Patients' memories of painful medical treatments: real-time and retrospective evaluations of two minimally invasive procedures

TLDR

Patients’ memories of painful medical procedures may influence future treatment decisions, yet these memories are imperfect and susceptible to bias. We recorded real‑time pain intensity during colonoscopy (n = 154) and lithotripsy (n = 133) and then examined patients’ retrospective total‑pain evaluations, relating them to the real‑time recordings. Patients remembered substantially different total pain amounts, and their judgments correlated strongly with peak pain and pain in the last 3 min, while longer procedures were not recalled as more aversive, indicating that memories mainly reflect pain at the worst and final moments.

Abstract

Patients' memories of painful medical procedures may influence their decisions about future treatments, yet memories are imperfect and susceptible to bias. We recorded in real-time the intensity of pain experienced by patients undergoing colonoscopy (n = 154) and lithotripsy (n = 133). We subsequently examined patients' retrospective evaluations of the total pain of the procedure, and related these evaluations to the real-time recording obtained during the experience. We found that individuals varied substantially in the total amount of pain they remembered. Patients' judgments of total pain were strongly correlated with the peak intensity of pain (P < 0.005) and with the intensity of pain recorded during the last 3 min of the procedure (P < 0.005). Despite substantial variation in the duration of the experience, lengthy procedures were not remembered as particularly aversive. We suggest that patients' memories of painful medical procedures largely reflect the intensity of pain at the worst part and at the final part of the experience.