Abstract：
OBJECTIVE: 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.
METHODS: 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).
RESULTS: 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.
CONCLUSIONS: 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.
CONCLUSIONS: Providers should avoid discrediting, silencing, or stereotyping female chronic pain patients\' pain to potentially avoid exacerbating pain-related health correlates.
METHODS: 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).
RESULTS: 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.
CONCLUSIONS: 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.
CONCLUSIONS: Providers should avoid discrediting, silencing, or stereotyping female chronic pain patients\' pain to potentially avoid exacerbating pain-related health correlates.
摘要：
目标：当医疗保健提供者声名狼藉时，沉默,和刻板印象的患者。尽管大量研究表明，患者与提供者之间的负面互动与幸福感较差之间存在关联，这项研究是首次调查患者-提供者DT在加重较差的疼痛相关健康相关性中的中介作用.
方法：患有慢性重叠疼痛的女性患者（N=348）完成了一项横断面调查，包括DT测量，疼痛严重程度，痛苦的灾难，和疼痛残疾，以及人口统计信息。AMOS29中的结构方程模型评估了DT是否介导了年龄之间的关系，教育程度,和性取向（人口统计），和疼痛的严重程度，灾难，和残疾（与疼痛相关的健康相关）。
结果：结构方程模型显示，DT介导了年龄之间的关系，教育程度,和性取向与疼痛相关的健康相关，因此，年轻和LGBQA+患者以及受教育程度较低的患者报告疼痛严重程度增加，灾难，和残疾时，他们也报告DT。
结论：与评估人口统计学和疼痛相关变量如何影响患者与提供者沟通的奖学金相反，本研究调查了DT在疼痛相关健康相关因素中的中介作用.
结论：提供者应避免抹黑，沉默,或对女性慢性疼痛患者进行刻板印象，以潜在地避免加剧与疼痛相关的健康相关因素。
方法：患有慢性重叠疼痛的女性患者（N=348）完成了一项横断面调查，包括DT测量，疼痛严重程度，痛苦的灾难，和疼痛残疾，以及人口统计信息。AMOS29中的结构方程模型评估了DT是否介导了年龄之间的关系，教育程度,和性取向（人口统计），和疼痛的严重程度，灾难，和残疾（与疼痛相关的健康相关）。
结果：结构方程模型显示，DT介导了年龄之间的关系，教育程度,和性取向与疼痛相关的健康相关，因此，年轻和LGBQA+患者以及受教育程度较低的患者报告疼痛严重程度增加，灾难，和残疾时，他们也报告DT。
结论：与评估人口统计学和疼痛相关变量如何影响患者与提供者沟通的奖学金相反，本研究调查了DT在疼痛相关健康相关因素中的中介作用.
结论：提供者应避免抹黑，沉默,或对女性慢性疼痛患者进行刻板印象，以潜在地避免加剧与疼痛相关的健康相关因素。
