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According to Smeltzer (2001) factors that affect pain response is:

1. Past experience
Individuals who have multiple and prolonged experience with pain will be less anxious and more tolerant to pain than people who only experience slight pain. For most people, however, this is not always true. Often, more experienced individuals to the pain experienced, the individual is more afraid of the painful events that will be caused.

2. Anxiety
The relationship between pain and anxiety are complex. Anxiety often increases the perception of pain, but pain can also cause a feeling of anxiety. Autonomic arousal pattern is the same in pain and anxiety. It is difficult to separate a sensation. Paice (1991) reported evidence that a painful stimulus activates the limbic part of which is believed to control one's emotions, especially anxiety. The limbic system can process emotional reactions to pain, which worsens or eliminate pain.

3. Culture
Beliefs and cultural values ​​affect the way individuals cope with pain. Individuals learn what to expect and what is acceptable to their culture. This includes how to react to pain. There is a difference of meaning and attitudes associated with pain in various cultural groups. An understanding of pain in terms of cultural significance will assist nurses in designing relevant nursing care to clients who experience pain (Potter, 2005).

4. Age
Age is an important factor affecting pain, particularly in children and the elderly. The development, which was found among this age group can influence how children and the elderly react to pain. Very young children have difficulty expressing pain.

5. The Placebo Effect
Placebo is a substance with no pharmacological activity in the form of tablets, capsules, liquid injection and so on. Placebos are generally composed of sugar, normal saline, or plain water. Because the placebo has no pharmacological effect, these drugs only effect the release of scientific products (endogenous) endorphins in descending control system, causing pain reduction effect (Tamsuri, 2006).
 
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