Can pain words hurt? A randomised trial comparing comfort versus pain scores following caesarean section

On the post-anaesthetic ward round within 10-36 hours after caesarean section, eligible women will be randomised to one of two groups. One group will be asked questions specifically about their level of comfort (Group C). The other group will be asked questions specifically about their level of pain (Group P). Overall, every participant will be asked the same questions, however the questions may be asked in a different order, depending on the Group. Participants will be interviewed by one of three researcher anaesthetists, medical students or midwives. After a greeting and introduction, women in Group C will be asked “Are you comfortable?”. If the woman says that they are not comfortable, they will be asked why they are not comfortable. They will then be asked for a Verbal Numerical Rating Score (VNRS) for comfort. More specifically they will be asked: “With regard to your healing caesarean wound, can you please rate your comfort level at rest, where 10 is most comfortable and zero is least comfortable” and then “When you move, how would you rate your level of comfort where 10 is most comfortable and zero is least comfortable?”. Women will then be asked “Is the healing wound bothering you?”, and then, “How much is the healing wound bothering you, where zero is least bothersome and 10 is most bothersome?”, and then “Would you like any additional medication to get you more comfortable?”. Women will then be asked to indicate how comfortable they are feeling, at rest and on movement, on a 100mm sliding Visual Analogue Scale (VAS) for comfort. Patient will then be asked “Do you have any pain?” and then will be asked for a VNRS for pain at rest and on movement, and their VAS for pain at rest and on movement. Women will then be asked “Would you prefer to be asked about your comfort level or your pain level or do you have no preference?”. If the woman reported that she was comfortable earlier in the interview, she will be asked “Earlier in this interview when you said that you were comfortable, did you have any pain at that exact moment in time”. If the woman reported that she was comfortable, and then later said she was in pain, she will then be asked “Why did you say you were comfortable even though later you said you were in pain?”. And finally, women will be asked whether their pain is an unpleasant experience or something that is not unpleasant.