The influence of gender and race on nursing care decisions
Disparate treatment among African Americans and women is a significant health issue for the United States population. Provider bias may contribute to disparate treatment of minorities by affecting clinical decision-making. The purpose of this study was to examine whether the race and gender of patients and providers influence post-operative pain management decisions made by nurses. Four vignettes including a patient photo that differed only by patient race and gender and a series of ranked care choices functioned as the study intervention. A randomized four group post-test only experimental design was implemented using a quota sample of 400 practicing Registered Nurses, including 100 White females, 100 Black females, 100 White males, and 100 Black males. A four-way between groups analysis of variance (ANOVA) was employed to determine whether the gender of the nurse, race of the nurse, gender of the patient, and/or race of the patient made any differences in the dose intensity of pain medications selected by the nurse sample.
The findings indicate that, overall, nurses use moderation in pain management choices. No significant interactions were noted between any combinations of the four independent variables. A significant main effect was noted in dose intensity for nurse gender revealing that male nurses selected a significantly higher dose intensity than female nurses. Although care decisions were not significantly influenced by the race of the nurse or the race and/or gender of the patient, two trends emerged. White female patients received the highest dose intensity while White males received the lowest dose intensity. Secondly, White female nurses gave the highest dose intensity to White female patients.
This study contributed added information to a very mixed body of literature. The large balanced quota sample was an important and unique strength of the study. Continued research related to race and gender influences on care decisions and disparate treatment is needed to better understand provider contribution to health disparities. As the United States becomes increasingly diverse, data-driven methods to decrease disparities across gender and race are needed. Nurses are well positioned to advocate for patients in a manner that can improve patient outcomes.