Large-Scale Online stimulus Norming and Surveys about Perceptions in Healthcare

疼痛可以通过支持患者-提供者关系的人际过程以及与治疗环境相关的背景因素来调节。在这个项目中，我们调查了美国关于医疗保健的大规模规范和信念，以及人们对治疗环境中的人的感知和其他视觉线索如何影响对治疗期间疼痛的预期以及对其他人感受到的疼痛的预期。该项目使用在线调查方法来衡量来自地理、种族和社会经济多元化的美国人口的大规模规范信仰和期望。这个项目的目的是调查可能在临床上增强或减轻疼痛的医疗信念，这可用于在实验室设计研究，以测试操纵这些信念是否有利于疼痛结果。该项目的数据收集工作于19财年开始。我们首先询问对医疗提供者的第一印象如何影响对医疗过程中疼痛的预期以及对手术后恢复的预期。过去的研究表明，对医疗提供者能力的感知会影响临床上的疼痛体验，而与患者相似的医疗提供者的感知会在模拟的临床互动中影响患者的疼痛体验。在医疗保健以外的领域，研究表明，即使是对能力等特质的第一印象也会影响人们的预期和行为：例如，看起来更能干的政客更有可能当选。因此，我们有兴趣衡量人们对医疗提供者的看法是否影响了他们对如果医疗提供者对他们进行手术时可能经历的疼痛的预期。我们还感兴趣的是，他们对医疗提供者和疼痛治疗选择的总体信念(即，医疗提供者总体上是有能力的，我对草药治疗疼痛的看法是有利的)是否会影响他们的期望。 在2019财年，我们在在线平台机械土耳其人上收集了四个样本来测试这个问题。参与者完成了调查，在这些调查中，他们观看了人脸的图像，并被告知他们应该想象这些人脸是可以为他们进行手术的潜在医疗提供者的人脸。他们首先选择了他们更愿意为他们进行痛苦手术的医疗提供者，然后他们评估了他们预计这些手术会有多痛苦，以及他们预计在手术后恢复过程中需要哪些类型的治疗。在我们的两个样本中，我们使用了计算机生成的人脸；在另外两个样本中，我们使用了真实的人脸。在我们的三个样本中，参与者对刺激面孔与他们自己的相似度进行了评分。在一些样本中，参与者还对面孔的感知能力进行了评级(在其他样本中，我们使用了来自已公布的刺激集的刺激，这些特征已经根据这些刺激集进行了评级)。 我们观察到，人们更喜欢看起来更有能力、更像他们的面孔来做他们的医疗提供者。此外，在由看起来更有能力的医疗提供者进行的假设程序之后，以及由与他们更相似的医疗提供者进行的程序之后，他们预计体验到的疼痛更少，对处方强度止痛药的需求也更少。我们现在正在探索他们的态度对他们的疼痛和治疗期望的作用，并正在探索假设性提供者人口统计特征(例如，种族/性别)对参与者期望的作用。我们还在撰写一份手稿以供出版，解释对提供者能力和相似性的第一印象对疼痛和治疗预期的影响。

Pain can be modulated by interpersonal processes that support the patient-provider relationship, and contextual factors related to the treatment environment. In this project, we investigate large-scale norms and beliefs about healthcare in America, and how perceptions of people and other visual cues in the treatment environment influence expectations about pain during treatment and about the pain other people feel. This project uses online survey methodologies to measure large scale normed beliefs and expectations from a geographically, ethnically, and socioeconomically diverse population of Americans. The purpose of this project is to investigate healthcare beliefs that may enhance or diminish pain in the clinic, which can be used to design studies in the laboratory to test if manipulating these beliefs can be advantageous for pain outcomes. Data collection for this project began in FY19. We began by asking how first impressions of medical providers influence expectations of pain during a medical procedure and expectations for post-surgical recovery. Past work has demonstrated that perceptions of medical providers competence influence the experience of pain in the clinic, and that perceptions of medical providers similarity to a patient influence the patients experience of pain in a simulated clinical interaction. In domains outside of healthcare, research has demonstrated that even first impressions of traits such as competence can influence expectations and behavior: for instance, more competent looking politicians are more likely to be elected. Therefore, we were interested in measuring whether peoples perceptions of medical providers influenced their expectations about pain they might experience if that medical provider were to conduct a procedure on them. We were also interested in whether their beliefs about medical providers and pain treatment options in general (i.e., medical providers in general are competent, I feel favorable about herbal medication for pain) would influence their expectations. In FY2019, we collected four samples on the online platform Mechanical Turk to test this question. Participants completed surveys in which they viewed images of peoples faces and were told that they should imagine that the faces were those of potential medical providers who could conduct a procedure on them. They first chose medical providers that they would prefer to conduct painful procedures on them, and then they rated how painful they expected those procedures to be and the types of treatment they would expect that they would need in post-surgical recovery. In two of our samples, we used computer generated faces; in two other samples, we used real human faces. In three of our samples, participants rated how similar the stimulus faces were to themselves. In some samples, participants also rated the faces on perceived competence (in other samples, we used stimuli from published stimulus sets on which these characteristics had already been rated). We observed that people preferred faces that looked more competent and more similar to them to be their medical providers. Furthermore, they expected to experience less pain and to have less need for prescription-strength pain medication following hypothetical procedures conducted by more competent looking medical providers and following procedures conducted by medical providers that were more similar to them. We are now exploring the role of their attitudes on their pain and treatment expectations, and are exploring the role of hypothetical provider demographic characteristics (e.g., race/sex) on participants expectations. We are also in the process of writing up a manuscript for publication explaining the effects of first impressions of provider competence and similarity on pain and treatment expectations.