Consequences of nonverbal expression of pain: patient distress and observer concern.

Two studies examined the effects on others of nonverbal expressiveness of pain. Subjects viewed one of three videotapes of a simulated doctor-patient interview, with identical verbal content but different levels of expressiveness, and then completed a rating form. In Study I subjects were 44 senior nursing students. High nonverbal expressiveness yielded significantly higher ratings of patient pain and distress and observer concern. These variables also were inversely related to amount of nursing experience. Expressiveness had no significant effects on psychological support or nursing aids recommended for the patient. In Study II, 88 female undergraduates were categorized as low, medium or high on a measure of their need to nurture others. Irrespective of nurturance, ratings of patient distress, but not pain, were significantly higher in the high expressive condition. Nonverbal expressiveness of pain appears to influence ratings of the patient's affective state (distress) and the observer's affective response (concern).