Examining pain-related distress in relation to pain intensity and psychological distress

Res Nurs Health. 2008 Feb;31(1):52-62. doi: 10.1002/nur.20262.


Despite frequent use of the term symptom distress in the pain literature, symptom distress is often confused with symptom intensity and psychological distress, contributing to inadequate assessment of symptoms and less than ideal symptom management. In this article we address these issues and propose a hybrid model, combining Price's interaction of pain sensation, pain unpleasantness, and secondary pain affect model with an information processing model. Recommendations on methods and techniques to reduce this confusion would assist healthcare professionals and researchers to better distinguish among these terms as they manage patient symptoms and design symptom management studies. Thus, the purpose of this article is to examine the terms symptom distress, symptom intensity, and psychological distress using pain as the example symptom.

Publication types

  • Review

MeSH terms

  • Adaptation, Psychological
  • Affect
  • Arousal
  • Attitude to Health
  • Discriminant Analysis
  • Factor Analysis, Statistical
  • Humans
  • Mental Processes
  • Models, Biological*
  • Models, Psychological*
  • Nurse's Role
  • Nursing Assessment
  • Pain / complications*
  • Pain / diagnosis
  • Pain / prevention & control
  • Pain / psychology
  • Pain Measurement / methods
  • Pain Measurement / nursing
  • Psychophysiology
  • Risk Factors
  • Severity of Illness Index*
  • Stress, Psychological / diagnosis
  • Stress, Psychological / etiology*
  • Stress, Psychological / prevention & control
  • Stress, Psychological / psychology
  • Surveys and Questionnaires