Home Articles List Article Information
International Journal of Health Policy and Management
Journal Archive
Volume Volume 8 (2019)
Volume Volume 7 (2018)
Volume Volume 6 (2017)
Volume Volume 5 (2016)
Volume Volume 4 (2015)
Volume Volume 3 (2014)
Volume Volume 2 (2014)
Volume Volume 1 (2013)
Ashraf, B., Saaiq, M., Uz-Zaman, K. (2014). Qualitative Study of Nocebo Phenomenon (NP) Involved in Doctor-Patient Communication. International Journal of Health Policy and Management, 3(1), 23-27. doi: 10.15171/ijhpm.2014.54
Bushra Ashraf; Muhammad Saaiq; Khaleeq Uz-Zaman. "Qualitative Study of Nocebo Phenomenon (NP) Involved in Doctor-Patient Communication". International Journal of Health Policy and Management, 3, 1, 2014, 23-27. doi: 10.15171/ijhpm.2014.54
Ashraf, B., Saaiq, M., Uz-Zaman, K. (2014). 'Qualitative Study of Nocebo Phenomenon (NP) Involved in Doctor-Patient Communication', International Journal of Health Policy and Management, 3(1), pp. 23-27. doi: 10.15171/ijhpm.2014.54
Ashraf, B., Saaiq, M., Uz-Zaman, K. Qualitative Study of Nocebo Phenomenon (NP) Involved in Doctor-Patient Communication. International Journal of Health Policy and Management, 2014; 3(1): 23-27. doi: 10.15171/ijhpm.2014.54

Qualitative Study of Nocebo Phenomenon (NP) Involved in Doctor-Patient Communication

Article 6, Volume 3, Issue 1, June 2014, Page 23-27  XML PDF (437 K)
Document Type: Original Article
DOI: 10.15171/ijhpm.2014.54
Authors
Bushra Ashraf1; Muhammad Saaiq 2; Khaleeq Uz-Zaman3
1Department of Obstetrics & Gynecology, Mother and Child Health Centre, Pakistan Institute of Medical Sciences, Shaheed Zulfiqar Ali Bhutto Medical University, Islamabad, Pakistan
2Department of Plastic Surgery and Burns, Pakistan Institute of Medical Sciences, Islamabad, Pakistan
3Departments of Neurosurgery and Medical Education, Pakistan Institute of Medical Sciences, Shaheed Zulfiqar Ali Bhutto Medical University, Islamabad, Pakistan
Abstract
Background
Doctor-patient communication has far reaching influences on the overall well-being of the patients. Words are powerful tools in the doctor’s armamentarium, having both healing as well as harming effects. Doctors need to be conscious about the choice of their words. This study aimed to determine the frequency and pattern of Nocebo Phenomenon (NP) un-intentionally induced by the communication of surgeons and anesthetists through the course of various interventional procedures such as surgery, anesthesia, and crucial communication encounters with their patients.
 
Methods
The study was carried out by the Department of Medical Education (DME), Pakistan Institute of Medical Sciences (PIMS), Shaheed Zulfiqar Ali Bhutto Medical University (SZABMU), Islamabad over six months period. All residents and faculty members serving at our institute in various surgical and anesthesia departments constituted the study population. A questionnaire was employed as the data collection tool.
 
Results
Significant proportions of the doctor-patient communications under scrutiny entailed NP. It was more frequently observed in association with female gender of the involved professionals, residency status versus faculty position, and shorter professional experience (i.e.  
Conclusion
NP existed in the clinical practice of the surgeons and anesthetists during their communication with patients. It was more frequently found among females, residents and professionals with less than five years of working experience. There is need to create awareness among these professionals about the subtle negative messages conveyed by such communication and alert them that the nocebo effects have negative repercussions on the clinical outcomes of their patients. The professionals should be formally educated to avoid nocebo words and phrases.
Keywords
Nocebo Phenomenon (NP); Nocebo Words; Nocebo Effects; Nocebo Response; Placebo Phenomenon; Doctor-Patient Communication
Main Subjects
Social Science in Health/Medicine
References
  1. Colloca L, Sigaudo M, Benedetti F. The role of learning in nocebo and placebo effects.  Pain 2008; 136: 211–8. doi: 10.1016/j.pain.2008.02.006
  2. Koyama T, McHaffie JG, Laurienti PJ, Coghill RC. The subjective experience of pain: where expectations became reality. Proc Natl Acad Sci U S A 2005; 102: 12950–5. doi: 10.1073/pnas.0408576102
  3. Kennedy WP. The nocebo reaction. Med World 1961; 95: 203–5.
  4. Colloca L, Miller FG. The nocebo effect and its relevance for clinical practice. Psychosom Med 2011; 73: 598–603. doi: 10.1097/psy.0b013e3182294a50
  5. Enck P, Benedetti F, Schedlowski M. New insights into the placebo and nocebo responses. Neuron 2008; 59: 195–206. doi: 10.1016/j.neuron.2008.06.030
  6. Klosterhalfen S, Kellermann S, Braun S, Kowalski A, Schrauth M, Zipfel S, et al. Gender and the nocebo response following conditioning and expectancy. J Psychosom Res 2009; 66: 323–8. doi: 10.1016/j.jpsychores.2008.09.019
  7. Benedetti F, Lanotte M, Lopiano L, Colloca L. When words are painful: unraveling the mechanisms of the nocebo effect. Neuroscience 2007; 147: 260-71. doi: 10.1016/j.neuroscience.2007.02.020
  8. Colloca L, Benedetti F. Placebo analgesia induced by social observational learning. Pain 2009; 144: 28–34. doi: 10.1016/j.pain.2009.01.033
  9. Scott DJ, Stohler CS, Egnatuk CM, Wang H, Koeppe RA, Zubieta JK. Placebo and nocebo effects are defined by opposite opioid and dopaminergic responses. Arch Gen Psychiatry 2008; 65: 220–31. doi: 10.1001/archgenpsychiatry.2007.34
  10. Benedetti F, Amanzio M, Vighetti S, Asteggiano G. The biochemical and  neuroendocrine bases of the hyperalgesic nocebo effect. J Neurosci 2006; 26: 12014–22. doi: 10.1523/JNEUROSCI.2947-06.2006
  11. Keltner JR, Furst A, Fan C, Redfern R, Inglis B, Fields HL. Isolating the modulatory effect of expectation on pain transmission: a functional magnetic resonance imaging study.  J Neurosci 2006; 26: 4437–43. doi: 10.1523/jneurosci.4463-05.2006
  12. Lorenz J, Hauck M, Paur RC, Nakamura Y, Zimmermann R, Bromm B, et al. Cortical correlates of false expectations during pain intensity judgments--a possible manifestation of placebo/nocebo cognitions. Brain Behav Immun 2005; 19: 283–95. doi: 10.1016/j.bbi.2005.03.010
  13. Bejenke CJ. Suggestive communication: its wide applicability in somatic medicine. In: Varga K, editor. Beyond the words: communication and suggestion in medical practice. New York: Nova Science Publishers; 2011. p. 83–96.
  14. Hansen E, Bejenke C. [Negative and positive suggestions in anaesthesia: Improved communication with anxious surgical patients]. Der Anaesthesist 2010; 59: 199–209. doi: 10.1007/s00101-010-1679-9
  15. Häuser W, Hansen E, Enck P. Nocebo phenomena in medicine: Their relevance in everyday clinical practice. Dtsch Arztebl Int 2012; 109: 459–65.
  16. Hansen E, Zimmermann M, Dünzl G. [Hypnotic communication with emergency patients]. Notfall Rettungsmed 2010; 13: 314–21. doi: 10.1007/s10049-010-1293-z
  17. Hansen E. [Negative suggestions in medicine]. Z Hypnose Hyp-nother 2011; 6: 65–82.
  18. Colloca L. The influence of the nocebo effect in clinical trials. Open Access J Clin Trials 2012; 4: 61–8. doi: 10.2147/oajct.s33730
  19. Ciaramella A, Paroli M, Poli P. An emerging dimension in psychosomatic research: The nocebo phenomenon in the management of chronic pain. ISRN Neuroscience 2013: 574526.  doi: 10.1155/2013/574526
  20. Saaiq M, Zaman KU. Breaking bad news in emergency: How do we approach it?  Ann Pak Inst Med Sci 2006; 2: 72–4.
  21. Saaiq M, Zaman KU. Casual consent to treatment: a neglected issue in our health care system.  Ann Pak Inst Med Sci 2006; 2: 207–12.
  22. Saaiq M, Zaman KU. Pattern of satisfaction among Neurosurgical inpatients. J Coll Physicians Surg Pak 2006; 16: 455–9.
  23. Cheek D. Importance of recognizing that surgical patients behave as though hypnotized. Am J Clin Hypnosis 1962; 4: 227–31. doi: 10.1080/00029157.1962.10401905
  24. Lang EV, Benotsch EG, Fick LJ. Adjunctive non-pharmacological analgesia for invasive medical procedures: a randomised trial. Lancet  2000;  355: 1486–90. Doi:  10.1016/S0140-6736(00)02162-0
  25. Varelmann D, Pancaro C, Cappiello EC, Camann WR. Nocebo induced  hyperalgesia during local anesthetic injection. Anesth Analg 2010; 110: 868–70. doi: 10.1213/ane.0b013e3181cc5727
  26. Lombardi C, Gargioni S, Canonica GW, Passalacqua G. The nocebo effect during oral challenge in subjects with adverse drug  reactions. Eur Ann Allergy Clin Immunol 2008; 40: 138–41.
  27. Mondaini N, Gontero P, Giubilei G.  Finasteride 5 mg and sexual side effects: how many of these are related to a nocebo phenomenon? J Sex Med 2007; 4: 1708–12. doi: 10.1111/j.1743-6109.2007.00563.x
  28. de la Cruz M, Hui D, Parsons HA, Bruera E.  Placebo and nocebo  effects in randomized double-blind clinical trials of agents for the  therapy for fatigue in patients with advanced cancer. Cancer  2010; 116: 766–74. doi: 10.1002/cncr.24751
  29. Silvestri A, Galetta P, Cerquetani E. Report of erectile dysfunction after therapy with beta-blockers is related to patient  knowledge of side effects and is reversed by placebo. Eur Heart J 2003; 24: 1928–32. doi: 10.1016/j.ehj.2003.08.016
  30. Liccardi G, Senna G, Russo M.  Evaluation of the nocebo effect during oral challenge in patients with adverse drug reactions.  J Investig Allergol Clin Immunol 2004; 14: 104–7.
  31. Manchikanti L, Pampati V, Damron K. The role of placebo and nocebo effects of perioperative administration of sedatives and  opioids in interventional pain management. Pain Physician 2005; 8: 349–55.
  32. Faasse K, Petrie KJ. The nocebo effect: patient expectations and medication side effects. Postgrad Med J   2013; 89: 540–6.  doi: 10.1136/postgradmedj-2012-131730
 

Statistics
Article View: 11,537
PDF Download: 3,373