Effect of patient and nurse ethnicity on emergency department analgesia for children with appendicitis in israeli government hospitals

Shavit, Itai; Jacob, Ron; Friedman, Nir; Capua, Tali; Klein, Adi; Chistyakov, Irena; Moldaver, I.; Krupik, Danna; Munchak, Itamar; Abozaid, Said; Rimon, Ayelet; Meirson, Gila; Leiba, Ronit; Cohen, Daniel M.

doi:10.1002/ejp.1257

Cited by 4 publications

(2 citation statements)

References 22 publications

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“…Notwithstanding the limitations, this work has a unique contribution to the work on empathy in the context of healthcare provision. Some previous studies investigated the effect of patient's characteristics on the observer's estimation of pain (Shavit et al., ), but we need to examine the underlying mechanisms to understand null results and find their relation to other studies. This is especially important when health care is provided in settings such as prisons where judgements and labelling of patients might be considered as a source of bias (Hill, ).…”

Section: Discussionmentioning

confidence: 99%

Observers’ impression of the person in pain influences their pain estimation and tendency to help

Khatibi

Mazidi

2019

European Journal of Pain

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Background Estimation of a patient's pain may have a considerable impact on the level of care that patient receives. Many studies have shown that contextual factors may influence an observer's pain estimation. Here, we investigate the effect of an observer's impression of a person in pain and justification of his/her pain on the observer's pain estimation, tendency to help and perceived empathy. Methods Thirty healthy individuals (half females) read scenarios aimed to manipulate the reader's impression of characters who ultimately were fired from their work (four positive characters and four negative; half females). Then they observed 1‐s videos of four levels of pain expression (neutral, mild, moderate, strong) in those characters during an examination. Subsequently, they rated pain estimation, tendency to help and perceived empathy. Afterwards, they rated their likability of characters and how just they find the end of story. Results People rated pain in positive characters higher than the pain in negative characters. They also expressed more tendency to help and a higher level of perceived empathy towards positive characters than negative characters. For the highest level of pain in positive characters, perceived injustice towards that person was the best predictor of the observer's pain estimation, tendency to help and perceived empathy. For negative characters, dislikeability was the best predictor of tendency to help and perceived empathy. Justification of their pain was a predictor of pain estimation and tendency to help. Conclusion Observers used different information to evaluate pain in positive and negative individuals. Significance Observers’ estimation of pain, perceived empathy and tendency to help biases by their understanding of the characteristics of the person in pain. In clinical settings, these biases may influence the quality of care and well‐being of patients. Understanding the underlying mechanisms of these biases can help us improve the quality of care and control the effect of prejudices on pain assessment.

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Section: Discussionmentioning

confidence: 99%

Observers’ impression of the person in pain influences their pain estimation and tendency to help

Khatibi

Mazidi

2019

European Journal of Pain

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“…However, interventions targeting improved documentation of pain scores did not translate into improved analgesic treatments [13, 14]. Racial disparities are associated with decreased utilization of analgesic medications [15–17]. This wide spectrum of factors leading to inadequate analgesia in the pediatric population leads to a conclusion that no single intervention is sufficient to solve this problem, and that only institutional culture change, with strong professional leadership can address the different barriers, and find effective solutions.…”

Section: Articlementioning

confidence: 99%

Optimizing the treatment of pain and anxiety in pediatric emergencies: the role of accreditation

Brody

Sethuraman

2019

Isr J Health Policy Res

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Pervasive disparities exist in the treatment of pain and anxiety in pediatric patients presenting to hospitals with emergency conditions. This finding has been demonstrated worldwide, and is especially exacerbated in general emergency departments, which treat both adults and children. Policies to promote appropriate analgesia in the context of pediatric emergency care have been developed by several professional societies and governmental agencies in the United States; however, progress has been uneven, and data regarding these questions is lacking. In their excellent article, Capua and her co-authors address this precise problem through a unique methodology, by surveying nurse directors of both pediatric accredited and non-accredited emergency departments. Survey questions focused on availability of pharmacological and non-pharmacological modalities, and on the prevalence with which providers administered both oral and parenteral medications. The results demonstrated widespread availability of evidence based analgesic and anxiolytic treatment, ranging from medical clowns and specific holding positions, to use of intravenous opiates and conscious sedation. No significant differences were found associated with accreditation. These results are surprising and seem to call into question the value of pediatric accreditation. However, an alternative hypothesis would be that accreditation has succeeded, and the results reflect a large spillover effect, in which providers trained in accredited institutions bring these advanced practices to their local departments. Regionalization has been promoted for emergency care of many acute conditions such as trauma, stroke, and myocardial infarction. These results suggest that for pediatric emergencies, at least in regard to analgesia, the answer likely lies in dissemination of knowledge, rather than super specialization. In other words, bring the expertise to the children, not the children to the experts. Further research in this area could focus on optimal ways to achieve such knowledge translation.

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General Concepts

Weinstein

Abd‐Elsayed

2020

Guide to the Inpatient Pain Consult

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Effect of patient and nurse ethnicity on emergency department analgesia for children with appendicitis in israeli government hospitals

Cited by 4 publications

References 22 publications

Observers’ impression of the person in pain influences their pain estimation and tendency to help

Observers’ impression of the person in pain influences their pain estimation and tendency to help

Optimizing the treatment of pain and anxiety in pediatric emergencies: the role of accreditation

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