facial expression when treating pain. A pain-management program should be developed that enables nurses to accurately recognize pain hidden in patients' faces and provides them with the knowledge of how to appropriately assess and manage patients' pain.