A study of primary care physicians rating their immigrant patients' pain intensity. (10th May 2012)

• Record Type: Journal Article
• Authors: André, M.; Löfvander, M.
• Is Part Of: European journal of pain. Volume 17:Number 1(2013)
• Page Start: 132
• Page End: 139
• Publication Date: 2012-05-10
• Subjects: Pain -- Periodicals; Pain -- Treatment -- Periodicals; Pain -- Physiological aspects -- Periodicals; 616.0472
• DOI: 10.1002/j.1532-2149.2012.00162.x
• Languages: English
• ISSNs: 1090-3801

Abstract

<abstract abstract-type="main"> <title>Abstract</title> <sec id="ejp162-sec-0003" sec-type="section"> <title>Background</title> <p>Few studies focus on how physicians evaluate pain in foreign‐born patients with varying cultural backgrounds. This study aimed to compare pain ratings [visual analogue scale (VAS) 0–100] done by Swedish primary care physicians and their patients, and to analyse which factors predicted physicians' higher ratings of pain in patients aged 18–45 years with long‐standing disabling back pain.</p> </sec> <sec id="ejp162-sec-0004" sec-type="section"> <title>Methods</title> <p>The two physicians jointly carried out the somatic and psychiatric diagnostic evaluations and alternated as consulting doctor or observer. One‐third of the consultations were interpreted. Towards the end of the consultations, the patients rated their pain intensity 'right now' (patients' VAS). After the patient had left, the two physicians independently rated how much pain they thought the patient had, without looking at the patient's VAS score. The mean of the two doctors' VAS values (physicians' VAS) for each patient was used in the logistic regression calculations of odds ratios (OR) in main effect models for physicians' VAS above median (md) with patient's sex, education, origin, depression, psychosocial stress and pain sites as explanatory variables.</p> </sec> <sec id="ejp162-sec-0005" sec-type="section"> <title>Results</title> <p>Physicians' VAS values were significantly lower (md 15) than patients' VAS (md 66; women md 73, men md 52). The ratings showed no significant association with whether the physician was acting as consultant or observer. The higher physician VAS was only predicted by findings of multiple pain sites.</p> </sec> <sec id="ejp162-sec-0006" sec-type="section"> <title>Conclusions</title> <p>Physicians appear to overlook psychological and emotional aspects when rating the pain of patients from other cultural backgrounds. This finding highlights a potential problem in multicultural care settings.</p> </sec> </abstract>