The influence of Race on Pain Outcomes

种族对疼痛结果的影响

• 批准号: 7578236
• 负责人: Miriam Omelebele Ezenwa
• 金额: $ 2.17万
• 依托单位: UNIVERSITY OF WISCONSIN-MADISON
• 依托单位国家: 美国
• 财政年份: 2008
• 资助国家: 美国
• 起止时间: 2008-05-01 至 2009-12-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7578236
• 关键词: African American; Arthritis; Attention; Behavior; Caucasians; Caucasoid Race; Centers for Disease Control and Prevention (U.S.); Chronic; Classification; Controlled Study; Cross-Sectional Studies; Data Analyses; Discrimination; Dose; Educational Intervention; Feeling hopeless; Future; Goals; Health Personnel; Healthcare; Hospitalization; Impaired wound healing; Life; Mediating; Modeling; National Health Interview Survey; Opioid; Outcome; Pain; Pain management; Patients; Prevalence; Public Health; Quality of life; Race; Reporting; Research; Research Personnel; Review Literature; Risk; Role; Severities; Testing; United States; design; expectation; experience; programs; racial and ethnic disparities; racial difference; satisfaction; stressor; ward

DESCRIPTION (provided by applicant): Pain is the most common reason people access healthcare in the United States and has been identified as a major public health problem. Despite this attention, investigators have found racial and ethnic disparities in pain management. In systematic literature reviews, it has been found that African Americans are more at risk than Caucasians for experiencing under-treatment of pain (Cintron & Morrison, 2006; Ezenwa, Ameringer, Ward, & Serlin, 2006). There are also racial differences in the prevalence of pain. In a Center for Disease Control study using the 2002 National Health Interview Survey; it was found that 34% of African Americans compared to 22.6% of Caucasians with arthritis had severe pain (Bolen, Sniezek, Theis, Helmick, & et al., 2005). Consistent with the above report, there are racial differences on the impact of pain. For instance, 59.6% of African Americans compared to 30.3% of Caucasians reported pain severe enough to impact behavior (Riley & Gilbert, 2002). The overall goal of my program of research is to better understand racial disparities in pain management. As a first step toward this goal, I will explore the influence of two race-related stressors, perceived discrimination and hopelessness on disparities in pain management. Perceived discrimination is defined as chronic and routine experiences of unfair treatment. Hopelessness is a negative expectation about one's present and future life. This study will test relationships proposed in a conceptual model which suggests that the effect of race on pain outcomes (pain severity, opioid dose, satisfaction with pain treatment, and quality of life) is mediated by perceived discrimination and hopelessness. The specific aims of this study are (1) to examine the relationship between race and pain outcomes and (2) to test whether perceived discrimination and hopelessness mediate the relationship between race and pain outcomes. This study will be a secondary analysis of data from a large cross-sectional survey of patients with chronic noncancer pain. Understanding the role of perceived discrimination and hopelessness on disparities in pain management may be useful in the future design of culturally appropriate pain management educational interventions for African Americans and culturally sensitive educational interventions for healthcare providers. This study will help reduce the public health problems that arise from poorly treated pain (e.g., unnecessary suffering, delayed healing, and lengthened hospitalization).

描述（由申请人提供）：疼痛是人们在美国获得医疗保健的最常见原因，并被确定为一个主要的公共卫生问题。尽管有这种关注，研究人员仍发现疼痛管理中的种族和种族差异。在系统的文献评论中，已经发现，非洲裔美国人比高加索人更容易受到疼痛治疗（Cintron＆Morrison，2006; Ezenwa，Ameringer，Ward，＆Serlin，2006年）。疼痛的患病率也存在种族差异。在疾病控制中心研究中，使用2002年国家健康访谈调查；发现有34％的非洲裔美国人相比有22.6％的白种人患有关节炎（Bolen，Sniezek，Theis，Helmick，Helmick等，2005）。与上述报告一致，疼痛的影响存在种族差异。例如，有59.6％的非裔美国人与30.3％的高加索人报告疼痛足以影响行为（Riley＆Gilbert，2002年）。我的研究计划的总体目标是更好地了解疼痛管理中的种族差异。作为实现这一目标的第一步，我将探讨两个与种族相关的压力源的影响，认为歧视和绝望对疼痛管理差异的影响。感知的歧视被定义为不公平治疗的慢性和常规经历。绝望是对当前和未来生活的负面期望。这项研究将测试在概念模型中提出的关系，该模型表明种族对疼痛结果（疼痛严重程度，阿片类药物剂量，对疼痛治疗的满意度和生活质量）的影响是由感知的歧视和绝望的介导的。这项研究的具体目的是（1）检查种族和疼痛结果之间的关系，以及（2）测试感知的歧视和绝望是否介导了种族与疼痛结果之间的关系。这项研究将是对慢性非癌疼痛患者的大型横断面调查的数据的次要分析。了解感知到的歧视和绝望对痛苦管理中差异的作用可能对未来的文化疼痛管理对非裔美国人的教育干预措施以及对医疗保健提供者的文化敏感教育干预措施有用。这项研究将有助于减少治疗疼痛不佳的公共卫生问题（例如，不必要的痛苦，延迟的康复和延长的住院）。