Highlights
- •The clinician-patient relationship may influence pain experienced in medical care.
- •Simulated clinical interactions were used to investigate this effect.
- •Patient feelings of similarity and trust toward clinicians influenced pain ratings.
- •Findings suggest that increasing patient feelings of similarity/trust may reduce pain report.
Abstract
Pain is influenced by many factors other than external sources of tissue damage. Among
these, the clinician-patient relationship is particularly important for pain diagnosis
and treatment. However, the effects of the clinician-patient relationship on pain
remain underexamined. We tested the hypothesis that patients who believe they share
core beliefs and values with their clinician will report less pain than patients who
do not. We also measured feelings of perceived clinician-patient similarity and trust
to see if these interpersonal factors influenced pain. We did so by experimentally
manipulating perceptions of similarity between participants playing the role of clinicians
and participants playing the role of patients in simulated clinical interactions.
Participants were placed in 2 groups on the basis of their responses to a questionnaire
about their personal beliefs and values, and painful thermal stimulation was used
as an analog of a painful medical procedure. We found that patients reported feeling
more similarity and trust toward their clinician when they were paired with clinicians
from their own group. In turn, patients' positive feelings of similarity and trust
toward their clinicians—but not clinicians' feelings toward patients or whether the
clinician and patient were from the same group—predicted lower pain ratings. Finally,
the most anxious patients exhibited the strongest relationship between their feelings
about their clinicians and their pain report. These findings increase our understanding
of context-driven pain modulation and suggest that interventions aimed at increasing
patients’ feelings of similarity to and trust in health care providers may help reduce
the pain experienced during medical care.
Perspective
We present novel evidence that the clinician-patient relationship can affect the pain
experienced during medical care. We found that “patients” in simulated clinical interactions
who reported feeling more similarity and trust toward their “clinicians” reported
less pain, suggesting that increasing feelings of clinician-patient similarity and
trust may reduce pain disparities.
Graphical abstract
Graphical Abstract
Key words
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Article Info
Publication History
Published online: May 04, 2017
Accepted:
February 1,
2017
Received in revised form:
January 10,
2017
Received:
September 12,
2016
Footnotes
This work was supported by the National Institutes of Health grants 2R01MH076136 and R01DA035484 (T.D.W., PI).
The authors have no conflicts of interest to declare.
Identification
Copyright
© 2017 by the American Pain Society
