Pain assessment: differences in quality and intensity of the words pain, ache and hurt

A study was undertaken to investigate if the concepts pain, ache and hurt differ from each other in intensity and quality and to identify discriminating semantic correlates for each of these concepts. Forty-one nurses with different backgrounds in nursing and 12 patients with chronic pain syndrome were included in the study. The methods used were a questionnaire, the visual analogue scale (VAS), and the McGill Pain Questionnaire (MPQ). There was a statistically significant difference in the intensity of the words pain, ache and hurt on both the VAS and the MPQ. Pain was shown to have the highest intensity, followed by ache with hurt having the lowest. Semantic correlates consisting of sensory and affective words which best discriminate between the concepts pain, ache and hurt were identified. Semantic correlates for pain were: cutting, crushing, tearing, sharp, dreadful, killing, torturing and suffocating: for ache were: aching, pulling, gnawing, irritating, annoying, troublesome, exhausting, unbearable and terrifying; for hurt were: pricking, pinching, stinging, sore, fearful, unhappy.     

Quantification of the pain terms hurt, ache and pain among nursing students

The aim of this study was to determine the quantitative meaning nursing students ascribe to the pain terms hurt (ont), ache (värk) and pain (smärta). In total, 549 nursing students filled in a questionnaire including questions about age, gender, and health care work experience. The students were also requested to rate response using a Visual Analogue Scale (VAS) rating for different statements about hurt, ache and pain. The results show that there were significant differences (p < 0.001) between rated intensity of the statements of hurt, ache and pain. There were, however, large variations in the students’ ratings of the pain terms; hurt ranged from 3 to 97 mm, ache from 7 to 97 mm and pain from 27 to 100 mm. There were no significant differences between male and female students regarding their ratings of hurt and ache when they were used to describe the worst self‐experienced pain. Female students rated their experience of pain significantly higher (p < 0.001) on the VAS compared with male students. There was no significant correlation between previous experience of health care work and rated intensity of hurt, ache and pain. In conclusion, this study shows that there exist significant differences between the pain terms hurt, ache and pain according to a rating on a VAS. However, the results also demonstrate that there are large individual variations in how the students quantify the fictitious patient statements of hurt, ache and pain.     

Worst experiences of pain and conceptions of worst pain imaginable among nursing students

Title. Worst experiences of pain and conceptions of worst pain imaginable among nursing students Aim. This paper is a report of a study to explore nursing students’ own worst experiences of pain as well as their conceptions of the worst pain imaginable. Background. Pain is a personal experience, often assessed using a visual analogue scale. The endpoints of this scale are labelled with the extremes for pain experience (e.g. no pain to worst pain imaginable). People may understand the meaning of ‘no pain’, but it is unclear what meaning they assign to ‘worst pain imaginable’. This indicates that a rating along the Visual Analogue Scale‐line is dependent on the individual’s previous experiences. Methods. Data were collected during the autumn of 2002. In total, 549 nursing students completed a questionnaire focusing on two main questions: ‘What is the worst experience of hurt, ache or pain you have had?’ and ‘What is the worst pain imaginable for you?’ Content analysis was used for data analysis. Results. The students’ worst experience of pain was mostly related to acute or traumatic painful conditions, pain associated with female physiology, inflicted pain, psychological suffering and chronic painful conditions. The worst pain imaginable was described as condition‐related pain, overwhelming pain, experiences of losses, deliberately inflicted pain, psychological suffering and as vicarious pain. Conclusion. The findings imply that nursing students, when they are imagining pain, include dimensions such as hope of relief, grief, control over the situation, powerlessness and empathy for and suffer with other people’s pain. Further research is needed to explore why professional experience as a nurse diminishes the ability to imagine patients’ pain.