The Influence of Race and Gender on Nursing Care Decisions: A Pain Management Intervention.

BACKGROUND: Understanding whether a patient's race or gender and/or the nurse's race or gender influence how nurses form care decisions can contribute to exploration of methods that can positively affect disparate treatment. AIMS: This research examined how the variables of race and gender of both the nurse and the patient influence nurses' decision making about pain management. DESIGN: A randomized four-group post-test-only experimental design was used to examine the variables and variable interactions. SETTINGS: An investigator-developed case vignette tool hosted online was used to obtain data about nursing pain management decisions. The vignette intervention was developed to simulate four exact patient scenarios that differed only by patient race and gender. Participants/Subjects: A quota sample of 400 nurses was recruited using a self-selected face-to-face recruitment technique. METHODS: A four-way between-groups analysis of variance assessed whether the gender of the nurse, race of the nurse, gender of the patient, or race of the patient made any differences in the dose intensity of pain medications selected by the nurse sample. RESULTS: No significant interactions were noted between any combinations of the four independent variables. A significant main effect was noted in medication intensity for nurse gender (F [1,384] = 9.75, p = .002). CONCLUSIONS: Data trends suggested that gender stereotypes about how patients managed pain played a role in dose intensity decisions because female patients on average were given higher doses of pain medication than male patients were by all the nurses in the study. Further research is needed in this complex area of study.

The Influence of Race and Gender on Pain Management: A Systematic Literature Review.

Racial and gender disparities in health are well documented in health science literature. Racial minorities and women are known to receive disproportionately poorer quality of health care when compared to non-Hispanic Whites. It is unknown why women and particular racial and ethnic minorities are more susceptible to experience disparities in patient care. Moreover, with pain being the most common complaint for those entering the healthcare system, gaps in understanding the potential relationship between the nurse provider's gender and/or race and ethnicity and pain management deserve exploration. A systematic literature review has been conducted to explore the current state of knowledge related to providers, health disparities, and pain. Much of the research to date has focused on the provider-patient relationship to health disparities in pain management. Further research is needed to examine how provider-patient interactions may influence patient outcomes, satisfaction, adherence and disparities in health.