The aim of this study was to test how practitioners’ pain communication affects the pain information provided by older adults. A posttest only double blind experiment was used to test how the phrasing of practitioners’ pain questions, open-ended and without social desirability bias; closed-ended and without social desirability bias; or open-ended and with social desirability bias, affected the pain information provided by 312 community living older adults with osteoarthritis pain. Older adults were randomly assigned to one of the three pain phrasing conditions to watch and orally respond to a computer displayed videotape of a practitioner asking about their pain. All responded to a second videotape of the practitioner asking if there was anything further they wanted to communicate. Lastly all responded to a third videotape asking if there was anything further they want to communicate about their pain. Transcripts of the audio taped responses were content analyzed using 16 a priori criteria from national guidelines to identify important pain information for osteoarthritis pain management. Older adults described significantly more pain information in response to the open-ended question without social desirability. The two follow up questions elicited significant additional information for all three groups, but did not compensate for the initial reduced pain information from the closed-ended and social desirability biased groups. Initial use of an open-ended pain question without social desirability bias and use of follow-up questions significantly increases the amount of important pain information provided by older adults with osteoarthritis pain.

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The effect of interrupting older adults as they talk about their osteoarthritis pain was examined in a secondary analysis using a nonrandomized two-group design. Participants were part of a study in which older adults orally responded to a series of three pain questions asked by a videotaped practitioner presented on a computer screen. The initial 96 participants were given visual and auditory cues to touch the computer screen to continue to the next question. The remaining 216 participants received only the visual cue after the auditory cue was noted to interrupt participant responses. Older adults’ pain communication was audiotaped, transcribed, and content analyzed using 16 a priori criteria from the American Pain Society’s (2002) Guidelines for the Management of Pain in Osteoarthritis, Rheumatoid Arthritis, and Juvenile Chronic Arthritis. Older adults in the uninterrupted group responded with significantly more pain information, M = 6.3 (SD = 3.69), than the interrupted group, M= 5.3 (SD = 3.22); F(1,300) = 4.49, p = .04, χ2 = 0.004. Adjusting for sample size differences, older adults in the interrupted group described 56% less information about the source of their pain, 41% less about the quality of their pain, 29% less about their pain treatments, 24% less about the timing of their pain, and 15% less about their pain intensity. The brief, innocuous interruption diminished the amount of important pain information communicated by the older adults. Deliberate interruptions by practitioners might further reduce communication of important pain information.

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