Hispanic and non-Hispanic white patient pain management expectations

Lee, Wally W.; Burelbach, Ann E.; Fosnocht, David E.

doi:10.1053/ajem.2001.28038

Cited by 34 publications

(19 citation statements)

References 7 publications

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“…Even though a large percentage of patients agreed that pain was a fact of labor, 73% answered that epidurals should be available upon request. This finding supports the notion that there is no evidence that minority patients have different pain management expectations [13]. As health care providers we are obligated to ensure that these expectations are met.…”

Section: Discussionsupporting

confidence: 75%

Exploring Factors Influencing Patient Request for Epidural Analgesia on Admission to Labor and Delivery in a Predominantly Latino Population

Orejuela

Garcia

Green

et al. 2011

J Immigrant Minority Health

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Ethnic disparities in labor pain management exist. Our purpose is to identify patients' attitudes and beliefs about epidural analgesia in order to develop a culturally competent educational intervention. A prospective observational study was conducted in patients admitted for vaginal delivery between July 1st-31st, 2009. Inclusion criteria were: singleton, term, cephalic, normal fetal heart tracing and no contraindications for epidural. Patients were surveyed regarding their wishes for analgesia, and their reasons for declining epidural. The obstetrics physician performed pain management counseling as is usually done. Patients were asked again about their choice for analgesia. Likert scale questionnaires were used. Wilcoxon signed ranked test was used for categorical variables. Logistic regression was performed to look for predictors of epidural request. Fifty patients were interviewed. Average age was (27.9 ± 6.7), gestational age (39.3 ± 1.3), and a median parity of 2 (range 0-6). 72% declined epidural upon admission, and 61% after counseling (P = 0.14). Most common reasons for declined epidural were 'women should cope with labor pain' (57%), 'fear of back pain' (54%) and 'family/friends advise against epidural' (36%). Acculturation was assessed by years living in the US (10 ± 6.3), preferred language (Spanish 80%) and ethnic self-identification (Hispanic 98%). 38% were high school graduates. In multivariate logistic regression, graduation from high school was the only variable associated to request for epidural in labor (OR 4.94, 95% CI 1.6-15.1). Educational level is associated to requesting an epidural in labor. Knowledge of patients' fears and expectations is essential to develop adequate counseling interventions.

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Section: Discussionsupporting

confidence: 75%

Exploring Factors Influencing Patient Request for Epidural Analgesia on Admission to Labor and Delivery in a Predominantly Latino Population

Orejuela

Garcia

Green

et al. 2011

J Immigrant Minority Health

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show abstract

“…In addition, different perceptions of painful stimuli between ethnic groups seem unable to account for differences in practice (22). Lee et al also failed to find differences in pain management expectations between Hispanics and non-Hispanic whites (24). In our study population, patient preference for route of medication delivery did not vary between Hispanics and non-Hispanic whites.…”

Section: Patient Medication Preferencecontrasting

confidence: 67%

“…Little information exists on the pain management expectations and preferences of ED patients. Recent reports have documented that patients expect timely relief, and that these expectations do not vary between non-Hispanic whites and Hispanics (23,24). Beel et al have reported preferred routes of pain medication administration for patients with acute fractures (25).…”

Section: Introductionmentioning

confidence: 99%

Patient preference for route of pain medication delivery

Fosnocht

Hollifield

Swanson

2004

The Journal of Emergency Medicine

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“…Also, white patients may be more likely to expect resolution of their pain and to request opioid analgesics on this basis, although at least 1 study has shown equal expectations of pain control comparing Hispanics with non-Hispanic whites. 35 In the context of cancerrelated pain, minority patients are less likely to perceive control over pain and its treatment, 36 and interventions to improve patients' understanding of pain and to help them know how to communicate their pain in clinical encounters have improved pain control and reduced disparities between whites and minorities with cancer. 37 Similar interactions of patient and physician assertiveness, selfefficacy, and expectations could help to explain racial/ethnic differences in opioid prescribing for emergency department patients with pain.…”

mentioning

confidence: 99%