Factors Influencing the Receipt of Discharge Pain Treatment by Injured Black Patients / Shoshana V Aronowitz.

Format:

Book

Thesis/Dissertation

Author/Creator:

Aronowitz, Shoshana V., author.

Contributor:

Richmond, Therese S., degree supervisor.

University of Pennsylvania. Department of Nursing, degree granting institution.

Language:

English

Subjects (All):

Nursing.

Medicine.

Nursing--Penn dissertations.

Penn dissertations--Nursing.

Local Subjects:

Nursing.

Medicine.

Nursing--Penn dissertations.

Penn dissertations--Nursing.

Genre:

Academic theses.

Physical Description:

1 online resource (154 pages)

Contained In:

Dissertations Abstracts International 81-04B.

Place of Publication:

[Philadelphia, Pennsylvania] : University of Pennsylvania ; Ann Arbor : ProQuest Dissertations & Theses, 2019.

Language Note:

English

System Details:

Mode of access: World Wide Web.

text file

Summary:

Undertreated pain can negatively influence outcomes in seriously injured patients. The current United States (US) opioid crisis has impacted prescribing practices. Concurrently, research has documented racial disparities in pain treatment for a variety of conditions, with Black patients less likely than White patients to receive pain treatment in emergency department and out-patient settings. However, research focused on differences in pain treatment among Black patients with acute injuries requiring hospitalization is lacking, as is literature that explores the factors providers consider when planning discharge pain treatment for severely injured patients. The aims of this multi-methods dissertation study were to synthesize the existing literature about the factors that impact the receipt of pain treatment by injured Black patients, to quantitatively describe the factors that predict the discharge opioid prescriptions in a cohort of seriously injured Black men, and to qualitatively explore the factors that providers take into consideration when prescribing discharge pain medications for seriously injured patients. A secondary analysis of data from the Psychological Effects of Injuries in Injured Black Men Study (ERRI) was used to describe the factors that predict discharge opioid prescriptions in a cohort of Black men hospitalized with serious injury. Injury severity, pain severity, length of stay (LOS) and self-reported substance overuse were associated with receipt of opioids at discharge. Among patients who received opioids, pain severity and LOS were associated with increasing dosages. Providers were interviewed using a semi-structured interview guide to explore the factors that they take into consideration when planning discharge pain treatment for seriously injured patients. Providers voiced the need to determine "true" pain and described reliable methods for doing so. They expressed concern about increased risk of opioid misuse and diversion in their patient population, and discussed the consequences of not getting it right with regards to determining which patients require pain treatment. While these findings suggest that receipt of opioids in the ERRI cohort was associated with injury and pain severity, LOS, and possibly substance overuse history, provider decision-making regarding discharge opioids is complex and likely related to issues of trust, especially in the age of the current opioid crisis.

Notes:

Source: Dissertations Abstracts International, Volume: 81-04, Section: B.

Advisors: Richmond, Therese S.; Committee members: Peggy Compton; Sara Jacoby; Justine Shults.

Department: Nursing.

Ph.D. University of Pennsylvania 2019.

Local Notes:

School code: 0175

ISBN:

9781088337202

Access Restriction:

Restricted for use by site license.

This item is not available from ProQuest Dissertations & Theses.

This item must not be sold to any third party vendors.