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Contextual factors triggering placebo and nocebo effects in nursing practice: Findings from a national cross-sectional study.
J Clin Nurs 2019; 28(9-10):1966-1978JC

Abstract

AIMS AND OBJECTIVES

To describe contextual factors (CFs) used by nurses to increase placebo and to prevent nocebo effects.

BACKGROUND

Placebo effects have been studied in the nursing discipline, but nocebo effects still remain unexplored. Recently, a set of CFs functioning as triggers of placebo/nocebo effects has been described; however, its use in daily care has never been documented to date.

DESIGN

A national cross-sectional survey, according to the Checklist for Reporting Results of Internet E-Surveys guidelines and STrengthening the Reporting of OBservational Studies in Epidemiology (STROBE), was performed in 2016.

METHODS

A wide sample of Italian nurses belonging to four national associations was involved. A questionnaire based on CFs literature was developed and administered through the SurveyMonkey Software® exploring: (a) CFs definition, (b) beliefs, (c) case-by-case frequency of use, (d) circumstances of application, (e) clinical conditions where participants perceived their potential beneficial effects, (f) ethical implications and (g) communication issues with the patient.

RESULTS

Out of 1,411 eligible nurses, 455 answered (32.2%) and 425 questionnaires (30.1%) were valid for the analysis. A total of 211 nurses (49.6%) defined the CFs as an intervention with a possible aspecific effect; participants believed in the CFs (2.91; 95%CI 2.88-2.94), using them >2 times/month, mainly in addition to a nursing intervention to optimise clinical outcomes (n = 79; 18.6%). Psychological and physiological therapeutic effects have been perceived mainly in chronic pain (n = 259; 60.9%) and insomnia (n = 243; 57.2%). According to participants, CFs have been reported as ethically acceptable when exerting beneficial psychological effects (n = 148; 34.8%); however, 103 (24.2%) of nurses did not communicate to the patient when CFs were used.

CONCLUSIONS

Nurses are aware of CFs as elements to increase the placebo and prevent the nocebo effects in concomitance with evidence-based nursing interventions.

RELEVANCE TO CLINICAL PRACTICE

The CFs valued by nurses and experienced as effective are mainly based upon the internal quality of the nurse and the quality of the relationship between the nurse and the patient. These qualities require a large personal investment; therefore, nurses should be supported in developing these qualities since their nursing graduation.

Authors+Show Affiliations

Department of Medical Sciences, School of Nursing, University of Udine, Udine, Italy.Centro di Riferimento Oncologico di Aviano (CRO), IRCCS, Aviano, Italy.Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genova, Savona, Italy.Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genova, Savona, Italy.Department of Pain Translational Symptom Science, School of Nursing, University of Maryland, Baltimore, Maryland. Department of Anesthesiology and Psychiatry, School of Medicine, University of Maryland, Baltimore, Maryland. Center to Advance Chronic Pain Research, University of Maryland, Baltimore, Maryland.Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genova, Savona, Italy.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

30706543

Citation

Palese, Alvisa, et al. "Contextual Factors Triggering Placebo and Nocebo Effects in Nursing Practice: Findings From a National Cross-sectional Study." Journal of Clinical Nursing, vol. 28, no. 9-10, 2019, pp. 1966-1978.
Palese A, Cadorin L, Testa M, et al. Contextual factors triggering placebo and nocebo effects in nursing practice: Findings from a national cross-sectional study. J Clin Nurs. 2019;28(9-10):1966-1978.
Palese, A., Cadorin, L., Testa, M., Geri, T., Colloca, L., & Rossettini, G. (2019). Contextual factors triggering placebo and nocebo effects in nursing practice: Findings from a national cross-sectional study. Journal of Clinical Nursing, 28(9-10), pp. 1966-1978. doi:10.1111/jocn.14809.
Palese A, et al. Contextual Factors Triggering Placebo and Nocebo Effects in Nursing Practice: Findings From a National Cross-sectional Study. J Clin Nurs. 2019;28(9-10):1966-1978. PubMed PMID: 30706543.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Contextual factors triggering placebo and nocebo effects in nursing practice: Findings from a national cross-sectional study. AU - Palese,Alvisa, AU - Cadorin,Lucia, AU - Testa,Marco, AU - Geri,Tommaso, AU - Colloca,Luana, AU - Rossettini,Giacomo, Y1 - 2019/02/18/ PY - 2018/07/29/received PY - 2019/01/07/revised PY - 2019/01/20/accepted PY - 2019/2/2/pubmed PY - 2019/5/16/medline PY - 2019/2/2/entrez KW - Italy KW - contextual factors KW - cross-sectional study KW - evidence-based nursing KW - nocebo effects KW - nurses KW - nursing KW - placebo effects KW - surveys SP - 1966 EP - 1978 JF - Journal of clinical nursing JO - J Clin Nurs VL - 28 IS - 9-10 N2 - AIMS AND OBJECTIVES: To describe contextual factors (CFs) used by nurses to increase placebo and to prevent nocebo effects. BACKGROUND: Placebo effects have been studied in the nursing discipline, but nocebo effects still remain unexplored. Recently, a set of CFs functioning as triggers of placebo/nocebo effects has been described; however, its use in daily care has never been documented to date. DESIGN: A national cross-sectional survey, according to the Checklist for Reporting Results of Internet E-Surveys guidelines and STrengthening the Reporting of OBservational Studies in Epidemiology (STROBE), was performed in 2016. METHODS: A wide sample of Italian nurses belonging to four national associations was involved. A questionnaire based on CFs literature was developed and administered through the SurveyMonkey Software® exploring: (a) CFs definition, (b) beliefs, (c) case-by-case frequency of use, (d) circumstances of application, (e) clinical conditions where participants perceived their potential beneficial effects, (f) ethical implications and (g) communication issues with the patient. RESULTS: Out of 1,411 eligible nurses, 455 answered (32.2%) and 425 questionnaires (30.1%) were valid for the analysis. A total of 211 nurses (49.6%) defined the CFs as an intervention with a possible aspecific effect; participants believed in the CFs (2.91; 95%CI 2.88-2.94), using them >2 times/month, mainly in addition to a nursing intervention to optimise clinical outcomes (n = 79; 18.6%). Psychological and physiological therapeutic effects have been perceived mainly in chronic pain (n = 259; 60.9%) and insomnia (n = 243; 57.2%). According to participants, CFs have been reported as ethically acceptable when exerting beneficial psychological effects (n = 148; 34.8%); however, 103 (24.2%) of nurses did not communicate to the patient when CFs were used. CONCLUSIONS: Nurses are aware of CFs as elements to increase the placebo and prevent the nocebo effects in concomitance with evidence-based nursing interventions. RELEVANCE TO CLINICAL PRACTICE: The CFs valued by nurses and experienced as effective are mainly based upon the internal quality of the nurse and the quality of the relationship between the nurse and the patient. These qualities require a large personal investment; therefore, nurses should be supported in developing these qualities since their nursing graduation. SN - 1365-2702 UR - https://www.unboundmedicine.com/medline/citation/30706543/Contextual_factors_triggering_placebo_and_nocebo_effects_in_nursing_practice:_Findings_from_a_national_cross_sectional_study_ L2 - https://doi.org/10.1111/jocn.14809 DB - PRIME DP - Unbound Medicine ER -