The interplay of fear of pain, emotional states, and pain perception in medical and nursing students: A cross-sectional study

PLoS One. 2024 Nov 21;19(11):e0314094. doi: 10.1371/journal.pone.0314094. eCollection 2024.

ABSTRACT

BACKGROUND: Fear of pain is known to influence pain perception and worsen pain outcomes. However, its relationship with pain threshold remains unclear. Negative emotional states, namely depression, anxiety, and stress, have been found to increase fear of pain. Previous pain experiences, both undergone and observed, can also influence fear of pain. Furthermore, healthcare students’ interactions with pain patients may be influenced by fear of pain and pain perception. This study aimed to assess fear of pain among Portuguese medical and nursing students, analyse its association with sex, negative emotional states, previous pain experiences, and curricular year, and evaluate the influence of fear of pain on heat pain threshold.

METHODS: A survey based on validated Portuguese questionnaires was carried out. Participants were then invited for quantitative sensory tests to assess heat pain threshold.

RESULTS: Fear of pain was similar for medical and nursing students. Female students presented a higher fear of medical pain. Stress was associated with an increased fear of severe pain. Previous painful experiences, particularly those involving medical procedures, have been found to be variably associated with fear of pain, depending on the type and characteristics of these experiences. No associations were found between fear of pain and curricular year, nor between heat pain threshold and sex or fear of pain.

CONCLUSIONS: This study highlights relevant aspects of the emotional and cognitive modulation of fear of pain and pain perception in medical and nursing students. The influence of previous pain experiences on fear of pain is also essential because healthcare students are frequently exposed to painful medical situations during their courses. As altered pain perception can influence their role as future healthcare professionals, the study of fear of pain and its modulators in healthcare students represents an important research field.

PMID:39570991 | DOI:10.1371/journal.pone.0314094