Pushkar D Ju, Kasjan G R, Zhivul'ko A R, Popova A S
Urologiia. 2015 May-Jun(3):109-13.
Nocebo effect is the onset or exacerbation of unwanted symptoms (adverse reaction) as a reaction to medical treatment. The nocebo effect is very common both in clinical practice and in clinical trials. Medical practitioner's knowledge of the patient's predisposition to nocebo effects can affect the management strategy and building doctor-patient relationship. It allows prediction and prevention of nocebo effect, especially if the patient has negative clinical encounters in the past.There is a dilemma: to inform the patient about the side effects and complications of treatment, which may lead to the development of nocebo effect and adversely influence the patient health and treatment outcomes, or conceal the information, thus infringing the patient civil rights. Solving this contradiction and minimizing the risk of nocebo effect allows choosing the proper strategy of doctor-patient communication. It is important not to ignore the various psychological, medical and organizational measures aimed at improving the patient comfort in the course of treatment. This prevents the accumulation of negative treatment experiences and is the key to successful treatment and prevention of nocebo effect.
反安慰剂效应是指作为对医学治疗的一种反应,出现不良症状(不良反应)或使不良症状加重。反安慰剂效应在临床实践和临床试验中都非常常见。医生对患者产生反安慰剂效应倾向的了解会影响管理策略以及医患关系的建立。它有助于预测和预防反安慰剂效应,尤其是当患者过去有过负面临床经历时。存在一个两难困境:告知患者治疗的副作用和并发症,这可能会导致反安慰剂效应的产生并对患者健康和治疗结果产生不利影响,或者隐瞒信息,从而侵犯患者的公民权利。解决这一矛盾并将反安慰剂效应的风险降至最低,有助于选择合适的医患沟通策略。在治疗过程中,重视各种旨在提高患者舒适度的心理、医学和组织措施非常重要。这可以防止负面治疗经历的积累,是成功治疗和预防反安慰剂效应的关键。