Placebo Effect of Saline in Pain Management: Compared Study with Hemodialysis and Non-hemodialysis Nurses' Experiences

Ünver, Seher; Yildirim, Meltem; Ünal, Emine

doi:10.5505/agri.2013.82621

Cited by 4 publications

(12 citation statements)

References 15 publications

(23 reference statements)

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“…Participants reported applying CFs in different circumstances, mainly in addition to nursing interventions required by the clinical condition to obtain therapeutic effects, such as to relax or control pain, as already documented among nurses (Baghcheghi & Koohestani, ; Nitzan & Lichtenberg, ; Unver et al, ) and physicians (Harris et al, ; Hróbjartsson & Norup, ; Nitzan & Lichtenberg, ; Sherman & Hickner, ). On the contrary, CFs adoption is rare when patients require continuously unjustifiable interventions to prevent their complaints or when evidence‐based interventions are ineffective, thus suggesting that CFs are not used alone for highly demanding and complex patients.…”

Section: Discussionmentioning

confidence: 92%

“…From the experience of participants, different clinical conditions can benefit from CFs, especially emotional disorders, chronic pain, cognitive disorders, insomnia and acute pain. With regards to pain, previous studies have documented nurses’ beliefs towards the use of placebo medication (Alaloul et al, ; Unver et al, ), but the adoption of other strategies aimed at reducing pain has never been documented to date. The remaining clinical conditions suggest that nurses have experienced positive effects in the majority of health issues with the exception of infections, immune problems/allergies, drug/medication addictions, and sexual problems.…”

Section: Discussionmentioning

confidence: 99%

“…In the nursing discipline, available studies have measured the perceived effectiveness of placebo as inert medication among rheumatology, haemodialysis and non-haemodialysis nurses (Alaloul et al, 2017;Berthelot, Maugars, Abgrall, & Prost, 2001;Unver, Yildirim, & Unal, 2013); and also among the managerial (Nitzan & Lichtenberg, 2004) and clinical nurses (Baghcheghi & Koohestani, 2011) • Contextual factors should be considered in nursing programmes to increase nurses' awareness in triggering placebo and in preventing nocebo effects.…”

Section: Backg Rou N Dmentioning

confidence: 99%

“…A survey instrument was developed using distinct and iterative steps (Streiner, Norman, & Cairney, 2015). Items from existing surveys on placebo were extracted from the available literature (Babel, 2013;Baghcheghi & Koohestani, 2011;Harris, Campbell, & Raz, 2015;Hassan, Fauzi, & Hasan, 2011;Howick et al, 2013;Hróbjartsson & Norup, 2003;Nitzan & Lichtenberg, 2004;Shah, Panchal, Vyas, & Patel, 2009;Sherman & Hickner, 2008;Tilburt et al, 2008;Unver et al, 2013). Differently, given that no survey on nocebos has been performed to date, it was not possible to base the questionnaire development on previous literature.…”

Section: Questionnaire Developmentmentioning

confidence: 99%

“…In the nursing discipline, available studies have measured the perceived effectiveness of placebo as inert medication among rheumatology, haemodialysis and non‐haemodialysis nurses (Alaloul et al, ; Berthelot, Maugars, Abgrall, & Prost, ; Unver, Yildirim, & Unal, ); and also among the managerial (Nitzan & Lichtenberg, ) and clinical nurses (Baghcheghi & Koohestani, ) regarding their aptitudes in adopting placebo, mainly by using monocentric cross‐sectional surveys. Therefore, no large‐scale data have been published to date regarding the daily use of different CFs by nurses as well as their clinical decision process of implementation, such as in which conditions they are mostly effective and their ethical implications.…”

Section: Introductionmentioning

confidence: 99%

See 4 more Smart Citations

Contextual factors triggering placebo and nocebo effects in nursing practice: Findings from a national cross‐sectional study

Palese

Cadorin

Testa

et al. 2019

Journal of Clinical Nursing

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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.

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Section: Discussionmentioning

confidence: 92%

Section: Discussionmentioning

confidence: 99%

Section: Backg Rou N Dmentioning

confidence: 99%

Section: Questionnaire Developmentmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Contextual factors triggering placebo and nocebo effects in nursing practice: Findings from a national cross‐sectional study

Palese

Cadorin

Testa

et al. 2019

Journal of Clinical Nursing

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The awareness of contextual factors, placebo and nocebo effects among nursing students: Findings from a cross-sectional study

Cadorin

Rossettini²,

Testa³

et al. 2020

Nurse Education in Practice

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Physical therapists’ perspectives on using contextual factors in clinical practice: Findings from an Italian national survey

Rossettini¹,

Palese

Geri³

et al. 2018

PLoS ONE

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BackgroundContextual factors (CFs) represent a potential therapeutic tool to boost physiotherapy outcomes, triggering placebo effects. Nevertheless, no evidence about the use of CFs among physical therapists is currently available.ObjectiveTo investigate the use of CFs and the opinion of Italian physical therapists specialized in Orthopaedic Manual Therapy (OMTs) on their therapeutic benefits.DesignAn exploratory cross-sectional online survey.MethodsA 17-item questionnaire and 2 clinical vignettes assessed the perspective of OMTs on the adoption of CFs in daily clinical practice. The target population was composed of 906 OMTs. An online survey was performed in 2016 using SurveyMonkey Software. Data were analyzed by descriptive and inferential statistics.ResultsA total of 558 volunteers (61.6% of the target OMT population) participated in the study. Half of the participants (52.0%) claimed to use CFs frequently in their practice. More of 50% of OMTs valued the therapeutic significance of CFs for different health problems as determined by a combined psychological and physiological effect. OMTs considered the use of CFs ethically acceptable when they exert beneficial therapeutic effects and their effectiveness has emerged in previous clinical experiences (30.6%). They disagreed on the adoption of CFs when they are deceptive (14.1%). Moreover, OMTs did not communicate the adoption of CFs to patients (38.2%), and CFs were usually used in addition to other interventions to optimize clinical responses (19.9%). Psychological mechanisms, patient’s expectation and conditioning were believed to be the main components behind CFs (7.9%).LimitationsConsidering that the data collected were self-reported and retrospective, recall and response biases may limit the internal and external validity of the findings.ConclusionsOMTs used CFs in their clinical practice and believed in their therapeutic effect. The knowledge of CFs, placebo and nocebo mechanisms and their clinical effects should be included in physical therapists’ university studies.

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Placebo Effect of Saline in Pain Management: Compared Study with Hemodialysis and Non-hemodialysis Nurses' Experiences

Cited by 4 publications

References 15 publications

Contextual factors triggering placebo and nocebo effects in nursing practice: Findings from a national cross‐sectional study

Contextual factors triggering placebo and nocebo effects in nursing practice: Findings from a national cross‐sectional study

The awareness of contextual factors, placebo and nocebo effects among nursing students: Findings from a cross-sectional study

Physical therapists’ perspectives on using contextual factors in clinical practice: Findings from an Italian national survey

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