Sex bias in pain management decisions

• 成果类型: Article
• 署名作者: Guzikevits, Mika; Gordon-Hecker, Tom; Rekhtman, David; Salameh, Shaden; Israel, Salomon; Shayo, Moses; Gozal, David; Perry, Anat; Gileles-Hillel, Alex; Choshen-Hillel, Shoham
• 署名单位: Hebrew University of Jerusalem; Hebrew University of Jerusalem; Ben-Gurion University of the Negev; Hebrew University of Jerusalem; Hadassah University Hospital; Hebrew University of Jerusalem; Hebrew University of Jerusalem; University of London; King's College London; University of Missouri System; University of Missouri Columbia; Marshall University; Hebrew University of Jerusalem; Hadassah University Hospital; Hebrew University of Jerusalem
• 刊物名称: PROCEEDINGS OF THE NATIONAL ACADEMY OF SCIENCES OF THE UNITED STATES OF AMERICA
• ISSN/ISSBN: 0027-9748
• DOI: 10.1073/pnas.2401331121
• 发表日期: 2024-08-13
• 关键词: patient gender; cried pain; emergency; RACE; disparities; analgesia; judgments; physician; IMPACT

摘要

In the pursuit of mental and physical health, effective pain management stands as a cornerstone. Here, we examine a potential sex bias in pain management. Leveraging insights from psychological research showing that females' pain is stereotypically judged as less intense than males' pain, we hypothesize that there may be tangible differences in pain management decisions based on patients' sex. Our investigation spans emergency department (ED) datasets from two countries, including discharge notes of patients arriving with pain complaints (N = 21,851). Across these datasets, a consistent sex disparity emerges. Female patients are less likely to be prescribed pain- relief medications compared to males, and this disparity persists even after adjusting for patients' reported pain scores and numerous patient, physician, and ED variables. This disparity extends across medical practitioners, with both male and female physicians prescribing less pain- relief medications to females than to males. Additional analyses reveal that female patients' pain scores are 10% less likely to be recorded by nurses, and female patients spend an additional 30 min in the ED compared to male patients. A controlled experiment employing clinical vignettes reinforces our hypothesis, showing that nurses (N = 109) judge pain of female patients to be less intense than that of males. We argue that the findings reflect an undertreatment of female patients' pain. We discuss the troubling societal and medical implications of females' pain being overlooked and call for policy interventions to ensure equal pain treatment.