Meints Samantha M, Cortes Alejandro, Morais Calia A, Edwards Robert R
Department of Anesthesiology, Pain Management Center, Brigham & Women's Hospital, Harvard Medical School, Chestnut Hill, MA 02467, USA.
Orthopaedic and Arthritis Center for Outcomes Research, Department of Orthopaedic Surgery, Brigham & Women's Hospital, Harvard Medical School, Boston, MA 02115, USA.
Pain Manag. 2019 May;9(3):317-334. doi: 10.2217/pmt-2018-0030. Epub 2019 May 29.
The burden of pain is unequal across racial and ethnic groups. In addition to racial and ethnic differences in the experience of pain, there are racial and ethnic disparities in the assessment and treatment of pain. In this article, we provide a nonexhaustive review of the biopsychosocial mechanistic factors contributing to racial and ethnic differences in both the experience and treatment of pain. Using a modified version of the Socioecological Model, we focus on patient-, provider- and system-level factors including coping, perceived bias and discrimination, patient preferences, expectations, patient/provider communication, treatment outcomes and healthcare access. In conclusion, we provide psychosocial factors influencing racial and ethnic differences in pain and highlight future research targets and possible solutions to reduce these disparities.
疼痛负担在不同种族和族裔群体中并不均衡。除了疼痛体验方面的种族和族裔差异外，在疼痛评估和治疗方面也存在种族和族裔差异。在本文中，我们对导致疼痛体验和治疗中种族和族裔差异的生物心理社会机制因素进行了非详尽的综述。我们使用社会生态模型的修改版，重点关注患者、提供者和系统层面的因素，包括应对方式、感知到的偏见和歧视、患者偏好、期望、患者/提供者沟通、治疗结果和医疗保健可及性。总之，我们阐述了影响疼痛种族和族裔差异的心理社会因素，并强调了未来的研究目标以及减少这些差异的可能解决方案。
