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Avoidance of nocebo effects by coincident naming of treatment benefits during the medical interview for informed consent—Evidence from dynamometry
INTRODUCTION: In the context of giving risk information for obtaining informed consent, it is not easy to comply with the ethical principle of “primum nihil nocere.” Carelessness, ignorance of nocebo effects and a misunderstood striving for legal certainty can lead doctors to comprehensive and bruta...
Autores principales: | , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Frontiers Media S.A.
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9397404/ https://www.ncbi.nlm.nih.gov/pubmed/36017426 http://dx.doi.org/10.3389/fpsyg.2022.923044 |
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author | Zech, Nina Schrödinger, Matthias Hansen, Ernil |
author_facet | Zech, Nina Schrödinger, Matthias Hansen, Ernil |
author_sort | Zech, Nina |
collection | PubMed |
description | INTRODUCTION: In the context of giving risk information for obtaining informed consent, it is not easy to comply with the ethical principle of “primum nihil nocere.” Carelessness, ignorance of nocebo effects and a misunderstood striving for legal certainty can lead doctors to comprehensive and brutal risk information. It is known that talking about risks and side effects can even trigger those and result in distress and nonadherence to medication or therapy. METHODS: Recently, we have reported on significant clinically relevant effects of verbal and non-verbal suggestions on maximal muscular arm strength in healthy volunteers and in patients at two time points before surgery. Maximal strength during arm abduction was measured by dynamometry of the deltoid muscle group. Suggestions from clinical everyday life were formulated as presumed negative and neutral versions. RESULTS: Here, we report on the effects of two versions of risk information in 45 patients. After sole mentioning risks of a puncture for the placement of a pain catheter, the maximal arm muscle strength was significantly reduced to 83% of baseline several days (T1), and to 84% the evening before surgery (T2). Strength was not significantly decreased and close to baseline at T1 and T2 when risks and benefits of a pain catheter were combined in one sentence. The difference between both versions was significant. With persistent normal distribution of values, the effect was due to uniform reactions of many patients, not to strong reactions of a few. High suggestibility and increase of anxiety with approaching surgery were identified as influencing factors for the neutralizing effect of modified wording. CONCLUSION: We not only suggest an alternative formulation for risk information to avoid nocebo effects but present an objective method to quantify and compare effects of different wordings. Thereby, we provide evidence that concurrently given positive aspects can neutralize negative effects during medical interview. |
format | Online Article Text |
id | pubmed-9397404 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Frontiers Media S.A. |
record_format | MEDLINE/PubMed |
spelling | pubmed-93974042022-08-24 Avoidance of nocebo effects by coincident naming of treatment benefits during the medical interview for informed consent—Evidence from dynamometry Zech, Nina Schrödinger, Matthias Hansen, Ernil Front Psychol Psychology INTRODUCTION: In the context of giving risk information for obtaining informed consent, it is not easy to comply with the ethical principle of “primum nihil nocere.” Carelessness, ignorance of nocebo effects and a misunderstood striving for legal certainty can lead doctors to comprehensive and brutal risk information. It is known that talking about risks and side effects can even trigger those and result in distress and nonadherence to medication or therapy. METHODS: Recently, we have reported on significant clinically relevant effects of verbal and non-verbal suggestions on maximal muscular arm strength in healthy volunteers and in patients at two time points before surgery. Maximal strength during arm abduction was measured by dynamometry of the deltoid muscle group. Suggestions from clinical everyday life were formulated as presumed negative and neutral versions. RESULTS: Here, we report on the effects of two versions of risk information in 45 patients. After sole mentioning risks of a puncture for the placement of a pain catheter, the maximal arm muscle strength was significantly reduced to 83% of baseline several days (T1), and to 84% the evening before surgery (T2). Strength was not significantly decreased and close to baseline at T1 and T2 when risks and benefits of a pain catheter were combined in one sentence. The difference between both versions was significant. With persistent normal distribution of values, the effect was due to uniform reactions of many patients, not to strong reactions of a few. High suggestibility and increase of anxiety with approaching surgery were identified as influencing factors for the neutralizing effect of modified wording. CONCLUSION: We not only suggest an alternative formulation for risk information to avoid nocebo effects but present an objective method to quantify and compare effects of different wordings. Thereby, we provide evidence that concurrently given positive aspects can neutralize negative effects during medical interview. Frontiers Media S.A. 2022-08-09 /pmc/articles/PMC9397404/ /pubmed/36017426 http://dx.doi.org/10.3389/fpsyg.2022.923044 Text en Copyright © 2022 Zech, Schrödinger and Hansen. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. |
spellingShingle | Psychology Zech, Nina Schrödinger, Matthias Hansen, Ernil Avoidance of nocebo effects by coincident naming of treatment benefits during the medical interview for informed consent—Evidence from dynamometry |
title | Avoidance of nocebo effects by coincident naming of treatment benefits during the medical interview for informed consent—Evidence from dynamometry |
title_full | Avoidance of nocebo effects by coincident naming of treatment benefits during the medical interview for informed consent—Evidence from dynamometry |
title_fullStr | Avoidance of nocebo effects by coincident naming of treatment benefits during the medical interview for informed consent—Evidence from dynamometry |
title_full_unstemmed | Avoidance of nocebo effects by coincident naming of treatment benefits during the medical interview for informed consent—Evidence from dynamometry |
title_short | Avoidance of nocebo effects by coincident naming of treatment benefits during the medical interview for informed consent—Evidence from dynamometry |
title_sort | avoidance of nocebo effects by coincident naming of treatment benefits during the medical interview for informed consent—evidence from dynamometry |
topic | Psychology |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9397404/ https://www.ncbi.nlm.nih.gov/pubmed/36017426 http://dx.doi.org/10.3389/fpsyg.2022.923044 |
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