The Influence of Race and Socioeconomic Factors on Patient Acceptance of Perioperative Epidural Analgesia

Ochroch, E. Andrew; Troxel, Andrea B.; Frogel, Jonathan; Farrar, John T.

doi:10.1213/01.ane.0000290339.76513.e3

Cited by 39 publications

(25 citation statements)

References 13 publications

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“…When compared with patients of other races, African Americans have been shown to provide less information and to be less assertive with medical providers (21, 22); lack of assertiveness may be related to less trust in medical providers (21–24). It is also possible that African American veterans are treated differently than other veterans in the disability examination, because they tend to have received less previous PTSD treatment (25).…”

Section: Discussionmentioning

confidence: 99%

Racial Differences in Veterans’ Satisfaction With Examination of Disability From Posttraumatic Stress Disorder

Rosen

Afshartous

Nwosu

et al. 2013

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Objective The examination to determine if a veteran has service-connected posttraumatic stress disorder (PTSD) affects veterans’ lives for years afterwards. This study examined factors potentially associated with veterans’ perception of their examination’s quality. Methods Three hundred eighty-four veterans participated in a clinical trial in which they received either a semi-structured interview or the examiner’s usual interview. Immediately after the interview, veterans completed confidential ratings of the examination’s quality and of their examiners’ interpersonal qualities and competence. Extensive data characterizing the veterans, the 33 participating examiners, and the examinations themselves were collected. Results Forty-seven percent of Caucasian veterans versus 34% of African American veterans rated their examination quality as “excellent.” In multivariate analysis, African Americans were less likely than Caucasians to assign a higher quality rating (odds ratio .61, 95% confidence interval .38 – .99). African Americans also rated their examiners as having significantly worse interpersonal qualities but not lower competence. Ratings were not significantly related to the veterans' age, gender, marital status, eventual diagnosis with PTSD, Global Assessment of Functioning score, the examiners’ perception of the prevalence of malingering, or the presence of a third party in the examination. Conclusions Ratings of disability examinations were generally high, although African American veterans' ratings were less favorable than Caucasian veterans' ratings.

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Section: Discussionmentioning

confidence: 99%

Racial Differences in Veterans’ Satisfaction With Examination of Disability From Posttraumatic Stress Disorder

Rosen

Afshartous

Nwosu

et al. 2013

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“…Among the patients to whom EDA was proposed, 22% declined. 26 Once in the operating theatre, technical failure prevented the patient benefiting from EDA in 6.3% 27 to 7.2% 22 of cases. In the model, we used an average value of 6.8%.…”

Section: Economic Analysis: Model and Assumptionsmentioning

confidence: 99%

Cost-effectiveness analysis comparing epidural, patient-controlled intravenous morphine, and continuous wound infiltration for postoperative pain management after open abdominal surgery

Tilleul

Aissou

Bocquet

et al. 2012

British Journal of Anaesthesia

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Device-related costs of using CWI for pain management after abdominal laparotomy are partly counterbalanced by a reduction in resource consumption. The cost-effectiveness analysis suggests that CWI is the dominant treatment strategy for managing postoperative pain (i.e. more effective and less costly) in comparison with i.v.-PCA. When compared with EDA, CWI is less costly with almost equivalent efficacy. This economic evaluation may be useful for clinicians to design algorithms for pain management after major abdominal surgery.

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“…57 This has implications for the use of patientcontrolled analgesia (PCA) techniques and the importance of teaching older AAs the value of ''staying on top of the pain'' and then systematically evaluating their PCA use to ensure effective selfadministration. Some AAs are reluctant to accept injections and intraspinal analgesics for pain management 21,34,[58][59][60] ; thus, thorough patient and family education is essential when these methods are required. This underscores the need to incorporate nonpharmacological interventions as well.…”

Section: Imani (Faith)-intercessionmentioning

confidence: 99%

Pain Management for Older African Americans in the Perianesthesia Setting: The “Eight I's”

Booker¹,

Herr²

2015

Journal of PeriAnesthesia Nursing

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The Influence of Race and Socioeconomic Factors on Patient Acceptance of Perioperative Epidural Analgesia

Abstract: Acceptance of perioperative epidural analgesia is strongly affected by race and socioeconomic status. Anesthesiologists need to recognize this potential barrier when trying to maximize patient comfort and outcome.

Cited by 39 publications

References 13 publications

Racial Differences in Veterans’ Satisfaction With Examination of Disability From Posttraumatic Stress Disorder

Racial Differences in Veterans’ Satisfaction With Examination of Disability From Posttraumatic Stress Disorder

Cost-effectiveness analysis comparing epidural, patient-controlled intravenous morphine, and continuous wound infiltration for postoperative pain management after open abdominal surgery

Pain Management for Older African Americans in the Perianesthesia Setting: The “Eight I's”

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