Category Archives: Pain
Martin Schiavenato, PhD, RN, is an assistant professor at the University of Miami School of Nursing and Health Studies, and a Robert Wood Johnson Foundation Nurse Faculty Scholar. This is part of a series of posts looking at diversity in the health care workforce.
It is human nature. The old adage “opposites attract” is a myth; in fact, the contrary is true. We feel more comfortable with and welcome those who share in our definition of “us” than not. Accordingly, this also forms the basis to how we define “them.” It is intuitive that we feel connected to and prefer those who share in what we believe to be our experience, and that we are suspicious and even spurn those who we feel do not. This phenomenon is referred to by psychologists as “in-group bias.”
"When it comes to providing best clinical care, race and culture matter."
In my field of pain research, there is ample documentation of how clinician preferences impact the care of patients. Clinicians better address pain management in patients who “match” their reference group or their preferences more closely. For example, better pain care is given to patients who speak the same language, are of similar socioeconomic status, or even those considered more attractive to the clinician. Subtle cues from the patient—their physical appearance, the circumstances that brought them to seek care, their behaviors and expressions—all will have a consequence on the nature of the care that they will receive. Thus, the race and culture of the clinician have the potential to be significant contributors in the quality of care that a patient will receive. This inherent tension between “us” and “them” may be particularly relevant in a country with a history of institutionalized racism.
It’s made of glass, and it glows and changes colors—but it’s not a crystal ball. It’s an “orb” and it’s poised to revolutionize the way providers assess and treat pain in premature infants.
Martin Schiavenato, PhD, RN, a Robert Wood Johnson Foundation (RWJF) Nurse Faculty Scholar, has invented a revolutionary tool to assess pain in premature infants and potentially protect them from its negative developmental effects.
The glass orb translates behavioral and physiological signs of pain in infants—such as body gestures and physiological signals like heart rate metrics—into a “real time” visual display of pain levels. It changes color depending on the subject’s pain levels, giving clinicians readouts on infant pain.
The Robert Wood Johnson Foundation (RWJF) Interdisciplinary Nursing Quality Research Initiative (INQRI) will host a webinar on January 31, 2013 as part of a series featuring all of the INQRI's grantee teams focused on translating research into practice. The webinar will feature INQRI Investigators Susan Beck, PhD, APRN, FAAN, and Nancy Dunton, PhD, FAAN, discussing their research on dissemination and implementation of evidence-based methods to measure and improve pain outcomes.
The webinar will be held from 2-3 p.m. EST.
By RWJF Executive Nurse Fellows alumna Keela Herr, PhD, RN, FAAN, Professor and Associate Dean for Faculty, The University of Iowa College of Nursing, Co-Director, Iowa John A. Hartford Center of Geriatric Nursing Excellence
A recent article in the New York Times highlighted an important study by Tim Platts-Mills, MD, and his colleagues that examined pain treatment of older adults in emergency departments across the country. They found that people over age 75 are about 20 percent less likely to have their pain treated than are middle-aged patients. More importantly, the researchers found that in the over-75 group, only 53 percent of those who reported pain received an analgesic or a prescription for one. In patients with severe pain, only 65 percent received an analgesic.
These findings indicate that we still have a lot of work to do to address the under-treatment of pain in older people. The findings contribute to data collected in other care settings (such as hospitals, nursing homes and hospices) that also show inadequate treatment of pain in older people.
Attention was first drawn to the problem in the early 1990s, and researchers and clinicians have since contributed knowledge to guide provider practices to improve pain care. Yet, here we are 20 years later, and the picture hasn’t improved much.
Many organizations and groups (such as the International Association for the Study of Pain, the American Pain Society, the American Society for Pain Management Nursing, the American Geriatric Society, and the American Pain Foundation) are committed to quality pain care for all people. These groups work to raise awareness, provide education and resources, develop clinical practice guidelines and advocate for research and policies that support good care.