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减少疼痛治疗中的种族差异:同理心和换位思考的作用。

Reducing racial disparities in pain treatment: the role of empathy and perspective-taking.

机构信息

Department of Psychology, University of Wisconsin-Madison, Madison, WI, USA School of Nursing, University of Wisconsin-Madison, Madison, WI, USA Department of Psychology, University of Northern British Columbia, Prince George, BC, Canada.

出版信息

Pain. 2011 May;152(5):1001-1006. doi: 10.1016/j.pain.2010.12.005. Epub 2011 Jan 28.

Abstract

Epidemiological evidence indicates that African Americans receive lower quality pain treatment than European Americans. However, the factors causing these disparities remain unidentified, and solutions to this problem remain elusive. Across three laboratory experiments, we examined the hypotheses that empathy is not only causing pain treatment disparities but that empathy-inducing interventions can reduce these disparities. Undergraduates (Experiments 1 and 2) and nursing professionals (Experiment 3) watched videos of real Black and White patients' genuine facial expressions of pain, provided pain treatment decisions, and reported their feelings of empathy for each patient. The efficacy of an empathy-inducing, perspective-taking intervention at reducing pain treatment disparities was also examined (Experiments 2 and 3). When instructed to attempt to provide patients with the best care, participants exhibited significant pro-White pain treatment biases. However, participants engaged in an empathy-inducing, perspective-taking intervention that instructed them to imagine how patients' pain affected patients' lives exhibited upwards of a 55% reduction in pain treatment bias in comparison to controls. Furthermore, Pro-White empathy biases were highly predictive of pro-White pain treatment biases. The magnitude of the empathy bias experienced predicted the magnitude of the treatment bias exhibited. These findings suggest that empathy plays a crucial role in racial pain treatment disparities in that it appears not only to be one likely cause of pain treatment disparities but also is an important means for reducing racial disparities in pain treatment.

摘要

流行病学证据表明,非裔美国人接受的疼痛治疗质量低于欧洲裔美国人。然而,导致这些差异的因素仍未确定,解决这一问题的方法也难以捉摸。在三项实验室实验中,我们检验了以下假设:同理心不仅是造成疼痛治疗差异的原因,而且同理心诱导干预可以减少这些差异。本科生(实验 1 和 2)和护理专业人员(实验 3)观看了真实的黑人和白人患者真实面部疼痛表情的视频,提供了疼痛治疗决策,并报告了对每位患者的同理心感受。还检验了一种同理心诱导、换位思考干预措施减少疼痛治疗差异的效果(实验 2 和 3)。当被指示尽力为患者提供最佳护理时,参与者表现出明显的亲白种人疼痛治疗偏见。然而,参与者参与了一种同理心诱导、换位思考的干预措施,即让他们想象患者的疼痛如何影响患者的生活,与对照组相比,疼痛治疗偏见减少了多达 55%。此外,亲白种人的同理心偏见高度预测了亲白种人的疼痛治疗偏见。体验到的同理心偏见的程度预测了表现出的治疗偏见的程度。这些发现表明,同理心在种族疼痛治疗差异中起着至关重要的作用,因为它不仅似乎是疼痛治疗差异的一个可能原因,而且是减少疼痛治疗中种族差异的一个重要手段。

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