Enabling Equitable Pain Management : Understanding gender bias in pain assessment and designing for equitable care delivery

Abstract: The healthcare field, just like any industry which is driven by people, their interactions and decisions, is affected by the social norms and biases. Historically being centred around the average white male, the healthcare structure, systems and process are not equitable. Pain Management is not an exception either, and with pain’s subjective nature, the road to equitable care delivery is longer. Pain and gender have a complex relation, and pain being a universal shared experience sees several gender norms established around it. Women’s pain has been disregarded for a very long tagging it is as hysteria and attributing their physical pain to psychological reasons. With lesser research on the female body, women being seen as weaker and emotional gender, and often blurred understanding of sex and gender lead to delayed and improper pain management for women. The work presented in this study captures how these biases exist and affect both the actors’ (patients and healthcare professionals (HCPs)) behaviours and actions throughout the pain management journey thus leading to a down-streaming effect on the treatment delivered. Service design approach with qualitative research methods has been used in the project to bring out the factors, enablers and impact of the bias existing in the pain management process. The insights and findings are used to establish a clear understanding of the entire pain assessment process which is summarised as perception-communication-assessment model in the work, with a focus on both the main actors and their interaction. Based on the findings, concepts were designed to enable an equitable delivery that aims at changing the decisions and actions of the patients and HCPs for a more gender intentional process. Further evaluation led to a final solution space with a focus on patients’ understanding of their own pain and enabling clearer communication with HCP thus bringing more trust to the process.