Nurses' Management of Acute Pain: Association With Opioid Use Disorder and Patient's Gender.

PURPOSE: To compare nurses' management of acute pain with opioids in different scenarios, depending on both the patient's gender and opioid use disorder (OUD) status. We also aimed to determine the knowledge, attitudes, and fears associated with the nonapplication of opioid prescriptions and to investigate potential differences in fears when prescribing opioids between male and female patients with OUD.

DESIGN

Cross-sectional study conducted with 196 registered nurses.

METHODS

Assessment of nurses' attitudes and behavior (i.e., application or not of opioid prescription) after presentations of clinical vignettes varying in terms of the patient's gender and OUD status. Investigation of the knowledge, attitudes, and fears related to opioid prescriptions in OUD patients (self-report questionnaire).

RESULTS

A less frequent application of opioid prescriptions was observed in the OUD scenario (63.3% vs. 86.7%; p < .001) and the female scenario. This lower application of opioid prescriptions in female was observed in both the OUD (55% vs. 73.6%; p < .01) and the non-OUD scenario (81.7% vs. 93.1%; p < .05). Nonapplication of opioid prescriptions in the OUD scenario was associated with the belief that patients with OUD may overestimate pain (52.6% vs. 14.8%; p < .001). Prescribing opioids to females with OUD was associated with more fears of worsening the OUD and overdose, but less fears of being not efficient on pain.

CONCLUSIONS

Managing acute pain in female patients and patients with OUD is associated with different behaviors, attitudes, and fears than in males, especially in women with OUD.

CLINICAL IMPLICATIONS: Tailored interventions that aim to address stigmatization and disparities in pain management should consider both the patient's opioid status and gender.