The last thing you want to hear from your doctor: 'this won't hurt a bit'

Medical practitioners are being urged to refrain from using language that might draw attention to pain or suffering.
FAIRFAX AUSTRALIA

Medical practitioners are being urged to refrain from using language that might draw attention to pain or suffering.

The old line "This won't hurt a bit" might actually be the last thing you want your doctor to say.

Because it turns out that words such as "sting", "hurt", "itch" and "worry" can change patients' perceptions and even enhance pain, according to research by an Australian obstetric and paediatric anaesthetist.

Dr Allan Cyna, from Adelaide Women's and Children's Hospital, said mounting evidence suggests patients who are calm can suddenly experience more pain or anxiety depending on what words their doctor uses.

"The classic examples are, 'there's nothing to worry about'. Subconsciously you're implying there is something to worry about," he said.

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"Or, 'would you like to kiss your child goodbye?' Obviously that's a subconscious suggestion for death, and often a parent will cry if they hear those words."

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GABRIELLE CHARLOTTE

Asking a parent if they would like to say goodbye to their child before a surgical procedure can trigger anxiety, says Dr Allan Cyna.

Health practitioners say these things with the best of intentions, but often do not realise they are "inadvertently unhelpful," Cyna said

He performed a trial in Adelaide where he inserted a drip into a small group of patients. Some were told it would sting while others were told about the procedure without researchers using the word "sting".

People were more likely to vocalise pain if the word "sting" had been used, he said.

Such words should be avoided unless a patient mentions them first. Drawing our attention to a sensation such as pain is likely to preempt how a patient might feel, Cyna said.

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"Some clinicians believe they're being honest by warning patients before a painful procedure, such as inserting a catheter into a vein, that it will hurt or sting."

But procedures that might be traditionally perceived as painful may not hurt some people, so long as our awareness to pain or suffering is not heightened.

Instead, doctors and medical specialists should focus more on positive language and explaining the process, Cyna said.

"Rather than saying, 'this will sting' ... the anaesthetist could say, 'we are numbing the skin to allow us to finish the procedure as comfortably and safely as possible'."

Phrases such as: 'are you comfortable?' and 'is it OK to carry on?" are a way of bringing some comfort to patients.

Cyna has helped develop a clinical communication strategy called LAURS, which stands for: listening, acceptance, utilisation, reframing and suggestion.

It is designed to emphasise the importance of a clinician communicating in ways that make the patient feel like they have been listed too and understood.

He will present his strategy and accompanying research paper on Tuesday at the Australian and New Zealand College of Anaesthetists' (ANZCA) conference in Brisbane - attended by more than 2000 international medical professionals.

The reporter travelled to Brisbane courtesy of ANZCA.

 - Stuff

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