Gender-based differential management of acute low back pain in the emergency department: A survey based on a clinical vignette

Author:

Schilter Léa V123,Le Boudec Joana AE2ORCID,Hugli Olivier4,Locatelli Isabella5,Staeger Phillippe2,Della Santa Vincent6,Frochaux Vincent7,Rutschmann Olivier8,Bieler Sandra9,Ribordy Vincent10,Fournier Yvan11,Decosterd Dumeng12,Clair Carole2

Affiliation:

1. Faculty of Biology and Medicine, University of Lausanne, Lausanne, Switzerland

2. Department of Ambulatory Care, Center for Primary Care and Public Health (UNISANTE), University of Lausanne, Lausanne, Switzerland

3. Internal Medicine Department, Lausanne University Hospital & Lausanne University (CHUV), Lausanne, Switzerland

4. Emergency Department, Lausanne University Hospital & Lausanne University (CHUV), Lausanne, Switzerland

5. Department of Epidemiology and Health Systems, Center for Primary Care and Public Health (UNISANTE), University of Lausanne, Lausanne, Switzerland

6. Emergency Department, Réseau Hospitalier Neuchâtelois (HNE), Neuchâtel, Switzerland

7. Emergency Department, Hôpital du Valais (HSV), Sion, Switzerland

8. Emergency Department, Hôpitaux Universitaires de Genève (HUG), Geneva, Switzerland

9. Emergency Department, Hôpital de Nyon (GHOL), Nyon, Switzerland

10. Emergency Department, Hôpital de Fribourg (HFR), Fribourg, Switzerland

11. Emergency Department, Hôpital de Payerne (HIB), Payerne, Switzerland

12. Intensive Care Unit, Réseau Hospitalier Neuchâtelois, Site de Pourtalès, Neuchâtel, Switzerland

Abstract

Background: Women may receive suboptimal pain management compared with men, and this disparity might be related to gender stereotypes. Objectives: To assess the influence of patient gender on the management of acute low back pain. Design: We assessed pain management by 231 physicians using an online clinical vignette describing a consultation for acute low back pain in a female or male patient. The vignette was followed by a questionnaire that assessed physicians’ management decisions and their gender stereotypes. Methods: We created an online clinical vignette presenting a patient with acute low back pain and assessed the influence of a patient’s gender on pain management. We investigated gender-related stereotyping regarding pain care by emergency physicians using the Gender Role Expectation of Pain questionnaire. Results: Both male and female physicians tended to consider that a typical man was more sensitive to pain, had less pain endurance, and was more willing to report pain than a typical woman. These stereotypes did not translate into significant differences in pain management between men and women. However, women tended to be referred less often for imaging examinations than men and were also prescribed lower doses of ibuprofen and opioids. The physician’s gender had a modest influence on management decisions, female physicians being more likely to prescribe ancillary examinations. Conclusion: We observed gender stereotypes among physicians. Our findings support the hypothesis that social characteristics attributed to men and women influence pain management. Prospective clinical studies are needed to provide a deeper understanding of gender stereotypes and their impact on clinical management.

Publisher

SAGE Publications

Reference54 articles.

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