Defining Racial and Ethnic Disparities in Pain Management
Defining Racial and Ethnic Disparities in Pain Management
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DOI：
10.1007/s11999-011-1770-9
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发表时间：
2011-07-01
影响因子：
4.2
通讯作者：
Mossey, Jana M.
中科院分区：
文献类型：
--
作者：
Mossey, Jana M.
在社区人群中，实质性疼痛的患病率高达40%。有一致的证据表明，种族/少数民族的个人是在那些谁的经验，这种疼痛和疼痛的管理是不充分的代表性。本文的目的是（1）定义参数和总结证据有关种族/少数民族的差异在疼痛管理，（2）确定因素造成观察到的差异，以及（3）确定策略以最小化差异。选择性地回顾科学文献，讨论疼痛流行病学，非西班牙裔白人与种族/少数民族群体在疼痛管理方面的差异，少数种族/族裔始终比非西班牙裔白人接受更少的急性和慢性疼痛的治疗，即使在控制了年龄，性别和疼痛强度之后。疼痛强度低报似乎是一个主要的贡献，少数人的疼痛管理的差距。医生对这种差异的主要贡献似乎反映了对他们自己的文化信仰和关于疼痛的刻板印象的认识有限，少数民族个体和麻醉性镇痛药的使用。种族/少数民族疼痛患者需要被授权准确报告疼痛强度水平，治疗此类患者的医生需要承认他们自己关于疼痛的信仰体系，并制定策略来克服无意识，但对少数民族患者的负面刻板印象可能是有害的。
Substantial pain prevalence is as high as 40% in community populations. There is consistent evidence that racial/ethnic minority individuals are overrepresented among those who experience such pain and whose pain management is inadequate.The objectives of this paper are to (1) define parameters of and summarize evidence pertinent to racial/ethnic minority disparities in pain management, (2) identify factors contributing to observed disparities, and (3) identify strategies to minimize the disparities.Scientific literature was selectively reviewed addressing pain epidemiology, differences in pain management of non-Hispanic whites versus racial/ethnic minority groups, and patient and physician factors contributing to such differences.Racial/ethnic minorities consistently receive less adequate treatment for acute and chronic pain than non-Hispanic whites, even after controlling for age, gender, and pain intensity. Pain intensity underreporting appears to be a major contribution of minority individuals to pain management disparities. The major contribution by physicians to such disparities appears to reflect limited awareness of their own cultural beliefs and stereotypes regarding pain, minority individuals, and use of narcotic analgesics.Racial/ethnic minority patients with pain need to be empowered to accurately report pain intensity levels, and physicians who treat such patients need to acknowledge their own belief systems regarding pain and develop strategies to overcome unconscious, but potentially harmful, negative stereotyping of minority patients.