Assessing the mediating role of disenfranchising talk on the well-being of female patients with chronic overlapping pain conditions.

Abstract

Disenfranchising talk (DT) occurs when health care providers discredit, silence, and stereotype patients. Although ample research has suggested associations among negative patient-provider interactions and poorer well-being, this study is the first to investigate the mediating role of patient-provider DT in exacerbating poorer pain-related health correlates. Female patients living with chronic overlapping pain conditions (N = 348) completed a cross-sectional survey including measures of DT, pain severity, pain catastrophizing, and pain disability, as well as demographic information. Structural equation modeling in AMOS 29 assessed whether DT mediated the relationship between age, educational attainment, and sexual orientation (demographics), and pain severity, catastrophizing, and disability (pain-related health correlates). Structural equation modeling revealed that DT mediated the relationship between age, educational attainment, and sexual orientation on pain-related health correlates, such that younger and LGBQA+ patients and those with less educational attainment reported heightened pain severity, catastrophizing, and disability when they also reported DT. In contrast to scholarship assessing how demographics and pain-related variables influence patient-provider communication, this study instead investigated the mediating role of DT in pain-related health correlates. Providers should avoid discrediting, silencing, or stereotyping female chronic pain patients' pain to potentially avoid exacerbating pain-related health correlates.