Department of Social and Organizational Psychology , ISCTE - Lisbon University Institute - Centro de Investigação e Intervenção Social, Portugal.
Psychol Health. 2011 Dec;26(12):1642-58. doi: 10.1080/08870446.2011.553680. Epub 2011 Jun 28.
Although women report feeling more pain than men, their pain is often underdiagnosed and undertreated. By proposing a gender-based theoretical conceptualisation, we argue that such sex-related biases may be enhanced or suppressed by contextual variables pertaining to the clinical situation, the perceiver or the patient. Consequently, we aimed to explore the moderator role of two clinically relevant variables in a chronic low-back pain (CLBP) scenario: diagnostic evidence of pathology (EP) and pain behaviours conveying distress. One-hundred and twenty-six female nurses (M = 35.33, SD = 7.64) participated in an experimental between-subjects design, 2 (patient's sex) × 2 (EP: present vs. absent) × 2 (pain behaviours: with vs. without distress). Independent variables were operationalised by vignettes depicting a patient with CLBP. Nurses judged the patient's pain on several dimensions: (1) credibility; (2) disability; (3) severity of the clinical situation; (4) psychological attributions and (5) willingness to offer support. Main findings showed that judgements of women's pain were influenced by EP, while judgements of men's pain were not. Moreover, nurses showed biases against men, but only in the presence of EP. The influence of distress cues was less consistent. Theoretical and practical implications are drawn.
尽管女性报告的疼痛比男性更强烈，但她们的疼痛往往被误诊和治疗不足。通过提出一种基于性别的理论概念化，我们认为这种与性别相关的偏见可能会因与临床情况、观察者或患者有关的情境变量而增强或抑制。因此，我们旨在探讨在慢性下背痛（CLBP）情况下两个临床相关变量的调节作用：病理诊断证据（EP）和传达痛苦的疼痛行为。126 名女性护士（M=35.33，SD=7.64）参与了一项实验性的被试间设计，2（患者的性别）×2（EP：存在与不存在）×2（疼痛行为：有与无痛苦）。通过描述 CLBP 患者的情景来操作自变量。护士根据几个维度判断患者的疼痛：（1）可信度；（2）残疾；（3）临床情况的严重程度；（4）心理归因；（5）提供支持的意愿。主要发现表明，女性疼痛的判断受到 EP 的影响，而男性疼痛的判断则不受影响。此外，护士对男性表现出偏见，但仅在存在 EP 的情况下。痛苦线索的影响则不那么一致。得出了理论和实践的意义。
