Bialosky Joel E, Robinson Michael E
Department of Physical Therapy, Center for Pain Research and Behavioral Health, University of Florida, Brooks-PHHP Research Collaboration, Gainesville, FL, USA.
Department of Clinical and Health Psychology, Center for Pain Research and Behavioral Health, University of Florida, Gainesville, FL, USA.
J Man Manip Ther. 2017 Jul;25(3):151-159. doi: 10.1080/10669817.2017.1298699. Epub 2017 Mar 9.
: The purposes of this study were to (1) determine whether disclosure of having received a placebo treatment following participation in a randomized manual therapy trial resulted in changes in negative mood or attitudes towards health care and the provider and (2) examine the association between changes in mood or attitude and changes in clinical outcomes over the two-week study period. : Participants with low back pain ( = 110) were randomly assigned to receive a spinal manipulative therapy (SMT), a standard placebo SMT in which participants were aware of a chance of receiving a placebo, an enhanced placebo SMT in which participants were instructed 'the manual therapy technique you will receive has been shown to significantly reduce low back pain in some people,' or no treatment. Outcomes included pain (Numeric Rating Scale), disability (Oswestry Disability Index), and negative mood and attitudes towards health care and the provider (visual analog scales). Pain and disability were obtained at baseline and two weeks. Mood and attitude measures were assessed at baseline, at the start of the final session, and upon completion of the final session following disclosure of group assignment. : Disclosure of having received a placebo treatment was not associated with worsening of mood or attitudes towards health care or the provider ( > 0.05). A small, but significant ( < 0.05) association was observed between two-week changes in disability and immediate changes in mood ( = 0.31-0.36) upon disclosure of having received a placebo. This analysis indicates an association between larger improvements in disability and more positive changes in mood. : Placebo treatment use in clinical practice is common yet controversial due to the deceptive nature. Our findings suggest disclosure of having received a placebo treatment is not associated with adverse changes in negative mood or attitudes towards health care or the provider.
(1)确定在参与一项随机手法治疗试验后披露接受了安慰剂治疗是否会导致负面情绪或对医疗保健及提供者的态度发生变化;(2)研究在为期两周的研究期间情绪或态度的变化与临床结果变化之间的关联。:腰痛患者(n = 110)被随机分配接受脊柱推拿治疗(SMT)、参与者知晓有可能接受安慰剂的标准安慰剂SMT、被告知“你将接受的手法治疗技术已被证明在某些人身上能显著减轻腰痛”的强化安慰剂SMT或不接受治疗。结果包括疼痛(数字评定量表)、残疾(奥斯威斯残疾指数)以及对医疗保健和提供者的负面情绪及态度(视觉模拟量表)。在基线和两周时获取疼痛和残疾情况。在基线、最后一次治疗开始时以及在披露分组情况后的最后一次治疗结束时评估情绪和态度指标。:披露接受了安慰剂治疗与情绪恶化或对医疗保健或提供者的态度恶化无关(P>0.05)。在披露接受安慰剂治疗后,观察到残疾情况的两周变化与情绪的即刻变化之间存在小但显著(P<0.05)的关联(r = 0.31 - 0.36)。该分析表明残疾改善越大与情绪更积极变化之间存在关联。:由于其欺骗性,安慰剂治疗在临床实践中的使用很常见但存在争议。我们的研究结果表明,披露接受了安慰剂治疗与负面情绪或对医疗保健或提供者的态度的不良变化无关。