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

Redelmeier, Donald A^a,b,*; Kahneman, Daniel^c

Author Information

^aDepartment of Medicine, University of Toronto,Toronto,Canada M4Y 1J3

^bDivision of Clinical Epidemiology, Wellesley Hospital Research Institute, Jones Bldg. #123,Toronto,Canada M4Y 1J3

^cDepartment of Psychology, Princeton University,Princeton,USA

^*Corresponding author: at Wellesley Hospital address. Tel.: +1 416 926-7696; fax: +1 416 926-4910.

Submitted April 10, 1995; revised September 12, 1995; accepted September 20, 1995.

Pain66(1):p 3-8, July 1996. |DOI:10.1016/0304-3959(96)02994-6

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.