Pain catastrophizing and its role in acute emotional distress among emergency trauma patients: Implications for emergency nursing care.

AIM: This study aimed to assess the role of pain catastrophizing in acute emotional distress, including pain, fear, and state anxiety, among trauma patients presenting to the emergency department.

METHODS

A cross-sectional study was conducted with 400 adult trauma patients presenting with isolated upper or lower extremity fractures. Data were collected using a sociodemographic form, the Visual Analog Scale (VAS) for pain/fear, the Pain Catastrophizing Scale (PCS), and the Spielberger State Anxiety Inventory (STAI-State). Descriptive statistics and structural equation modeling were used to examine associations among pain-related, cognitive, and psychological variables.

RESULTS

Participants reported moderate to high levels of acute pain (VAS = 7.05 ± 1.74), fear (VAS = 5.66 ± 2.12), pain catastrophizing (PCS = 24.19 ± 12.37), and state anxiety (STAI-S = 46.60 ± 6.40). Pain intensity and fear were strongly associated (rₛ = 0.865, p < 0.001). Both variables showed significant positive associations with pain catastrophizing and state anxiety (all p < 0.001). Structural equation modeling indicated that the associations between pain- and fear-related distress and state anxiety were accounted for by pain catastrophizing. When catastrophizing was considered, the associations between pain or fear and state anxiety were no longer evident.

CONCLUSION

These findings underscore the importance of early, nurse-led assessment of pain catastrophizing to identify emergency trauma patients at risk for acute emotional distress and to inform holistic emergency nursing care.