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Title: Engendering pain management practices: the role of physician sex on chronic low-back pain assessment and treatment prescriptions
Authors: Bernardes, S. F.
Costa, M.
Carvalho, H.
Keywords: Gender biases
Chronic low-back pain
General practitioners
Pain management practices
Issue Date: 2013
Publisher: Churchill Livingstone
Abstract: The impact of physician sex on dimensions of medical care such as treatment prescriptions and referrals has been underexplored, especially in a pain context. Also, few studies have analyzed whether physician sex moderates the influence of patients' or clinical situations' characteristics on pain management practices or its mediating processes. Therefore, our goal was to explore whether physician sex moderates the effects of patient (distressed) pain behaviors and diagnostic evidence of pathology (EP) on treatment prescriptions and referrals for chronic low-back pain, and to explore the mediating role of pain credibility judgments and psychological attributions on these effects. A total of 310 general practitioners (GPs; 72.6% women) participated in a between-subjects design, 2 (patient pain behaviors) x 2 (EP) x 2 (GP sex) x 2 (patient sex). GPs were presented with vignettes depicting a fe(male) chronic low-back pain patient, with(out) distress and with(out) EP (eg, herniated disc). GPs judged the patient's pain and the probability of treatment prescriptions and referrals. Results showed that EP had a larger effect on male than on female physicians' referrals to psychology/psychiatry. Also, GP sex moderated the pain judgments that accounted for the effect of EP and pain behaviors on prescriptions. These findings suggest framing medical decision-making as a process influenced by gender assumptions.
Peer reviewed: yes
DOI: 10.1016/j.jpain.2013.03.004
ISSN: 1526-5900
Accession number: WOS:000324656000005
Appears in Collections:CIS-RI - Artigos em revistas científicas internacionais com arbitragem científica
CIES-RI - Artigos em revista científica internacional com arbitragem científica

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