Stigmatizing language in electronic health records of adolescent patients presented to the emergency department pre-Covid 19 pandemic.
Presentation
Overview
Overview
Description
Electronic health records (EHRs) shape clinician perceptions and care delivery, yet provider documentation may inadvertently perpetuate stigma—an understudied concern in adolescent emergency care. Guided by Goffman’s Stigma Theory, this mixed‑methods, retrospective study examined stigmatizing language in resident and attending physician notes for adolescents aged 10–19 presenting to a Midwestern pediatric emergency department in 2019. A paired sample of 200 encounters was randomly selected, with 183 charts containing complete documentation included in the final analysis. Quantitative analyses (McNemar’s test, chi‑square tests, and multivariable logistic regression) assessed differences in stigmatizing language use, while qualitative deductive thematic analysis applied five predefined stigma categories. Resident physicians used stigmatizing language significantly more often than attending physicians (10.9% vs. 2.2%, p<.001). Stigmatizing language appeared more frequently in notes for female and older adolescents, whereas trauma‑related visits were associated with lower odds of such language. Findings underscore the importance of early bias‑aware documentation training, stronger supervisory oversight, and standardized EHR language guidelines to promote equitable, respectful care for adolescents in emergency settings.
