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The document proposes developing a new framework to better assess pain in minoritized groups by conducting a qualitative study on their experiences with pain management. It acknowledges that current pain scales do not adequately capture cultural influences and that minoritized patients are less likely to receive pain medication. A new language may help articulate these issues to spur developing a more culturally sensitive pain assessment tool and improve healthcare outcomes. Measuring success will be difficult but could guide future research. Potential impacts include better healthcare and less medical marginalization.

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67 views

Team Project Slides

The document proposes developing a new framework to better assess pain in minoritized groups by conducting a qualitative study on their experiences with pain management. It acknowledges that current pain scales do not adequately capture cultural influences and that minoritized patients are less likely to receive pain medication. A new language may help articulate these issues to spur developing a more culturally sensitive pain assessment tool and improve healthcare outcomes. Measuring success will be difficult but could guide future research. Potential impacts include better healthcare and less medical marginalization.

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api-545982271
Copyright
© © All Rights Reserved
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Reassessing the Quality of Pain

Assessment for Minoritized


Groups

HONORS 220 Team Project


by Sasha Friese, Shannon Hong, Jason Lim, & Saagar Mehta
Background
● Pain is individualized to the patient
○ Chronic pain: persistent pain that
lasts for 3 to 6 months
● Variety of pain assessment tools in the
clinical setting
● Self-report is often viewed as the most
reliable method
● Examples include using numbers or https://whyy.org/segments/reassessing-the-assessment-of-pain-how-

faces to rate one’s pain the-numeric-scale-became-so-popular-in-health-care/

Ambardekar, Nayana. “What Is Chronic Pain Management? Symptoms and Reasons to


Control Chronic Pain.” WebMD, WebMD, 23 May 2019, www.webmd.com/pain-
management/guide/understanding-pain-management-chronic-pain.
Background (cont.) and Significance
● Current pain scales fail to capture
cultural influences on pain
● Minoritized patients less likely to receive
pain-relieving medications than white
patients
○ Unclear whether these outcomes are
due to the design of the pain scale
or the implementation of it
● No current solutions so there is a need to
https://www.pbs.org/newshour/nation/3-ways-that-the-u-s-
address this problem for the sake of these population-will-change-over-the-next-decade

patients Brigham and Women's Hospital. "Minority patients less likely to receive analgesic medications for
abdominal pain: New research indicates that minority patients seeking care in the emergency department
were 22-30 percent less likely than white patients to receive analgesic medication.." ScienceDaily.
ScienceDaily, 17 November 2015. <www.sciencedaily.com/releases/2015/11/151117143530.htm>.
Addressing This Social Justice Issue
● Need a language/framework to articulate the issue of
disparity in pain management for minoritized groups, this
being dominated by racial/ethnic categorization in the US
● The 1980s Afro-German Movement
○ German nationality “ius sanguinis” (through blood) → white blood
○ Binary of Black or German
○ Language (e.g. “Afro-German”) to create space & express oppression
● Foundation on which the creation of a culturally sensitive
pain assessment mechanism could be created
● If we are aware that these disparities in outcome exist, it is an
https://www.tolerance.org/magazine/sp
ethical responsibility to address them ring-2019/audre-lorde

Hickmon, Gabrielle. “What Audre Lorde Learned in Berlin About Afro-German Identity.” Literary
Hub, 10 Dec. 2019, lithub.com/what-audre-lorde-learned-in-berlin-about-afro-german-identity/.
“Delivering better pain management
outcomes to historically marginalized
racial/ethnic groups through the
development of the language to articulate
the issue, supported by the authority of the
medical community.”
Proposed ● Originally intended to create an
entirely new pain scale
Plan ○ But realized that there isn’t enough
research about this topic
● Criteria and considerations
A qualitative study evaluating the ○ Can we establish a relationship between
pain management experiences of personal experiences in pain management
chronic pain patients across and decreased quality of care?
minoritized racial and ethnic ● The stakeholders
identities who have been seeking pain ○ Society as a whole
management for 3+ years ○ Racial/ethnic minorities needing to seek
pain management
○ Pain management healthcare providers
Risk Evaluation
● How do we group minorities?
○ How macro/micro should we get?
○ Where do we draw the line?
● More stereotyping
● Use in practice
● Race correction
● Intersectionality
○ Disability
○ Socioeconomic status
○ Sexuality

https://www.bostonglobe.com/arts/books/2017/10/20/publisher-apologizes-after-outcry-
over-offensive-nursing-textbook/k6COKWl5ftuHsjooIxUK4K/story.html
Measuring Success
● Difficult to measure success directly
○ Could guide future research towards a more fully
realized solution
● Possibility of establishing a clear relationship
between patient experience and medical
outcomes
● New language to articulate this issue backed
by authority of medical space
○ Links patient experiences to measurable health https://blog.optimalworkshop.com/qualitative-research-methods/
outcomes
○ Ex. difficulty in everyday life, more necessary
follow-up appointments compared to others with
similar health issues, etc.
Potential Impacts
● Better healthcare
○ Better self-reporting
○ Fewer opportunities for unchecked physician bias
● Less medical marginalization
○ Reduces inequality due to worse health outcomes
(financial, emotional, etc.)
● Strengthens triage systems
○ COVID-19 care https://scholarblogs.emory.edu/philosophy316/2014/04/0
5/providing-healthcare-should-it-truly-be-equal/

Hoffman, Kelly M, et al. “Racial Bias in Pain Assessment and Treatment Recommendations, and
False Beliefs about Biological Differences between Blacks and Whites.” Proceedings of the
National Academy of Sciences of the United States of America, National Academy of Sciences,
19 Apr. 2016, www.ncbi.nlm.nih.gov/pmc/articles/PMC4843483/.

Phua, Jason, et al. “Intensive Care Management of Coronavirus Disease 2019


(COVID-19): Challenges and Recommendations.” The Lancet, 2020,
https://creakyjoints.org/doctor-patient/pain- www.thelancet.com/journals/lanres/article/PIIS2213-2600(20)30161-2/fulltext.
scale-not-best-way-communicate-pain/
Bibliography
1. Ambardekar, Nayana. “What Is Chronic Pain Management? Symptoms and Reasons to Control Chronic Pain.”
WebMD, WebMD, 23 May 2019, www.webmd.com/pain-management/guide/understanding-pain-management-
chronic-pain.
2. Brigham and Women's Hospital. "Minority patients less likely to receive analgesic medications for abdominal pain:
New research indicates that minority patients seeking care in the emergency department were 22-30 percent less likely
than white patients to receive analgesic medication.." ScienceDaily. ScienceDaily, 17 November 2015.
<www.sciencedaily.com/releases/2015/11/151117143530.htm>.
3. Hickmon, Gabrielle . “What Audre Lorde Learned in Berlin About Afro-German Identity.” Literary Hub, 10 Dec.
2019, lithub.com/what-audre-lorde-learned-in-berlin-about-afro-german-identity/.
4. Hoffman, Kelly M, et al. “Racial Bias in Pain Assessment and Treatment Recommendations, and False Beliefs about
Biological Differences between Blacks and Whites.” Proceedings of the National Academy of Sciences of the United
States of America, National Academy of Sciences, 19 Apr. 2016, www.ncbi.nlm.nih.gov/pmc/articles/PMC4843483/.
5. Phua, Jason, et al. “Intensive Care Management of Coronavirus Disease 2019 (COVID-19): Challenges and
Recommendations.” The Lancet, 2020, www.thelancet.com/journals/lanres/article/PIIS2213-2600(20)30161-2/fulltext.

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