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The Influence of Gender Bias: Is Pain Management in the Field Affected by Health Care Provider’s Gender?

Published online by Cambridge University Press:  04 August 2022

Adi Karas Open the ORCID record for Adi Karas [Opens in a new window] ,
Lidar Fridrich ,
Irina Radomislensky ,
Guy Avital ,
Sami Gendler ,
Jacob Chen Open the ORCID record for Jacob Chen [Opens in a new window] ,
Shaul Gelikas  and
Avi Benov
Adi Karas*
Affiliation:
Trauma and Combat Medicine Branch, Surgeon General’s Headquarters, Israel Defense Forces, Ramat Gan, Israel
Lidar Fridrich
Affiliation:
Department of Physiology and Pharmacology, Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
Irina Radomislensky
Affiliation:
Trauma and Combat Medicine Branch, Surgeon General’s Headquarters, Israel Defense Forces, Ramat Gan, Israel National Center for Trauma and Emergency Medicine Research, Gertner Institute for Epidemiology and Health Policy Research, Sheba Medical Center, Ramat Gan, Israel
Guy Avital
Affiliation:
Trauma and Combat Medicine Branch, Surgeon General’s Headquarters, Israel Defense Forces, Ramat Gan, Israel Division of Anesthesia, Intensive Care, and Pain Management, Tel-Aviv Medical Center, Tel-Aviv University, Tel-Aviv, Israel
Sami Gendler
Affiliation:
Trauma and Combat Medicine Branch, Surgeon General’s Headquarters, Israel Defense Forces, Ramat Gan, Israel
Jacob Chen
Affiliation:
Hospital Management, Meir Medical Center, Kfar Saba; Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
Shaul Gelikas
Affiliation:
Trauma and Combat Medicine Branch, Surgeon General’s Headquarters, Israel Defense Forces, Ramat Gan, Israel Department of Internal Medicine E, Sheba Medical Center, Tel Hashomer, Israel
Avi Benov
Affiliation:
Trauma and Combat Medicine Branch, Surgeon General’s Headquarters, Israel Defense Forces, Ramat Gan, Israel The Azrieli Faculty of Medicine, Bar-Ilan University, Safed, Israel
*
Correspondence: Adi Karas, MD The Trauma and Combat Medicine Branch Surgeon General’s Headquarters Ramat Gan, Israel Email: [email protected]
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Abstract

Introduction:

Appropriate pain management indicates the quality of casualty care in trauma. Gender bias in pain management focused so far on the patient. Studies regarding provider gender are scarce and have conflicting results, especially in the military and prehospital settings.

Study Objective:

The purpose of this study is to investigate the effect of health care providers’ gender on pain management approaches among prehospital trauma casualties treated by the Israel Defense Forces (IDF) medical teams.

Methods:

This retrospective cohort study included all trauma casualties treated by IDF senior providers from 2015-2020. Casualties with a pain score of zero, age under 18 years, or treated with endotracheal intubation were excluded. Groups were divided according to the senior provider’s gender: only females, males, or both female and male. A multivariate analysis was performed to assess the odds ratio of receiving an analgesic, depending on the presence of a female senior provider, adjusting for potential confounders. A subgroup analysis was performed for “delta-pain,” defined as the difference in pain score during treatment.

Results:

A total of 976 casualties were included, of whom 835 (85.6%) were male. Mean pain scores (SD) for the female only, male only, and both genders providers were 6.4 (SD = 2.9), 6.4 (SD = 3.0), and 6.9 (SD = 2.8), respectively (P = .257). There was no significant difference between females, males, or both female and male groups in analgesic treatment, overall and per specific agent. This remained true also in the multivariate model. Delta-pain difference between groups was also not significant. Less than two-thirds of casualties in this study were treated for pain among all study groups.

Conclusion:

This study found no association between IDF Medical Corps providers’ gender and pain management in prehospital trauma patients. Further studies regarding disparities in acute pain treatment are advised.

Keywords

gender biaspain managementprehospitalprovider gendertrauma
Type
Original Research
Information
Prehospital and Disaster Medicine , Volume 37 , Issue 5 , October 2022 , pp. 638 - 644
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Copyright
© The Author(s), 2022. Published by Cambridge University Press on behalf of the World Association for Disaster and Emergency Medicine

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Footnotes

Note: SG and AB contributed to the manuscript equally and are co-last authors.

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