An exploration of the relationship between anxiety, expectations and memory for postoperative pain

Abstract

Summary Background It is unclear how expectations of postoperative pain, anxiety and memory for that pain are interrelated. This study aimed to (1) explore the relationship between patients’ expectations, actual pain experiences and retrospective reports of postoperative pain intensity and quality and (2) examine the relationships between pain ratings and measures of patient anxiety. Methods Twenty-four participants used the short form McGill Pain Questionnaire (SF-MPQ) and VASs to report expectations of pain prior to surgery, actual postoperative pain and retrospective ratings 4–6 weeks postoperatively. Anxiety was measured using Spielberger's state trait anxiety inventory prior to surgery, within 48 h following surgery and 4–6 weeks postoperatively. Results No significant differences were found between intensity ratings of expectations, actual experiences and retrospective ratings of pain. However, kappa analyses revealed inconsistencies in the choice of SF-MPQ descriptors used to express pain quality. Anxiety scores were positively related to pain intensity ratings and negatively related to the consistency between qualitative pain reports. Conclusion Whilst memory for pain intensity appeared to be more accurate than for pain quality, the study also highlighted difficulties in inferring recollective experiences from verbal reports. The study also confirms the importance of reducing patients’ anxiety and avoiding unrealistic expectations of postoperative pain.