Aim: To explore the factors that influence provider pain treatment decision-making and the receipt of pain management by injured Black patients in the United States.
Design: We completed a systematic mixed studies review using a results-based convergent synthesis design.
Data sources: PubMed, SCOPUS and CINAHL were searched for articles published between 2007-2017 using the search terms 'African American', 'Black American', 'race', 'pain treatment', 'pain management' and 'analgesia'. Twenty studies were included in this review.
Review method: A search of databases and hand-searching identified peer-reviewed published papers. The Mixed Method Appraisal Tool was used to appraise the studies.
Results: The results indicate that healthcare provider characteristics, racial myths about pain sensitization and assumed criminality all impact provider treatment decision-making and the receipt of pain treatment by injured Black patients.
Impact: This review addresses racial disparities in pain management by focusing on the factors that impact the receipt of pain treatment by injured Black patients. The findings will have an impact on providers who prescribe pain treatment and on the patients they treat. These findings suggest that assumed criminality of certain patients can negatively impact care, which is a type of bias not frequently explored or discussed in health disparities research. This review will help inform further research in healthcare disparities and prompt providers to examine their assumptions about the patients for whom they care.
Conclusion: These results provide important areas for further study, including how assumed criminality of certain patients can have a negative impact on care.
目的: 在于探讨影响医疗保健提供者疼痛治疗决策和美国黑人受伤患者接受疼痛管理的因素。 设计: 我们通过使用基于结果的汇聚式合成设计完成了系统性混合研究综述。 资料来源: 通过搜索‘非裔美国人’、‘美国黑人’、‘种族’、‘ 疼痛治疗’、‘疼痛管理’和‘镇痛’之类的术语,在PubMed、SCOPUS 和CINAHL 搜索了在2007-2017年间发表的相关文章。这篇综述纳入了20项研究。 综述方法: 对数据库进行了搜索,并手工搜索了经同行评审的出版论文。采用了混合方法评价工具(Mixed Method Appraisal Tool,MMAT)对各项研究进行评价。 结果: 研究结果表明,医疗服务提供者的特征、关于痛觉敏化的种族神话和假定犯罪行为都会影响到医疗服务提供者的治疗决策和黑人受伤患者接受疼痛治疗的情况。 影响: 这篇综述通过关注影响黑人受伤患者接受疼痛治疗的因素来处理疼痛管理中的种族差异。这些调查结果既对开疼痛治疗处方的医疗服务提供者有影响,也对他们救治的患者有影响。这些调查结果表明,某些患者存在犯罪行为这一假定会对护理产生负面影响,这是一种在健康差异研究中不常探索或讨论的偏见。这一综述将有助于进一步研究医疗保健方面的差异,并促使医疗服务提供者审视他们对所护理患者的假定。 结论: 这些结果为今后研究提供了重要领域,包括某些患者存在犯罪行为这一假定是如何对护理产生负面影响的。.
Keywords: African Americans; Black Americans; Decision-making; bias; injuries; nurse; opioids; pain; pain management; results-based convergent synthesis; stereotyping; systematic mixed studies review.
© 2019 John Wiley & Sons Ltd.