Recalling pain experienced during a colonoscopy: Pain expectation and variability

Objectives. This study investigated the relationship between participants' expected levels of pain intensity before a colonoscopy, pain intensity experienced while they were undergoing this medical procedure (real-time pain), and their retrospective evaluation of this experience. Design. Correlational design. Regression analyses were performed and mediational models were tested. Methods. Ninety patients who were about to undergo a colonoscopy were asked to report the pain intensity on a scale ranging from 0 (no pain) to 10 (extreme pain). They reported the expected intensity of pain before the examination, their real-time intensity of pain every 60 s during the colonoscopy, and their global retrospective evaluation of the pain experienced when the procedure was over. Results. Results confirmed that, regardless of participants' gender, the variability of the real-time pain distribution was a significant predictor of the accuracy of recall (i.e. the discrepancy between recalled pain and mean real-time pain). Moreover, participants' pain expectations preceding the examination were a significant predictor of the accuracy of recall. It was further demonstrated that the effect of patients' expectations on the discrepancy was mediated by the real-time pain variability. Conclusions. The results of the present study provide useful indications about what the target of interventions aimed at reducing the bias in pain recall should be.