Education to Identify and Combat Racial Bias in Pain Treatment

Drwecki, Brian B.

doi:10.1001/journalofethics.2015.17.3.medu1-1503

Cited by 10 publications

(2 citation statements)

References 49 publications

(34 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Community involvement and church-based self-management programs have been effective in improving health outcomes and wellbeing among African Americans [26, 50]. Several strategies have also been developed to target healthcare providers’ racial bias when caring for African Americans with pain, including perspective-taking [14], and shared decision-making [13, 46]. Expansion of Medicaid coverage to include care coordination and peer support for disadvantaged opioid users has also been proposed in some states [31, 53].…”

Section: Discussionmentioning

confidence: 99%

Prescription Medication Use Among Community-Based U.S. Adults With Chronic Low Back Pain: A Cross-Sectional Population Based Study

Shmagel

Ngo

Ensrud

et al. 2018

The Journal of Pain

View full text Add to dashboard Cite

show abstract

Section: Discussionmentioning

confidence: 99%

Prescription Medication Use Among Community-Based U.S. Adults With Chronic Low Back Pain: A Cross-Sectional Population Based Study

Shmagel

Ngo

Ensrud

et al. 2018

The Journal of Pain

View full text Add to dashboard Cite

show abstract

“…Obstetric clinicians should be aware of inequities in the assessment and treatment of postpartum pain and consider their own biases that may contribute to and perpetuate disparities. 29,30 A hybridization of individualized pain management balanced with institutional protocols may decrease disparities in treatment by reducing the influence of internal and external biases, 27,31 yet further work is needed to determine the optimal approach.…”

Section: Discussionmentioning

confidence: 99%

Understanding the Postpartum Cesarean Pain Experience Among Individuals With Publicly Funded Insurance: A Qualitative Investigation

Badreldin

DiTosto

Leziak

et al. 2023

J Midwife Womens Health

View full text Add to dashboard Cite

IntroductionPain is the most common postpartum concern and has been associated with adverse outcomes, such as difficulty with neonatal bonding, postpartum depression, and persistent pain. Furthermore, racial and ethnic disparities in the management of postpartum pain are well described. Despite this, less is known regarding patients’ lived experiences regrading postpartum pain. The purpose of this study was to assess patient experiences related to postpartum pain management after cesarean birth.MethodsThis is a prospective qualitative study of patients’ experiences with postpartum pain management after cesarean birth at a single large tertiary care center. Individuals were eligible if they had publicly funded prenatal care, were English or Spanish speaking, and underwent a cesarean birth. Purposive sampling was used to ensure a racially and ethnically diverse cohort. Participants underwent in‐depth interviews using a semistructured interview guide at 2 time points: postpartum day 2 to 3 and 2 to 4 weeks after discharge. Interviews addressed perceptions and experiences of postpartum pain management and recovery. Data were analyzed using the constant comparative method.ResultsOf 49 participants, 40.8% identified as non‐Hispanic Black and 40.8% as Hispanic. The majority (59.2%) had experienced a cesarean birth with a prior pregnancy. Thematic analysis yielded 2 overarching domains: (1) experience of pain after cesarean birth and (2) pain management and opioid use after cesarean birth. Themes related to the experience of pain included pain as a meaningful experience, pain not aligned with expectations, and limitations caused by pain. All participants discussed limitations caused by their pain, voicing frustration with pursuing activities of daily living, caring for home and family, caring for neonate, and impact on mood. Themes related to pain management and opioid use addressed a desire for nonpharmacologic pain management, positive and negative experiences using opioids, and hesitancy and perceived judgement regarding opioid use. Several participants described experiences of judgement regarding the request for opioids and needing stronger pain medications, such as oxycodone.DiscussionUnderstanding experiences regarding postpartum cesarean pain management and recovery is essential to improving patient‐centered care. The experiences identified by this analysis highlight the need for individualized postpartum pain management, improved expectation counseling, and the expansion of multimodal pain management options.

show abstract

Racialization as a Barrier to Achieving Health Equity for Native Americans

2020

AMA Journal of Ethics

View full text Add to dashboard Cite

Racial identity is a complex idea, particularly for American Indian and Alaska Native (AI/AN) populations. The idea of a single AI/AN race developed from a European-American view of phenotypic and cultural differences. It continues to have significant consequences for AI/AN populations within the clinical-medical context. For clinicians, using this flawed category in medical decision making poses ethical challenges and has implications for patient autonomy and justice. This article briefly traces the development of the idea of an AI/AN race, the concerns raised in using this identity marker, and the ethical implications of employing the categorization. I really feel that identity is a very complicated mixture, of what you grow up with, what you find out about yourself. I didn't want to add any confusion to it. It wouldn't do me any harm, but when I asked my extended family about this-and I did go to everyone-I was told, "It's not yours to give, Louise." 1 Racial Categorization in Medicine Racial categories are ubiquitous in modern medicine, particularly in research, health professions education, public health efforts, and clinical practice. Although race as a biological category has been disavowed by professional societies, including the American Public Health Association, 2 the American Sociological Association, 3 the American Anthropological Association, 4 and the American Association of Physical Anthropologists, 5 clinicians often invoke biological differences based on racial or ethnic identity-and often a conflation of the 2 categories-to structure diagnostic and treatment approaches to a wide range of conditions, from sickle cell anemia to mental health illnesses. 6,7,8,9 In this article, we explore racialization of American Indian and Alaska Native (AI/AN) identity within clinical contexts, tracing the history and development of Native identity as a sociocultural-political identity that continues to affect clinicians' presumptions about

show abstract

Education to Identify and Combat Racial Bias in Pain Treatment

Cited by 10 publications

References 49 publications

Prescription Medication Use Among Community-Based U.S. Adults With Chronic Low Back Pain: A Cross-Sectional Population Based Study

Prescription Medication Use Among Community-Based U.S. Adults With Chronic Low Back Pain: A Cross-Sectional Population Based Study

Understanding the Postpartum Cesarean Pain Experience Among Individuals With Publicly Funded Insurance: A Qualitative Investigation

Racialization as a Barrier to Achieving Health Equity for Native Americans

Contact Info

Product

Resources

About