Chan Carmen W H, Thompson David R
Nethersole School of Nursing, Chinese University of Hong Kong, Hong Kong SAR, China.
J Clin Nurs. 2006 May;15(5):521-4. doi: 10.1111/j.1365-2702.2006.01373.x.
This paper reviews placebo and placebo effects and their measurement and application to nursing. Ethical and methodological issues are also discussed. Implications for nursing and recommendations for future study are offered.
Placebos have been used for decades in clinical trials but discussion about conceptual, methodological and ethical issues has been comparatively scarce.
It is concluded that true placebo effects are difficult to measure and control and the use of credible placebo is sometimes impractical in clinical nursing research. This leads to the increased use of usual care as a control by researchers. However, more information should be reported in studies that use this approach, including the specification of usual care, its monitoring and patient adherence.
Where its use is considered ethical, safe and feasible, a placebo arm should be included in studies of efficacy to distinguish between active and inactive treatment.
本文回顾了安慰剂及安慰剂效应、其测量方法及其在护理中的应用。同时还讨论了伦理和方法学问题。并提出了对护理的启示以及对未来研究的建议。
安慰剂在临床试验中已使用了数十年,但关于概念、方法和伦理问题的讨论相对较少。
得出的结论是,真正的安慰剂效应难以测量和控制,在临床护理研究中使用可靠的安慰剂有时不切实际。这导致研究人员更多地将常规护理用作对照。然而,在采用这种方法的研究中应报告更多信息,包括常规护理的具体说明、其监测情况以及患者的依从性。
在认为使用安慰剂符合伦理、安全且可行的情况下,疗效研究应设置安慰剂组,以区分活性治疗和非活性治疗。