PERCEIVED CONTROL MEDIATES THE RELATIONSHIP BETWEEN PAIN SEVERITY ANDPATIENT SATISFACTION

The factors that account for patient satisfaction with acute pain mana gement remain a mystery. Consistently, there has been an inverse, but very small association between pain severity and patients satisfaction ; most patients are in severe pain, yet report they are satisfied with pain management. The hypothesis that perceived control mediates the r elationship between pain severity and patient satisfaction was examine d in 137 patients who underwent elective inpatient orthopedic surgery. Postoperatively, patients rated their pain severity (the highest leve l of pain experienced), their perceptions of control over the pain and taking pain medication, and their satisfaction with the relief they o btained from analgesics. Path analysis using LISREL was used to test f or mediation. Pain severity was associated inversely with perceptions of control over pain and with satisfaction. There was a significant as sociation between perceived control and satisfaction and perceived con trol partially mediated the relationship between pain severity and sat isfaction. Although individuals who report experiencing severe pain ar e less satisfied with pain relief than individuals with less pain, it is the interpretation or perception of having control over the pain th at most relates to satisfaction with pain relief. Clinically, it is im portant to examine ways in which individuals control their pain, teach them methods to exert control, and educate them that it is preferable to not allow pain to become severe-it is easier to ''control'' pain i f you intervene at an early point. (C) U.S. Cancer Pain Relief Committ ee, 1998.