Addressing complaints of pain in the hospitalized substance-abusing patient poses a significant and challenging nursing care problem. Nurses practicing in acute care settings are well-aware of the difficulties in objectively assessing the substance abuser's pain. Patient manipulation regarding medication regimens is well-documented. Related to their diminished ability to self-care and promote their own health, these persons are extremely likely to become ill and require medical care, which typically result in the response of pain. The objective of the proposed research is to develop a better understanding of the experience of pain for the substance abuser so that nurses can better assess and manage these patients' discomfort.
The specific aim of the study is to learn if their pain experience is related to their perceptual style, which is also expected to be manifest in their preferred drug of use. Based upon Petrie's (1967) theory of perceptual reactance, persons who characteristically augment or magnify sensory stimuli would be relatively pain intolerant and prefer drugs which restrict subjective sensory experience, whereas persons who perceptually reduce or attenuate the same would be more pain tolerant and prefer the subjective effects of sensory- expanding drugs. Utilizing a descriptive, survey research design, the relationships among perceptual reactance, drug of choice and pain perception in known substance abusers will be explored. Perceptual reactance in a convenience sample of 60 substance abusers currently in treatment and 60 recovering substance abusers will be described using Vando's (1969) psychometric scale and basal skin conductance levels. Drug of choice will be dichotomized as either a sensory-expanding or sensory-restricting drug and be operationalized by responses to The Addiction Severity Index and a single multiple-choice question assessing drug preference. Pain perception will be measured as tolerance to a single cold pressor trial. Correlations among these variables will be calculated, as will a multiple regression equation to learn of the predictive value of perceptual style, drug of choice and other demographic variables gleaned from the Addiction Severity Index in predicting pain tolerance. Identifying the variables which influence substance abusers' pain experience will enable health care professionals to more effectively comfort these patients and explore non-pharmacological interventions which address perceptual preferences and tolerances.
| Compton, M A (1994) Cold-pressor pain tolerance in opiate and cocaine abusers: correlates of drug type and use status. J Pain Symptom Manage 9:462-73 |
