Pain assessment and treatment disparities: A virtual human technology investigation
Pain assessment and treatment disparities: A virtual human technology investigation
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DOI：
10.1016/j.pain.2009.02.005
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发表时间：
2009-05-01
期刊：
影响因子：
7.4
通讯作者：
Robinson, Michael E.
中科院分区：
文献类型：
--
作者：
Hirsh, Adam T.;George, Steven Z.;Robinson, Michael E.
疼痛的评估和治疗受患者人口学特征和非语言表达的影响。方法上的挑战限制了对这些问题的实证研究。目前的模拟研究采用创新的研究设计和新颖的虚拟人（VH）技术来调查疼痛相关临床决策的差异。54名护士观看了由VH患者的视频片段和描述术后情况的临床摘要信息组成的小片段。参与者在计算机视觉模拟量表上做出评估（疼痛强度和不愉快）和治疗（非阿片类药物和阿片类药物）的决定。VH人口统计学线索的性别，种族，年龄，以及面部表情的痛苦，被系统地操纵和假设，以影响决策评级。对这些假设进行了具体统计分析和形态统计分析。具体结果表明，性别、面部、年龄和疼痛表情提示在许多护士的决策政策中占显著的、独特的差异。在这种情况下，疼痛表情是最显著的线索。同构结果表明，在兴趣的VH线索中存在差异，这些差异的大小和一致性在政策领域中有所不同。本研究展示了VH技术和镜头模型方法在疼痛相关决策差异研究中的应用。急性术后疼痛的评估和治疗通常根据VH人口统计学和面部表情线索而有所不同。这些数据有助于现有文献对疼痛实践差异的研究，并强调了一种新方法的潜力，这种新方法可以作为未来研究这些关键问题的模型。由爱思唯尔B.V.代表国际疼痛研究协会出版。
Pain assessment and treatment is influenced by patient demographic characteristics and nonverbal expressions. Methodological challenges have limited the empirical investigation of these issues. the current analogue study employed an innovative research design and novel Virtual human (VH) technology to investigate disparities in pain-related clinical decision-making. Fifty-four nurses viewed vignettes consisting of a video clip of the VH patient and clinical summary information describing a post-surgical context. Participants made assessment (pain intensity and unpleasantness) and treatment (non-opioid and opioid medications) decisions On Computerized Visual analogue scales. VH demographic cues of sex, race, and age, as well as facial expression of pain, were systematically manipulated and hypothesized to influence decision ratings. Idiographic and nomothetic statistical analyses were conducted to test these hypotheses. Idiographic results indicated that sex, Face, age, and pain expression Cues accounted for significant, unique variance in decision policies among many nurses. Pain expression was the most salient Cue in this context. Nomothetic results indicated differences within VH cues of interests the size and consistency of these differences varied across policy domains. This Study demonstrates the application of VH technology and lens model methodology to the Study of disparities in pain-related decision-making. Assessment and treatment Of acute post-surgical pain often varies based on VH demographic and facial expression Cues. These data contribute to the existing literature on disparities in pain practice and high-light the potential of a novel approach chat may serve as a model for future investigation of these critical issues. Published by Elsevier B.V. on behalf of International Association for the Study of Pain.