Assessing surgical patients' expectations and subsequent perceptions of pain in the context of exploring the effects of preparatory information: raising issues of gender and status

The present study explored both patients' expectations and experiences of pain in the context of utilizing an established research procedure, which previously reported a significant effect of instructional information on post-surgical recovery. No research to date has systematically attempted to identify pre-operative expectations of post-operative pain, nor has it compared pre- and post-operative ratings. A further variable scrutinized during the study was patient gender. Thirty-two males and 31 females undergoing two types of elective surgery were randomly allocated into experimental and control conditions by a third party. Patients in the experimental group received additional instruction information pre-operatively from the anaesthetist and the control group received the routine preoperative visit. Using a numerical pain scale, all participants provided ratings of expected pain levels and subsequently rated their pain following surgery. Results obtained were contrary to expectations with respect to the effects observed by the established study as instructional information had no significant effect on recovery variables. However, the study did suggest that pre- and post-operative pain ratings were broadly equivalent. A significant gender difference was also found with male patients expecting less pain than they perceived and an opposite pattern for females. Measuring both pain expectations and perceptions is considered a useful technique to inform pain management and is worthy of further investigation. The inconsistent effect of instructional information and the gendered rating patterns are considered in relation to gender and status differentials between health providers and have important implications for future research. (C) 1999 European Federation of Chapters of the International Association for the Study of Pain.