The impact of shift work on pain recognition, a robust ability among intensive care nurses.
Journal
European journal of pain (London, England)
ISSN: 1532-2149
Titre abrégé: Eur J Pain
Pays: England
ID NLM: 9801774
Informations de publication
Date de publication:
Nov 2023
Nov 2023
Historique:
revised:
07
06
2023
received:
14
01
2023
accepted:
10
06
2023
pubmed:
12
7
2023
medline:
12
7
2023
entrez:
12
7
2023
Statut:
ppublish
Résumé
Pain empathy is essential for high-quality of care. The cognitive ability to identify and understand the pain in others remains underexplored in the context of hospital shift work. This study aimed to observe the early subliminal ability to detect pain in other faces and to investigate pain intensity evaluations during day and night shifts. Twenty-one nurses (31 ± 7 years, 20 women) from cardio-paediatric intensive care participated in this study. Eighteen nurses completed all testing in the morning and evening hours, before and after the 12-hour day and night shift. In the first test, the nurses had to decide if facial stimuli presented subliminally showed pain or not. During the second test, they consciously determined the intensity of the painful faces on a numerical scale. Sleep, sleepiness and empathy were also measured. Recognition accuracy and pain sensitivity remained stable over time, only sensitivity increased following the work shift (F(1,15) = 7.10, p = 0.018). Intensity ratings remained stable. Sleepiness at the end of the night shift was negatively correlated with accuracy (ρ = -0.51, p = 0.018) and positively correlated with prior night shifts (ρ = -0.50, p = 0.022). The judgement of facial pain expressions seems robust across shift types, only individual factors such as sleepiness interfere with pain recognition. Pain sensitivity may be enhanced during working hours. Some professions need to know how to assess pain 24/7 and a lack of sleep can disrupt the cognitive processes necessary for this assessment. Night shifts provoke a bias in pain management, and sleep deprivation, a decrease in pain evaluation. By conducting a repeated measure study in the field that applied a different paradigm (subliminal recognition of facial cues) we add evidence to the understanding of pain recognition and the impact of sleep deprivation on the early processing of pain in others.
Sections du résumé
BACKGROUND
BACKGROUND
Pain empathy is essential for high-quality of care. The cognitive ability to identify and understand the pain in others remains underexplored in the context of hospital shift work. This study aimed to observe the early subliminal ability to detect pain in other faces and to investigate pain intensity evaluations during day and night shifts.
METHODS
METHODS
Twenty-one nurses (31 ± 7 years, 20 women) from cardio-paediatric intensive care participated in this study. Eighteen nurses completed all testing in the morning and evening hours, before and after the 12-hour day and night shift. In the first test, the nurses had to decide if facial stimuli presented subliminally showed pain or not. During the second test, they consciously determined the intensity of the painful faces on a numerical scale. Sleep, sleepiness and empathy were also measured.
RESULTS
RESULTS
Recognition accuracy and pain sensitivity remained stable over time, only sensitivity increased following the work shift (F(1,15) = 7.10, p = 0.018). Intensity ratings remained stable. Sleepiness at the end of the night shift was negatively correlated with accuracy (ρ = -0.51, p = 0.018) and positively correlated with prior night shifts (ρ = -0.50, p = 0.022).
CONCLUSION
CONCLUSIONS
The judgement of facial pain expressions seems robust across shift types, only individual factors such as sleepiness interfere with pain recognition. Pain sensitivity may be enhanced during working hours.
SIGNIFICANCE STATEMENT
CONCLUSIONS
Some professions need to know how to assess pain 24/7 and a lack of sleep can disrupt the cognitive processes necessary for this assessment. Night shifts provoke a bias in pain management, and sleep deprivation, a decrease in pain evaluation. By conducting a repeated measure study in the field that applied a different paradigm (subliminal recognition of facial cues) we add evidence to the understanding of pain recognition and the impact of sleep deprivation on the early processing of pain in others.
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1203-1215Informations de copyright
© 2023 European Pain Federation - EFIC ®.
Références
Achterberg, W. P., Erdal, A., Husebo, B. S., Kunz, M., & Lautenbacher, S. (2021). Are chronic pain patients with dementia being undermedicated? Journal of Pain Research, 14, 431-439. https://doi.org/10.2147/JPR.S239321
Amalean, A., Pavuluri, H., Schmidt, W. M., & Fowler, L. A. (2021). The effects of sleepiness, time of day, and 12-h shifts on affective and cognitive empathy in emergency medical technicians. Sleep and Biological Rhythms, 19(1), 105-107. https://doi.org/10.1007/s41105-020-00280-y
Arzalier-Daret, S., Buléon, C., Bocca, M. L., Denise, P., Gérard, J. L., & Hanouz, J. L. (2018). Effect of sleep deprivation after a night shift duty on simulated crisis management by residents in anaesthesia. A randomised crossover study. Anaesthesia Critical Care and Pain Medicine, 37(2), 161-166. https://doi.org/10.1016/j.accpm.2017.05.010
Beattie, L., Walsh, D., McLaren, J., Biello, S. M., & White, D. (2016). Perceptual impairment in face identification with poor sleep. Royal Society Open Science, 3(10), 160321. https://doi.org/10.1098/rsos.160321
Benuzzi, F., Lui, F., Ardizzi, M., Ambrosecchia, M., Ballotta, D., Righi, S., Pagnoni, G., Gallese, V., & Porro, C. A. (2018). Pain mirrors: Neural correlates of observing self or others' facial expressions of pain. Frontiers in Psychology, 9, 1825. https://doi.org/10.3389/fpsyg.2018.01825
Bérastégui, P., Jaspar, M., Ghuysen, A., & Nyssen, A.-S. (2018). Fatigue-related risk management in the emergency department: A focus-group study. Internal and Emergency Medicine, 13(8), 1273-1281. https://doi.org/10.1007/s11739-018-1873-3
Bianchi, M. T., Williams, K. L., Mckinney, S., & Ellenbogen, J. M. (2013). The subjective-objective mismatch in sleep perception among those with insomnia and sleep apnea. Journal of Sleep Research, 22(5), 557-568. https://doi.org/10.1111/JSR.12046
Brand, K., & Al-Rais, A. (2019). Pain assessment in children. Anaesthesia & Intensive Care Medicine, 20(6), 314-317. https://doi.org/10.1016/J.MPAIC.2019.03.003
Bumgarner, J. R., Ii, W. H. W., & Nelson, R. J. (2021). Circadian rhythms and pain. Neuroscience and Biobehavioral Reviews, 129, 296-306. https://doi.org/10.1016/j.neubiorev.2021.08.004
Carroll, N. C., & Young, A. W. (2018). Priming of Emotion Recognition, 58(7), 1173-1197. doi:10.1080/02724980443000539
Chang, Y. S., Wu, Y. H., Hsu, C. Y., Tang, S. H., Yang, L. L., & Su, S. F. (2011). Impairment of perceptual and motor abilities at the end of a night shift is greater in nurses working fast rotating shifts. Sleep Medicine, 12(9), 866-869. https://doi.org/10.1016/j.sleep.2011.03.018
Choshen-Hillel, S., Sadras, I., Gordon-Hecker, T., Genzer, S., Rekhtman, D., Caruso, E. M., Clements, K. L., Ohler, A., Gozal, D., Israel, S., Perry, A., & Gileles-Hillel, A. (2022). Physicians prescribe fewer analgesics during night shifts than day shifts. Proceedings of the National Academy of Sciences of the United States of America, 119(27), e2200047119. https://doi.org/10.1073/PNAS.2200047119
Chu, Y., He, H., Liu, Q., Jia, S., Fan, W., & Huang, F. (2022). The circadian clocks, oscillations of pain-related mediators, and pain. Cellular and Molecular Neurobiology, 2022, 1-13. https://doi.org/10.1007/S10571-022-01205-8
Czeisler, C. A., Pellegrini, C. A., & Sade, R. M. (2013). Should sleep-deprived surgeons Be prohibited from operating. HHS Public Access, 95(2), 757-766. https://doi.org/10.1016/j.athoracsur.2012.11.052
Czekala, C., Mauguière, F., Mazza, S., Jackson, P. L., & Frot, M. (2015). My brain reads pain in your face, before knowing your gender. The Journal of Pain, 16(12), 1342-1352. https://doi.org/10.1016/J.JPAIN.2015.09.006
Drimalla, H., Landwehr, N., Hess, U., & Dziobek, I. (2019). From face to face: The contribution of facial mimicry to cognitive and emotional empathy. Cognition and Emotion, 33(8), 1672-1686. https://doi.org/10.1080/02699931.2019.1596068
Duan, H., Wang, Y. J., & Lei, X. (2021). The effect of sleep deprivation on empathy for pain: An ERP study. Neuropsychologia, 163, 108084. https://doi.org/10.1016/j.neuropsychologia.2021.108084
Dula, D. J., Dula, N. L., Hamrick, C., & Wood, G. C. (2001). The effect of working serial night shifts on the cognitive functioning of emergency physicians. Annals of Emergency Medicine, 38(2), 152-155. https://doi.org/10.1067/mem.2001.116024
Dutheil, F., Marhar, F., Boudet, G., Perrier, C., Naughton, G., Chamoux, A., Huguet, P., Mermillod, M., Saâdaoui, F., Moustafa, F., & Schmidt, J. (2017). Maximal tachycardia and high cardiac strain during night shifts of emergency physicians. International Archives of Occupational and Environmental Health, 90(6), 467-480. https://doi.org/10.1007/s00420-017-1211-5
Faul, F., Erdfelder, E., Lang, A. G., & Buchner, A. (2007). G*Power 3: A flexible statistical power analysis program for the social, behavioral, and biomedical sciences. Behavior Research Methods, 39(2), 175-191. https://doi.org/10.3758/BF03193146
Finan, P. H., Quartana, P. J., Remeniuk, B., Garland, E. L., Rhudy, J. L., Hand, M., Irwin, M. R., & Smith, M. T. (2017). Partial sleep deprivation attenuates the positive affective system: Effects across multiple measurement modalities. Sleep, 40(1), zsw017. https://doi.org/10.1093/SLEEP/ZSW017
Fowler, L. A., & Ellis, S. (2019). The effect of 12 hour shifts, time of day, and sleepiness on emotional empathy and burnout in medical students. Clocks & Sleep, 1(4), 501-509. https://doi.org/10.3390/CLOCKSSLEEP1040038
Ganesan, S., Magee, M., Stone, J. E., Mulhall, M. D., Collins, A., Howard, M. E., Lockley, S. W., Rajaratnam, S. M. W., & Sletten, T. L. (2019). The impact of shift work on sleep, alertness and performance in healthcare workers. Scientific Reports, 9(1), 4635. https://doi.org/10.1038/s41598-019-40914-x
Glenn, S., Poole, H., & Oulton, P. (2020). Individual differences and similarities in the judgement of facial pain: A mixed method study. European Journal of Investigation in Health, Psychology and Education, 10(4), 1186-1194. https://doi.org/10.3390/ejihpe10040083
Gu, X., Liu, X., Guise, K. G., Naidich, T. P., Hof, P. R., & Fan, J. (2010). Functional dissociation of the frontoinsular and anterior cingulate cortices in empathy for pain. Journal of Neuroscience, 30(10), 3739-3744. https://doi.org/10.1523/JNEUROSCI.4844-09.2010
Guadagni, V., Burles, F., Ferrara, M., & Iaria, G. (2014). The effects of sleep deprivation on emotional empathy. Journal of Sleep Research, 23(6), 657-663. https://doi.org/10.1111/jsr.12192
Guadagni, V., Cook, E., Hart, C., Burles, F., & Iaria, G. (2018). Poor sleep quality affects empathic responses in experienced paramedics. Sleep and Biological Rhythms, 16(3), 365-368. https://doi.org/10.1007/S41105-018-0156-8/FIGURES/1
Hagenauer, M. H., Crodelle, J. A., Piltz, S. H., Toporikova, N., Ferguson, P., & Booth, V. (2017). The modulation of pain by circadian and sleep-dependent processes: A review of the experimental evidence. In Association for Women in Mathematics series (Vol. 8, pp. 1-21). Springer International Publishing. https://doi.org/10.1007/978-3-319-60304-9_1
Hojat, M., DeSantis, J., Shannon, S. C., Mortensen, L. H., Speicher, M. R., Bragan, L., LaNoue, M., & Calabrese, L. H. (2018). The Jefferson Scale of Empathy: A nationwide study of measurement properties, underlying components, latent variable structure, and national norms in medical students. Advances in Health Sciences Education, 23(5), 899-920. https://doi.org/10.1007/s10459-018-9839-9
Holland, A. C., O'Connell, G., & Dziobek, I. (2021). Facial mimicry, empathy, and emotion recognition: A meta-analysis of correlations. Cognition and Emotion, 35(1), 150-168. https://doi.org/10.1080/02699931.2020.1815655
Jauniaux, J., Khatibi, A., Rainville, P., & Jackson, P. L. (2019). A meta-analysis of neuroimaging studies on pain empathy: Investigating the role of visual information and observers' perspective. Social Cognitive and Affective Neuroscience, 14(8), 789-813. https://doi.org/10.1093/SCAN/NSZ055
Kabes, A. M., Graves, J. K., & Norris, J. (2009). Further validation of the nonverbal pain scale in intensive care patients. Critical Care Nurse, 29(1), 59-66. https://doi.org/10.4037/CCN2009992
Killgore, W. D. S., Balkin, T. J., Yarnell, A. M., & Capaldi, V. F. (2017). Sleep deprivation impairs recognition of specific emotions. Neurobiology of Sleep and Circadian Rhythms, 3, 10-16. https://doi.org/10.1016/j.nbscr.2017.01.001
Killgore, W. D. S., & Weber, M. (2014). Sleep deprivation and cognitive performance. In M.T. Bianchi (Ed.), Sleep deprivation and disease (pp. 209-229). Springer. https://doi.org/10.1007/978-1-4614-9087-6_16
Krause, A. J., Prather, A. A., Wager, T. D., Lindquist, M. A., & Walker, M. P. (2019). The pain of sleep loss: A brain characterization in humans. The Journal of Neuroscience : The Official Journal of the Society for Neuroscience, 39(12), 2291-2300. https://doi.org/10.1523/JNEUROSCI.2408-18.2018
Kunz, M., Lautenbacher, S., Leblanc, N., & Rainville, P. (2012). Are both the sensory and the affective dimensions of pain encoded in the face? Pain, 153(2), 350-358. https://doi.org/10.1016/J.PAIN.2011.10.027
Kyle, S. D., Beattie, L., Spiegelhalder, K., Rogers, Z., & Espie, C. A. (2014). Altered emotion perception in insomnia disorder. Sleep, 37(4), 775-783. https://doi.org/10.5665/sleep.3588
Lamond, N., Dorrian, J., Burgess, H., Holmes, A., Roach, G., McCulloch, K., Fletcher, A., & Dawson, D. (2004). Adaptation of performance during a week of simulated night work. Ergonomics, 47(2), 154-165. https://doi.org/10.1080/00140130310001617930
Latimer, M., Jackson, P. L., Eugène, F., MacLeod, E., Hatfield, T., Vachon-Presseau, E., Michon, P. E., & Prkachin, K. M. (2017). Empathy in paediatric intensive care nurses part 1: Behavioural and psychological correlates. Journal of Advanced Nursing, 73(11), 2676-2685. https://doi.org/10.1111/jan.13333
Lauderdale, D. S., Knutson, K. L., Yan, L. L., Liu, K., & Rathouz, P. J. (2008). Sleep duration: How well do self-reports reflect objective measures? The CARDIA sleep study. Epidemiology (Cambridge, Mass.), 19(6), 838. https://doi.org/10.1097/EDE.0B013E318187A7B0
Lautenbacher, S., & Kunz, M. (2016). Facial pain expression in dementia: A review of the experimental and clinical evidence. Current Alzheimer Research, 14(5), 501-505. https://doi.org/10.2174/1567205013666160603010455
Mathôt, S., Schreij, D., & Theeuwes, J. (2012). OpenSesame: An open-source, graphical experiment builder for the social sciences. Behavior Research Methods, 44(2), 314-324. https://doi.org/10.3758/S13428-011-0168-7/FIGURES/4
Mende-Siedlecki, P., Qu-Lee, J., Lin, J., Drain, A., & Goharzad, A. (2020). The Delaware pain database: A set of painful expressions and corresponding norming data. Pain Reports, 5(6), e853. https://doi.org/10.1097/PR9.0000000000000853
Mercer, S. W., & Reynolds, W. J. (2002). Empathy and quality of care. British Journal of General Practice, 52(Suppl), S9-S12.
Naeeri, S., Mandal, S., & Kang, Z. (2019). Analyzing pilots' fatigue for prolonged flight missions: Multimodal analysis approach using vigilance test and eye tracking. Proceedings of the Human Factors and Ergonomics Society Annual Meeting, 63(1), 111-115. https://doi.org/10.1177/1071181319631092
Nook, E. C., Lindquist, K. A., & Zaki, J. (2015). A new look at emotion perception: Concepts speed and shape facial emotion recognition. Emotion, 15(5), 569-578. https://doi.org/10.1037/A0039166
Owens, J. A. (2007). Sleep loss and fatigue in healthcare professionals. Journal of Perinatal and Neonatal Nursing, 21(2), 92-100. https://doi.org/10.1097/01.JPN.0000270624.64584.9d
Philibert, I. (2005). Sleep loss and performance in residents and nonphysicians: A meta-analytic examination. Sleep, 28(11), 1392-1402. https://doi.org/10.1093/SLEEP/28.11.1392
Prkachin, K. M., Mass, H., & Mercer, S. R. (2004). Effects of exposure on perception of pain expression. Pain, 111(1-2), 8-12. https://doi.org/10.1016/j.pain.2004.03.027
Prkachin, K. M., & Rocha, E. M. (2010). High levels of vicarious exposure bias pain judgments. The Journal of Pain, 11(9), 904-909.
Ren, Q., Yang, Y., Wo, Y., Lu, X., & Hu, L. (2022). Different priming effects of empathy on neural processing associated with firsthand pain and nonpain perception. Annals of the New York Academy of Sciences, 1509(1), 184-202. https://doi.org/10.1111/NYAS.14723
Roche, J., & Harmon, D. (2017). Exploring the facets of empathy and pain in clinical practice: A review. Pain Practice, 17(8), 1089-1096. https://doi.org/10.1111/PAPR.12563
Roter, D. L., Frankel, R. M., Hall, J. A., & Sluyter, D. (2006). The expression of emotion through nonverbal behavior in medical visits. Mechanisms and outcomes. Journal of General Internal Medicine, 21(Suppl 1), S28-S34. https://doi.org/10.1111/J.1525-1497.2006.00306.x
Ruben, M. A., & Hall, J. A. (2013). “I know your pain” proximal and distal predictors of pain detection accuracy. Personality and Social Psychology Bulletin, 39(10), 1346-1358. https://doi.org/10.1177/0146167213493188
Ruben, M. A., van Osch, M., & Blanch-Hartigan, D. (2015). Healthcare providers' accuracy in assessing patients' pain: A systematic review. Patient Education and Counseling, 98(10), 1197-1206. https://doi.org/10.1016/J.PEC.2015.07.009
Russo, M., Sing, H., Kendall, A., Johnson, D., Santiago, S., Escolas, S., … Thomas, M. (2005). Visual perception, flight performance, and reaction time impairments in military pilots during 26 hours of continuous wake: Implications for automated workload control systems as fatigue management tools. Research & Technology Organization, 27(1), 1-16.
Schiöth, H. B., Brooks, S. J., & Benedict, C. (2012). Healthcare systems never sleep: Are medical residents today the patients of tomorrow? Sleep Medicine, 13(7), 965. https://doi.org/10.1016/j.sleep.2012.05.001
Singer, T., Seymour, B., O'doherty, J., Kaube, H., Dolan, R. J., & Frith, C. D. (2004). Empathy for pain involves the affective but not sensory components of pain. Science, 303(5661), 1157-1162. https://doi.org/10.1126/science.109353
Song, J., Wei, Y., & Ke, H. (2019). The effect of emotional information from eyes on empathy for pain: A subliminal ERP study. PLoS One, 14(12), e0226211. https://doi.org/10.1371/JOURNAL.PONE.0226211
Tamm, S., Nilsonne, G., Schwarz, J., Lamm, C., Kecklund, G., Petrovic, P., Fischer, H., Åkerstedt, T., & Lekander, M. (2017). The effect of sleep restriction on empathy for pain: An fMRI study in younger and older adults. Scientific Reports, 7(1), 1-14. https://doi.org/10.1038/s41598-017-12098-9
Tamm, S., Schwarz, J., Thuné, H., Kecklund, G., Petrovic, P., Åkerstedt, T., Fischer, H., Lekander, M., & Nilsonne, G. (2020). A combined fMRI and EMG study of emotional contagion following partial sleep deprivation in young and older humans. Scientific Reports, 10(1), 17944. https://doi.org/10.1038/s41598-020-74489-9
Tempesta, D., Couyoumdjian, A., Curcio, G., Moroni, F., Marzano, C., De Gennaro, L., & Ferrara, M. (2010). Lack of sleep affects the evaluation of emotional stimuli. Brain Research Bulletin, 82, 104-108. https://doi.org/10.1016/j.brainresbull.2010.01.014
Vachon-Presseau, E., Roy, M., Martel, M. O., Albouy, G., Chen, J., Budell, L., Sullivan, M. J., Jackson, P. L., & Rainville, P. (2012). Neural processing of sensory and emotional-communicative information associated with the perception of vicarious pain. NeuroImage, 63(1), 54-62. https://doi.org/10.1016/J.NEUROIMAGE.2012.06.030
Van Der Helm, E., Gujar, N., & Walker, M. P. (2010). Sleep deprivation impairs the accurate recognition of human emotions. Sleep, 33(3), 335-342. https://doi.org/10.1093/sleep/33.3.335
Whelehan, D. F., Alexander, M., & Ridgway, P. F. (2020). Would you allow a sleepy surgeon operate on you? A narrative review. Sleep Medicine Reviews, 53, 101341. W.B. Saunders Ltd. https://doi.org/10.1016/j.smrv.2020.101341
Williams, A. C. D. C. (2002). Facial expression of pain, empathy, evolution, and social learning. Behavioral and Brain Sciences, 25(4), 475-488. https://doi.org/10.1017/S0140525X02430087
Xiang, Y., Wang, Y., Gao, S., Zhang, X., & Cui, R. (2018). Neural mechanisms with respect to different paradigms and relevant regulatory factors in empathy for pain. Frontiers in Neuroscience, 12(JUL), 507. https://doi.org/10.3389/FNINS.2018.00507/BIBTEX
Yamada, M., & Decety, J. (2009). Unconscious affective processing and empathy: An investigation of subliminal priming on the detection of painful facial expressions. Pain, 143(1-2), 71-75. https://doi.org/10.1016/J.PAIN.2009.01.028
Zenasni, F., Boujut, E., du Vaure, B., Catu-Pinault, A., Tavani, J. L., Rigal, L., Jaury, P., Magnier, A. M., Falcoff, H., & Sultan, S. (2012). Development of a French-language version of the Jefferson Scale of Physician Empathy and association with practice characteristics and burnout in a sample of general practitioners. International Journal of Person Centered Medicine, 2(4), 759-766. https://doi.org/10.5750/IJPCM.V2I4.295
Zhou, F., Li, J., Zhao, W., Xu, L., Zheng, X., Fu, M., Yao, S., Kendrick, K. M., Wager, T. D., & Becker, B. (2020). Empathic pain evoked by sensory and emotional-communicative cues share common and process-specific neural representations. eLife, 9, 1-27. https://doi.org/10.7554/ELIFE.56929
Åkerstedt, T., & Gillberg, M. (1990). Subjective and objective sleepiness in the active individual. International journal of neuroscience, 52(1-2), 29-37.