The Influence of Experimenter Gender and Race on Pain Reporting: Does Racial or Gender Concordance Matter?

Weisse, Carol S.; Foster, Kimberley; Fisher, Annice

doi:10.1111/j.1526-4637.2005.05004.x

Cited by 72 publications

(43 citation statements)

References 55 publications

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“…Patients' trust, satisfaction, utilization of services, and involvement in decision making have been reported higher when the patient and physician share the same race or ethnicity. [12][13][14][15][16][17] On the other hand, other studies have found no signifi cant effects associated with racially concordant physician-patient relationships, [18][19][20][21][22] and the benefi ts of other types of concordance (eg, sex or age) are even more equivocal. [23][24][25][26] Whereas concordance studies have produced some intriguing fi ndings, they also raise important methodological questions.…”

Section: Introductionmentioning

confidence: 75%

Understanding Concordance in Patient-Physician Relationships: Personal and Ethnic Dimensions of Shared Identity

Street¹,

O’Malley²,

Cooper³

et al. 2008

The Annals of Family Medicine

521

367

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PURPOSE Although concordance by race and sex in physician-patient relationships has been associated with patient ratings of better care, mechanisms through which concordance leads to better outcomes remains unknown. This investigation examined (1) whether patients' perceptions of similarity to their physicians predicted their ratings of quality of care and (2) whether perceived similarity was infl uenced by racial and sexual concordance and the physician's communication. METHODSThe research design was a cross-sectional study with 214 patients and 29 primary care physicians from 10 private and public outpatient clinics. Measures included postvisit patient ratings of similarity to the physician; satisfaction, trust, and intent to adhere; and audiotape analysis of patient involvement and physicians' patient-centered communication.RESULTS Factor analysis revealed 2 dimensions of similarity, personal (in beliefs, values) and ethnic (in race, community). Black and white patients in racially concordant interactions reported more personal and ethnic similarity (mean score, 87.6 and 78.8, respectively, on a 100-point scale) to their physicians than did minority patients (mean score, 81.4 and 41.2, respectively) and white patients (mean score, 84.4 and 41.9, respectively) in racially discordant encounters. In multivariable models, perceived personal similarity was predicted by the patient's age, education, and physicians' patient-centered communication, but not by racial or sexual concordance. Perceived personal similarity and physicians' patient-centered communication predicted patients' trust, satisfaction, and intent to adhere. CONCLUSIONSThe physician-patient relationship is strengthened when patients see themselves as similar to their physicians in personal beliefs, values, and communication. Perceived personal similarity is associated with higher ratings of trust, satisfaction, and intention to adhere. Race concordance is the primary predictor of perceived ethnic similarity, but several factors affect perceived personal similarity, including physicians' use of patient-centered communication.

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Section: Introductionmentioning

confidence: 75%

Understanding Concordance in Patient-Physician Relationships: Personal and Ethnic Dimensions of Shared Identity

Street¹,

O’Malley²,

Cooper³

et al. 2008

The Annals of Family Medicine

521

367

View full text Add to dashboard Cite

show abstract

“…Greater scores are also generally reported for the BASDAI in women compared with men (20,21). Moreover, pain reporting is influenced by the sex of the experimenter, with men reporting lower scores for pain in the presence of a female experimenter (22). This may be relevant to clinical trials in which clinical coordinators are typically female.…”

Section: Discussionmentioning

confidence: 99%

Thresholds of patient‐reported outcomes that define the patient acceptable symptom state in ankylosing spondylitis vary over time and by treatment and patient characteristics

Maksymowych

Gooch

Dougados

et al. 2010

Arthritis Care & Research

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Objective. The patient acceptable symptom state (PASS) is a single-question outcome tool to assess the level of symptoms at which patients with rheumatic diseases consider themselves well. We evaluated whether ankylosing spondylitis (AS) patient characteristics were associated with attaining the PASS and whether these characteristics influenced PASS thresholds for patient-reported outcome (PRO) tools. Methods. The Adalimumab Trial Evaluating Long-term Efficacy and Safety for Ankylosing Spondylitis was a randomized, placebo-controlled study that evaluated the efficacy and safety of adalimumab in treating AS. The PASS and PROs were assessed over 24 weeks. PASS thresholds for PROs were set as either the 25th or 75th percentiles of the PRO response score. Logistic regression analyses were conducted to determine the associations of particular patient characteristics with the PASS and other response outcomes at 12 weeks (ASessment in Ankylosing Spondylitis International Working Group criteria for 20% improvement [ASAS20], ASAS40, ASAS5/6, ASAS partial remission, and Bath Ankylosing Spondylitis Disease Activity Index 50% improvement). Results. Age >40 years, disease duration >10 years, female sex, placebo treatment, and English-speaking site were consistently associated with greater PASS thresholds for PROs. Age, male sex, disease duration, and treatment were each independently associated with attainment of the PASS at 12 weeks. Only age and treatment were independently associated with other response outcomes. PASS thresholds also decreased over 24 weeks. Conclusion. PASS thresholds for PROs changed over time. These thresholds, as well as the attainment of the PASS, were affected by covariates unrelated to treatment. If confirmed in other studies, these results cast doubt on using the PASS to assess absolute health status in clinical research.

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“…The ethnicity and cultural background of participants and experimenters also influences pain response in laboratory Watson et al, 2005;Weisse et al, 2005;Rahim-Williams et al, 2007;Forsythe et al, 2011) and clinical settings (Edwards et al, 2001;Green et al, 2003). Recently, we have shown that Libyan women had higher pain sensitivity to cold noxious stimuli than Libyan men, and that both Libyan men and women had heightened pain sensitivity compared with their counterparts in Europe (Tashani et al, 2010;Alabas et al, 2012).…”

Section: Discussionmentioning

confidence: 99%

Gender role affects experimental pain responses: A systematic review with meta‐analysis

Alabas

Tashani

Tabasam

et al. 2012

European Journal of Pain

170

123

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Gender role refers to the culturally and socially constructed meanings that describe how women and men should behave in certain situations according to feminine and masculine roles learned throughout life. The aim of this meta-analysis was to evaluate the relationship between gender role and experimental pain responses in healthy human participants. We searched computerized databases for studies published between January 1950 and May 2011 that had measured gender role in healthy human adults and pain response to noxious stimuli. Studies were entered into a meta-analysis if they calculated a correlation coefficient (r) for gender role and experimental pain. Searches yielded 4465 'hits' and 13 studies were eligible for review. Sample sizes were 67-235 participants and the proportion of female participants was 45-67%. Eight types of gender role instrument were used. Meta-analysis of six studies (406 men and 539 women) found a significant positive correlation between masculine and feminine personality traits and pain threshold and tolerance, with a small effect size (r = 0.17, p = 0.01). Meta-analysis of four studies (263 men and 297 women) found a significant negative correlation between gender stereotypes specific to pain and pain threshold and tolerance, with a moderate effect size (r = -0.41, p < 0.001). In conclusion, individuals who considered themselves more masculine and less sensitive to pain than the typical man showed higher pain thresholds and tolerances. Gender stereotypes specific to pain scales showed stronger associations with sex differences in pain sensitivity response than masculine and feminine personality trait scales.

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The Influence of Experimenter Gender and Race on Pain Reporting: Does Racial or Gender Concordance Matter?

Abstract: Racial and gender concordance did not influence pain reporting; however, pain reporting was influenced by interactions between gender and race in the subject-experimenter dyads.

Cited by 72 publications

References 55 publications

Understanding Concordance in Patient-Physician Relationships: Personal and Ethnic Dimensions of Shared Identity

Understanding Concordance in Patient-Physician Relationships: Personal and Ethnic Dimensions of Shared Identity

Thresholds of patient‐reported outcomes that define the patient acceptable symptom state in ankylosing spondylitis vary over time and by treatment and patient characteristics

Gender role affects experimental pain responses: A systematic review with meta‐analysis

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