The Journal of adolescent health : official publication of the Society for Adolescent Medicine · 2020
Pain Perception and Treatment for Adolescents in Racially Concordant Versus Discordant Patient-Provider Scenarios.
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Guillermo Steffanie, Barre-Hemingway Madisen
Аннотация
PURPOSE: We tested assessments of adolescent pain and treatment recommendations in vignette cases that reflected racial concordance or discordance.
METHODS: Participants, black and white medical professionals, evaluated two vignettes, an acute asthma exacerbation and a leg injury. Vignettes presented either black or white patients. Participants estimated patients' pain level and indicated their agreement with two treatment recommendations-an optimal and an adequate treatment.
RESULTS: We expected stronger racial bias in pain estimates for white participants, although results did not support this hypothesis. We expected higher agreement with optimal treatment and lower agreement with adequate treatment, in racially concordant versus discordant scenarios. However, the results did not support this prediction. We hypothesized that pain assessments and treatments would be more strongly correlated in racially concordant compared with discordant scenarios. Results supported this hypothesis in the leg vignette and were most pronounced for optimal treatment (F(1, 70) = 4.38; η2 = .059; 95% CI: .007-.280; p = .04). Findings from the asthma vignette contradicted our hypothesis; higher pain estimates more strongly correlated with reduced agreement with an adequate treatment in racially discordant versus concordant scenarios (F(1, 72) = 6.46; η2 = .082; 95% CI: .025-.206; p = .01).
CONCLUSIONS: There were no race-based differences in pain estimates or agreement with treatment recommendations. Assessments of adolescent pain are more strongly correlated with acute pain treatment, specifically narcotic analgesic treatment, in racially concordant versus discordant scenarios. The correlation between pain assessment and treatment is also present in racially discordant scenarios for asthma treatment.
METHODS: Participants, black and white medical professionals, evaluated two vignettes, an acute asthma exacerbation and a leg injury. Vignettes presented either black or white patients. Participants estimated patients' pain level and indicated their agreement with two treatment recommendations-an optimal and an adequate treatment.
RESULTS: We expected stronger racial bias in pain estimates for white participants, although results did not support this hypothesis. We expected higher agreement with optimal treatment and lower agreement with adequate treatment, in racially concordant versus discordant scenarios. However, the results did not support this prediction. We hypothesized that pain assessments and treatments would be more strongly correlated in racially concordant compared with discordant scenarios. Results supported this hypothesis in the leg vignette and were most pronounced for optimal treatment (F(1, 70) = 4.38; η2 = .059; 95% CI: .007-.280; p = .04). Findings from the asthma vignette contradicted our hypothesis; higher pain estimates more strongly correlated with reduced agreement with an adequate treatment in racially discordant versus concordant scenarios (F(1, 72) = 6.46; η2 = .082; 95% CI: .025-.206; p = .01).
CONCLUSIONS: There were no race-based differences in pain estimates or agreement with treatment recommendations. Assessments of adolescent pain are more strongly correlated with acute pain treatment, specifically narcotic analgesic treatment, in racially concordant versus discordant scenarios. The correlation between pain assessment and treatment is also present in racially discordant scenarios for asthma treatment.