TABLE 1.
Qualitative themes.
| Theme/Subtheme | Sample 1 (S1, n = 90) | Sample 2 (S2, n = 248) | Combined sample (n = 338) | |
| Self-perspective: reasons for under-reporting pain | ||||
| Impression management | 9 | 13 | 22 | |
| Appear tough | 7 | 5 | 12 | |
| Self-conscious/embarrassed | 4 | 9 | 13 | |
| Adjustment to expectations | 0 | 1 | 1 | |
| Downplaying pain | 8 | 4 | 12 | |
| Fear and avoidance | 10 | 20 | 30 | |
| Fear of bad news/denial | 1 | 1 | 2 | |
| Avoidance of medical settings | 1 | 5 | 6 | |
| Avoid medication/treatment | 5 | 13 | 18 | |
| Reduce time in care | 3 | 4 | 7 | |
| Cost | 7 | 2 | 9 | |
| Cost/access to care | 1 | 1 | 2 | |
| Reduce repercussions | 5 | 1 | 6 | |
| Price of desired outcome | 1 | 0 | 1 | |
| Other-oriented | 4 | 8 | 12 | |
| Concern for social networks | 2 | 5 | 7 | |
| Practitioner inconvenience | 2 | 1 | 3 | |
| General concern | 0 | 2 | 2 | |
| Cognitive modulation | 3 | 1 | 4 | |
| Counteract over-reporting | 1 | 1 | 2 | |
| Subjective misunderstanding | 2 | 1 | 3 | |
| Deference/doctor as expert | 1 | 1 | 2 | |
| Simply restating | 1 | 2 | 3 | |
| Total endorsements | 78 | 101 | 179 | |
| Total participants that endorsed | 33 | 46 | 79 | |
| Self-perspective: reasons for over-reporting pain | ||||
| Ensure treatment | 19 | 28 | 47 | |
| Taken seriously/secure assistance | 12 | 14 | 26 | |
| Receive medication/treatment | 10 | 9 | 19 | |
| Accelerate care | 1 | 9 | 10 | |
| Discrimination | 1 | 0 | 1 | |
| Solicit social support | 1 | 1 | 2 | |
| Alternative motives | 6 | 9 | 15 | |
| Influence of addiction | 0 | 1 | 1 | |
| Extra/stronger medication or treatment | 5 | 6 | 11 | |
| Avoid work/social interaction | 1 | 2 | 3 | |
| Fear and avoidance | 4 | 8 | 12 | |
| General fear/anxiety | 1 | 3 | 4 | |
| Proactive reporting | 3 | 5 | 8 | |
| Cognitive modulation | 1 | 5 | 6 | |
| Prior/lack of experience | 1 | 3 | 4 | |
| Dynamic appraisal | 0 | 2 | 2 | |
| Justification | 2 | 0 | 2 | |
| Simply restating | 2 | 2 | 4 | |
| Total endorsements | 70 | 107 | 177 | |
| Total participants that endorsed | 30 | 47 | 77 | |
| Self-perspective: reasons for neither under- nor over-reporting pain | ||||
| Trust in doctor | 1 | 2 | 3 | |
| Ensure proper treatment | 2 | 10 | 12 | |
| Morals | 2 | 15 | 17 | |
| Simply restating | 16 | 78 | 94 | |
| Individual differences | 0 | 3 | 3 | |
| Total endorsements | 21 | 108 | 129 | |
| Total participants that endorsed | 21 | 101 | 122 | |
| Other perspective: reasons for under-reporting pain | ||||
| Impression management | 22 | 34 | 56 | |
| Appear tough | 16 | 21 | 37 | |
| Self-conscious/embarrassed | 8 | 16 | 24 | |
| Deflect drug-seeking stereotypes | 0 | 1 | 1 | |
| Conveying health/resilience | 0 | 1 | 1 | |
| Downplaying pain | 8 | 10 | 18 | |
| Fear and avoidance | 21 | 28 | 49 | |
| Fear of bad news/denial | 10 | 7 | 17 | |
| Avoidance of doctors/medical settings | 2 | 7 | 9 | |
| Avoid medication/treatment | 7 | 16 | 23 | |
| Reduce time in care | 1 | 3 | 4 | |
| Cost | 4 | 10 | 14 | |
| Cost/access to care | 2 | 7 | 9 | |
| Reduce repercussions | 2 | 2 | 4 | |
| Time | 1 | 1 | 2 | |
| Other-oriented | 6 | 6 | 12 | |
| Concern for social networks | 3 | 1 | 4 | |
| Practitioner inconvenience | 2 | 0 | 2 | |
| Concern for un-named other | 2 | 5 | 7 | |
| Cognitive modulation | 2 | 3 | 5 | |
| Pain expectations/misconceptions | 0 | 1 | 1 | |
| Prior/lack of experience | 0 | 1 | 1 | |
| Subjective misunderstanding | 2 | 1 | 3 | |
| Deference/doctor as expert | 1 | 0 | 1 | |
| Enjoy pain | 0 | 1 | 1 | |
| Simply restating | 1 | 3 | 4 | |
| Total endorsements | 123 | 186 | 309 | |
| Total participants that endorsed | 50 | 81 | 131 | |
| Other perspective: reasons for over-reporting pain | ||||
| Ensure treatment | 32 | 71 | 103 | |
| Taken seriously/secure assistance | 15 | 24 | 39 | |
| Receive medication/treatment | 16 | 47 | 63 | |
| Accelerate care | 6 | 15 | 21 | |
| Solicit social support | 1 | 7 | 8 | |
| Derogatory assessment | 7 | 12 | 19 | |
| Alternative motives | 17 | 66 | 83 | |
| Influence of addiction | 2 | 9 | 11 | |
| Extra/Stronger medication or treatment | 8 | 46 | 54 | |
| Receive compensation | 0 | 1 | 1 | |
| Psychosocial | 7 | 15 | 22 | |
| Fear and avoidance | 1 | 3 | 4 | |
| General fear/anxiety | 0 | 1 | 1 | |
| Proactive reporting | 1 | 1 | 2 | |
| Cognitive modulation | 2 | 7 | 9 | |
| Prior/lack of experience | 0 | 2 | 2 | |
| Adjustment to expectations | 1 | 2 | 3 | |
| Subjective misunderstanding | 0 | 4 | 4 | |
| Justification | 2 | 0 | 2 | |
| Simply restating | 3 | 5 | 8 | |
| Total endorsements | 121 | 338 | 459 | |
| Total participants that endorsed | 58 | 138 | 196 | |
| Other perspective: reasons for neither under- nor over-reporting pain | ||||
| Ensure proper treatment | 0 | 1 | 1 | |
| Total endorsements | 0 | 1 | 1 | |
| Total participants that endorsed | 0 | 1 | 1 | |
| Other perspective: recognition of pain subjectivity | ||||
| Individual differences | 1 | 4 | 5 | |
| Total endorsements | 1 | 4 | 5 | |
| Total participants that endorsed | 1 | 4 | 5 | |