The effects of children's gender, race, and level of attractiveness on nurses' pain management decisions

This study examined whether nurses' perceptions of pain and pain management decisions were affected by stereotypes of school-aged children with varying gender, race, and attractiveness. Seven hundred randomly selected registered nurses in the United States were sent study packets with three vignettes and pain assessment and treatment questions. Three-hundred thirty-four nurses from around the country participated in the study, an overall return rate of 50%.; The vignettes varied on one independent variable (gender, race, level of attractiveness) at a time, while the child's pain and other characteristics remained constant, thus creating an experimental design.; Pain management decisions were assessed by the total amount of analgesic the nurses would administer to each child, the timing of the analgesic, the number of non-pharmacological procedures recommended, and whether the nurses would involve the child's family and/or contact the physician.; Using nursing characteristics that correlated significantly with pain management dependent variables as covariates, the analyses of covariance showed no differences between the boys and the girls, the African-American and Caucasian children, or attractive and plain children with regard to nurses' decision on mean dose of analgesic and non-pharmacological interventions. Pain perception was perceived as slightly higher for the less attractive child (the VAS 95.5 vs. 93.4 p = .03) but did not influence pain management decisions. T-tests showed no significant differences in decisions to involve family or to contact physician based on child's gender, race, or attractiveness. Simultaneous multiple regression of eleven personal and professional nurse characteristics explained little of the variance on pain (aR2 = .005), mean dose of analgesics (aR2 = .039), or use of non-pharmacological methods (aR2 = .021).; Nurse practitioners and non-nurse practitioners rated children's pain similarly, but nurse practitioners were found to give significantly higher doses of pain medication (t 2.20, p = .02). Nurses with a personal pain history gave more pain medication than nurses without such a history (t 1.98, p = .04). Nurses' race (t 2.41, p = .02) and current working status (t 1.96, p = .05) were found to influence significant differences in the number of non-pharmacological methods used in the vignettes. Some choices of non-pharmacological interventions varied by child's gender and race.