Anesthesiologists must recognize and respond both verbally and nonverbally to their patients’ pain. The current study analyzed 65 videotaped interactions between anesthesiology residents, a standardized registered nurse, and a standardized male patient in pain awaiting urgent repair of a perforated gastric ulcer. Interactions were assessed using a modified version of the Empathic Communication Coding System to code verbal and nonverbal responses to pain cues. Nearly 60% of the time, residents responded with denial or disconfirmation of the pain, either completely ignoring or disconfirming that the patient’s pain was real or needed to be addressed. Only 29% of all responses verbally acknowledged the patient’s pain. Residents responded with more empathic verbal responses to verbal pain cues compared to nonverbal pain cues, and to more intense pain cues compared to less intense pain cues. Residents were more likely to respond when the nurse advocated for the patient’s pain rather than when the patient expressed his own pain. Residents who were more responsive nonverbally and had higher total responsiveness had shorter interactions with the patient. Residents who were more verbally responsive were more likely to prescribe pain medication and prescribe it earlier in the interaction, which was the appropriate clinical action in this scenario to reduce patient suffering. These findings suggest that there may be specific skills and behaviors that physicians can learn to improve recognition, acknowledgment, and treatment of acute pain, enhance patient satisfaction, reduce suffering, and allow for more efficient interactions, especially in the acute care context.

麻醉师必须识别患者的疼痛并对其做出口头和非语言反应。目前的研究分析了麻醉科住院医师、一名标准化注册护士和一名等待紧急修复穿孔胃溃疡的标准化男性患者之间的 65 次录像互动。使用移情通信编码系统的修改版本来评估交互，以编码对疼痛线索的语言和非语言反应。近 60% 的情况下，住院医师的回应是否认或否认疼痛，要么完全无视，要么否认患者的疼痛是真实的或需要解决。所有答复中只有 29% 口头上承认了患者的疼痛。与非语言疼痛线索相比，居民对语言疼痛线索的口头反应更具同理心，与较不强烈的疼痛线索相比，更强烈的疼痛线索。当护士主张患者的疼痛而不是患者表达自己的疼痛时，住院医师更有可能做出反应。非语言反应性更强且总反应性更高的住院医师与患者的互动时间更短。口头反应更好的居民更有可能开止痛药，并在互动中更早开出处方，这是在这种情况下减少患者痛苦的适当临床行动。这些发现表明，医生可以学习一些特定的技能和行为，以提高对急性疼痛的识别、承认和治疗，提高患者满意度，减少痛苦，并允许更有效的互动，尤其是在急性护理环境中。