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父母对儿童使用安慰剂的态度。

Parental Attitudes About Placebo Use in Children.

作者信息

Faria Vanda, Kossowsky Joe, Petkov Mike P, Kaptchuk Ted J, Kirsch Irving, Lebel Alyssa, Borsook David

机构信息

Center for Pain and the Brain, Department of Anesthesiology, Perioperative and Pain Medicine, Boston Children's Hospital, Harvard Medical School, Boston, MA; Department of Psychology, Uppsala University, Uppsala, Sweden; Program in Placebo Studies, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA.

Program in Placebo Studies, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA; Department of Anesthesiology, Perioperative and Pain Medicine, Boston Children's Hospital, Harvard Medical School, Boston, MA; Department of Clinical Psychology and Psychotherapy, University of Basel, Basel, Switzerland.

出版信息

J Pediatr. 2017 Feb;181:272-278.e10. doi: 10.1016/j.jpeds.2016.10.018. Epub 2016 Nov 15.

Abstract

OBJECTIVE

To assess parental attitudes regarding placebo use in pediatric randomized controlled trials and clinical care.

STUDY DESIGN

Parents with children under age 18 years living in the US completed and submitted an online survey between September and November 2014.

RESULTS

Among all 1300 participants, 1000 (76.9%; 538 mothers and 462 fathers) met the study inclusion criteria. The majority of surveyed parents considered the use of placebos acceptable in some pediatric care situations (86%) and some pediatric trials (91.5%), whereas only 5.7% of parents found the use of placebos in children always unacceptable. The clinical use of placebo was considered acceptable by a majority of parents for only 7 (mostly psychological) of the 17 conditions presented. Respondents' judgment about acceptability was influenced by the doctors' opinions about the therapeutic benefits of placebo treatment, the conditions for pediatric placebo use, transparency, safety, and purity of placebos.

CONCLUSION

Most surveyed parents accepted the idea of using placebos in pediatric trials and within the clinic for some conditions without the practice of deception and with the creation of guidelines for ethical and safe use. This study suggests a need to reconsider pediatric trial design and clinical therapy in the light of generally positive parental support of appropriate placebo use.

摘要

目的

评估家长对儿科随机对照试验和临床护理中使用安慰剂的态度。

研究设计

2014年9月至11月期间,居住在美国的有18岁以下子女的家长完成并提交了一项在线调查。

结果

在所有1300名参与者中,1000名(76.9%;538名母亲和462名父亲)符合研究纳入标准。大多数接受调查的家长认为在某些儿科护理情况(86%)和某些儿科试验(91.5%)中使用安慰剂是可以接受的,而只有5.7%的家长认为在儿童中使用安慰剂总是不可接受的。对于所列出的17种情况中的7种(大多为心理方面),大多数家长认为安慰剂的临床使用是可以接受的。受访者对可接受性的判断受到医生对安慰剂治疗的治疗益处、儿科安慰剂使用条件、透明度、安全性和安慰剂纯度的意见的影响。

结论

大多数接受调查的家长接受在儿科试验和临床中针对某些情况使用安慰剂的想法,前提是不进行欺骗行为,并制定道德和安全使用的指导原则。这项研究表明,鉴于家长对适当使用安慰剂普遍持积极支持态度,有必要重新考虑儿科试验设计和临床治疗。

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