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      Pain Recollection after Chest Pain of Cardiac Origin

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          Memory for pain is an important research and clinical issue since patients ability to accurately recall pain plays a prominent role in medical practice. The purpose of this prospective study was to find out if patients, with an episode of chest pain due to suspected acute myocardial infarction could accurately retrieve the pain initially experienced at home and during the first day of hospitalization after 6 months. A total of 177 patients were included in this analysis. The patients rated their experience of pain on a numerical rating scale. The maximal pain at home was retrospectively assessed, thereafter pain assessments were made at several points of time after admission. After 6 months they were asked to recall the intensity of pain and once again rate it on the numerical rating scale. The results from the initial and 6-month registrations were compared. In general, patients rated their maximal intensity of chest pain as being higher at the 6-month recollection as compared with the assessments made during the initial hospitalization. In particular, in patients with a high level of emotional distress, there was a systematic overestimation of the pain intensity at recall.

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          Most cited references 5

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          Patients' memories of painful medical treatments: real-time and retrospective evaluations of two minimally invasive procedures.

          Patients' memories of painful medical procedures may influence their decisions about future treatments, yet memories are imperfect and susceptible to bias. We recorded in real-time the intensity of pain experienced by patients undergoing colonoscopy (n = 154) and lithotripsy (n = 133). We subsequently examined patients' retrospective evaluations of the total pain of the procedure, and related these evaluations to the real-time recording obtained during the experience. We found that individuals varied substantially in the total amount of pain they remembered. Patients' judgments of total pain were strongly correlated with the peak intensity of pain (P < 0.005) and with the intensity of pain recorded during the last 3 min of the procedure (P < 0.005). Despite substantial variation in the duration of the experience, lengthy procedures were not remembered as particularly aversive. We suggest that patients' memories of painful medical procedures largely reflect the intensity of pain at the worst part and at the final part of the experience.
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            Vivid memories

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              Memory of dental pain.

              The possibility that patients' memory for acute pain is reconstructed over time was tested by comparing the degree of pain remembered 3 months after a dental appointment with both expected and experienced pain, as reported immediately before and after the appointment. As hypothesised, there was a closer association between remembered and expected pain than between remembered and experienced pain, particularly for those patients who scored high on the Dental Anxiety Scale. These results suggest that the accuracy of patients' reports of pain experienced in the past may be suspect, and that dental anxiety may be slow to extinguish because the discrepancy between expected and experienced pain felt at one appointment may not be recalled accurately by anxious patients at their next appointment.

                Author and article information

                S. Karger AG
                February 2000
                07 March 2000
                : 92
                : 2
                : 115-120
                aDepartment of Medicine, Central Hospital, Uddevalla; bDepartments of Clinical Pharmacology and cDivision of Cardiology, Sahlgrenska University Hospital, Göteborg, Sweden
                6958 Cardiology 1999;92:115–120
                © 2000 S. Karger AG, Basel

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                Page count
                Figures: 1, Tables: 4, References: 25, Pages: 6
                Coronary Care


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