Parents Reliably Identify Pain Dismissal by Pediatric Providers. Issue 2 (February 2020)

• Record Type: Journal Article
• Authors: Igler, Eva; Lang, Amy; Balistreri, Kathryn; Sejkora, Ellen; Drendel, Amy; Davies, William H.
• Is Part Of: Clinical journal of pain. Volume 36:Issue 2(2020)
• Publication Date: 2020-02
• Subjects: pain dismissal -- pediatric chronic pain -- sex -- parent perception -- providers; Pain -- Periodicals; Pain -- Treatment -- Periodicals; Analgesia -- Periodicals; 616.047205
• DOI: 10.1097/AJP.0000000000000776
• Languages: English
• ISSNs: 0749-8047

Abstract

Abstract : Objectives: Approximately 40% of children and adolescents with chronic pain report at least 1 dismissal experience, citing medical providers and parents as the primary and most distressing dismissers. Previous research indicates sex differences in pain dismissal experience and observer pain perception. This study examined parental reactions to dismissive provider-child scenarios and the influence of provider and patient sex on perceptions. Methods: Community parents (N=326) completed an online survey. Parents were randomized to listen to 1 of 8 vignettes of a provider-child chronic pain scenario. Vignettes varied by type of scenario (appropriate vs. dismissive)×provider sex×patient sex. Results: Overall, parents rated the dismissive scenario more negatively. There was a significant interaction between provider sex and scenario regarding likelihood to bring their own child to this provider and a significant 3-way interaction regarding provider belief of the pain complaint. When asked how they would feel if this was their own child, parents who heard the dismissive scenario reported more negative reactions. When asked what they would say to the provider, parents in the dismissive condition were more likely to defend their child and request a second opinion. Discussion: Parents consistently identified the dismissive language in a child and provider scenario. Female providers and sex-matched dyads seem to be more polarizing in terms of likelihood to bring their child to the provider and belief of pain, respectively. Providers within these groups may need to be especially cautious with their language when responding to pediatric chronic pain complaints. Abstract : Supplemental Digital Content is available in the text.