Start Date

April 2021

Document Type

Poster Session

Department

Nursing

Faculty Mentor

Linda Samia, PhD, RN, CNL

Keywords

Black/African American, bias, prejudice, discrimination, unconscious bias, pain management, pain reduction, pain control; analgesic

Abstract

Black Americans face unequal treatment for pain management when seeking care. The aim of this systematic literature review is to examine the impact of provider bias on Black patients receiving appropriate pain management interventions in the clinical setting. This review followed the Preferred Reporting Items for Systematic Literature Reviews and Meta-Analysis guidelines. CINAHL and PubMed were searched with the following key search terms: Black/African American, bias, prejudice, discrimination, unconscious bias, pain management, pain reduction, pain control and analgesic. A self-developed Critical Appraisal Tool was used for quality assessment of the studies included in the review. A total of 101 probable studies that fit the inclusionary criteria were identified in the initial search, with eight studies being included in the final review. Most studies used randomized control design or cross-sectional analysis. Study participants totaled 942,761 and fell into two groups: physicians in various care settings and patients being treated for pain. The variables of pain management and bias were assessed primarily using pain scales, Implicit Association Tests (IATs) and analysis of clinical judgement in both simulated and actual practice. Six of eight studies were considered to be high-quality with two studies being of intermediate quality. The findings from these studies were indicative of a relationship between provider bias and resultant sub-optimal pain management in Black patients, emphasizing the need for policy change and reform of the medical establishment. Future studies should be inclusive of other clinical providers (e.g. APRNs, PAs) and examine bias of minority providers providing care to Black patients.

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Apr 30th, 12:00 AM

Examining the Effect of Provider Bias on Pain Management in Black Patients: A Systematic Literature Review

Black Americans face unequal treatment for pain management when seeking care. The aim of this systematic literature review is to examine the impact of provider bias on Black patients receiving appropriate pain management interventions in the clinical setting. This review followed the Preferred Reporting Items for Systematic Literature Reviews and Meta-Analysis guidelines. CINAHL and PubMed were searched with the following key search terms: Black/African American, bias, prejudice, discrimination, unconscious bias, pain management, pain reduction, pain control and analgesic. A self-developed Critical Appraisal Tool was used for quality assessment of the studies included in the review. A total of 101 probable studies that fit the inclusionary criteria were identified in the initial search, with eight studies being included in the final review. Most studies used randomized control design or cross-sectional analysis. Study participants totaled 942,761 and fell into two groups: physicians in various care settings and patients being treated for pain. The variables of pain management and bias were assessed primarily using pain scales, Implicit Association Tests (IATs) and analysis of clinical judgement in both simulated and actual practice. Six of eight studies were considered to be high-quality with two studies being of intermediate quality. The findings from these studies were indicative of a relationship between provider bias and resultant sub-optimal pain management in Black patients, emphasizing the need for policy change and reform of the medical establishment. Future studies should be inclusive of other clinical providers (e.g. APRNs, PAs) and examine bias of minority providers providing care to Black patients.

 

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