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Two articles this month in the journal Pain, discuss either the impact of words on pain or the impact of pain on words.
Hurt Words
One article by a group from the University of British Columbia, evaluates the vocabulary of children in describing pain. In order to clinically assess what degree of pain a child is experiencing, it is crucial understand which words were most commonly used by young children to describe pain and the age of onset of use of these words.
Researchers looked at an aggregated transcript database of multiple research studies examining spontaneous speech development across childhood. Transcripts of 14 randomly selected studies, yielding a total of 245 child participants ranging in age from 1 to 9 years, were searched for seven English primary pain word-stems: 'ache', 'boo-boo', 'hurt', 'ouch', 'ow', 'pain', and 'sore.' Another part of this study surveyed 111 parents of children aged 3 to 6 years old concerning words the children commonly used for pain. Parents rated their children's frequency and age of first use of the seven pain word-stems. The research revealed that the most frequently used word-stems were 'hurt', 'ouch', and 'ow'. These words first emerged in children's vocabularies as early as 18 months of age.
The word-stem 'pain' was the least used and infrequently and only gradually emerged in children's vocabularies. These findings indicate that young children rely on a select number of words to describe pain, with these words appearing in children's vocabularies at an early age. These results have implications for developmentally appropriate pain assessment in young children.
Words Hurt
The other study, from Beth Israel Deaconess Medical Center in Boston, asked "Can words hurt? Generally, patients are prepared for a medical procedure by having their physician or healthcare provider describe the procedure. This often included an explanation of the discomforts and descriptions of pain or undesirable experiences. Being prepared and understanding a procedure is important but there is little data on how such descriptions affect patients' pain and anxiety during medical procedures.
Patient -clinician interactions were videotaped during interventional radiological procedures. One hundred and fifty-nine videos were reviewed. All statements that described painful or undesirable experiences as warning before potentially noxious stimuli or as expression of sympathy afterwards were recorded. Patients' ratings of pain and anxiety on 0-10 numerical scales (0=No Pain, No Anxiety at All and 10=Worst Pain Possible, Terrified) after the painful event and/or sympathizing statement were the basis for this study. Warning the patient in terms of pain or undesirable experiences resulted in greater pain (P<0.05) and greater anxiety (P<0.001) than not doing so. Sympathizing with the patient in such terms after a painful event did not increase reported pain, but resulted in greater anxiety (P<0.05). Contrary to common belief, warning or sympathizing using language that refers to negative experiences may not make patients feel better. This conclusion has implications for the training in medical communication skills and suggests the need for randomized trials testing different patient-practioner interactions.
10:44:06 AM 
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