患者报告的术后疼痛和麻醉中的污名化语言:一个横截面研究 (2017-2019)
S E Harkins1, C D Thomas2, I I Hulchafo3
1Columbia University Irving Medical Center, Department of Obstetrics & Gynecology, New York, NY, United States.
International journal of obstetric anesthesia
|November 27, 2025
概括
产科患者的术后疼痛与麻醉科医生对污名化语言的记录增加有关,特别是将患者标记为"困难". 这突显了疼痛管理中的潜在偏见和无偏见的产周护理的需要.
科学领域:
- 产科和妇科 产科和妇科
- 麻醉学 麻醉学
- 医疗保健服务研究 医疗服务研究
背景情况:
- 临床笔记中的污名化语言可能反映了提供者偏见.
- 以前的研究表明,在产科笔记中记录的污名化语言中存在种族/民族差异.
- 这项研究旨在探索术后疼痛与麻醉师记录的污名化语言之间的联系.
研究的目的:
- 调查术后疼痛与在麻醉中使用污名化语言之间的关联.
- 确定与患者疼痛状态相关的特定类型的污名化语言.
主要方法:
- 分析了两家医院 (2017-2019) 的4383名产科患者的电子健康记录.
- 疼痛定义为口头数值疼痛评分 (VNPS) ≥1 在剖腹产后或手术后.
- 自然语言处理 (NLP) 算法用于检测自由文本麻醉笔记中的污名化语言.
- 应用多变量逻辑回归来评估疼痛与污名化语言之间的关联.
主要成果:
- 污名化的语言出现在9.9%的术后麻醉笔记中.
- 报告疼痛的患者显著更有可能记录任何耻辱语言 (aOR,1.64;95% CI,1.26-2.13).
- 疼痛与语言标记患者"困难"的可能性更高相关 (aOR,1.81;95% CI,1.34-2.45).
- 对于与边缘化身份,威权决策或信誉质疑相关的语言,没有发现显著差异.
结论:
- 产后患有疼痛的患者表现出更高的患有标志性语言记录的几率.
- 研究结果表明,麻醉师可能会认为患者报告疼痛是"困难的".
- 需要质量改进举措来监测疼痛管理不平等,并促进以患者为中心,无偏见的产周护理.
更多相关视频
相关概念视频
Endoscopic Procedures IV: Sigmoidoscopy and Laproscopy
519
Sigmoidoscopy and laparoscopy are distinct medical procedures that enable physicians to internally inspect different parts of the GI tract. Although they serve different purposes, each is essential for diagnosing and, in some cases, treating various medical conditions.
Sigmoidoscopy
Sigmoidoscopy is a diagnostic procedure that uses a flexible sigmoidoscope equipped with a light source and camera to examine the rectum and sigmoid colon. The procedure involves inserting the tube through the anus...
Sigmoidoscopy
Sigmoidoscopy is a diagnostic procedure that uses a flexible sigmoidoscope equipped with a light source and camera to examine the rectum and sigmoid colon. The procedure involves inserting the tube through the anus...
519
Peripheral Artery Disease V: Postoperative Nursing Management
354
During the postoperative period, it is crucial to focus on maintaining circulation, identifying and managing potential complications, and planning for discharge.Nursing AssessmentVital signs monitoring: Regularly monitor vital signs, including blood pressure, heart rate, respiratory rate, and temperature, to detect early signs of complications such as bleeding and infection.Circulation assessment: Monitor pulses, perform Doppler assessments, and check capillary refill, color, temperature, and...
354
General Anesthesia: Overview
552
Anesthesia is a medical procedure that uses drugs for CNS suppression to enable painless surgeries and procedures. The selection of anesthetics is influenced by their pharmacokinetic properties, side effects, and patient characteristics. Various types of anesthesia include general, local, regional, spinal, and inhalational.
General anesthesia induces unconsciousness in the whole body, while the others target specific areas or sensations. It is administered to minimize adverse effects, maintain...
General anesthesia induces unconsciousness in the whole body, while the others target specific areas or sensations. It is administered to minimize adverse effects, maintain...
552
SBAR II: Application of SBAR
5.6K
SBAR is an effective communication tool used by healthcare professionals to communicate patient information accurately. SBAR stands for Situation, Background, Assessment, and Recommendation. For a better understanding, an example is given below.
SBAR Report from a Nurse to a Health Care Provider
S: "Hello, Dr. Smith. This is Jane, RN, from the Med Surg unit. I am calling to tell you about Ms. White in Room 210, who is experiencing increased pain and redness at her incision site. Her recent...
SBAR Report from a Nurse to a Health Care Provider
S: "Hello, Dr. Smith. This is Jane, RN, from the Med Surg unit. I am calling to tell you about Ms. White in Room 210, who is experiencing increased pain and redness at her incision site. Her recent...
5.6K
Stages of General Anesthesia
1.4K
Various sedation levels offer significant advantages in facilitating procedural interventions for patients undergoing medical or invasive surgical procedures. These levels span from anxiolysis to general anesthesia, providing a spectrum of sedative effects to cater to specific patient needs. Anxiolysis reduces anxiety and is achieved through minimal sedation, enabling patients to remain awake and responsive while feeling more at ease during the procedure. This level can benefit minor...
1.4K


