Stuhlreyer Julia, Klinger Regine
Universitätsklinikum Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Deutschland.
Schmerz. 2022 Jun;36(3):157-165. doi: 10.1007/s00482-021-00575-0. Epub 2021 Aug 30.
Preoperative treatment expectations have a significant influence on postoperative pain and treatment outcomes. Positive expectations are an important mechanism of the placebo effect and negative expectations are an important mechanism of the nocebo effect.
What is the influence of treatment expectations, how are they assessed in the clinical setting, and how can the findings be implemented in clinical practice?
A literature search was performed using the keywords "expectation" AND ("postoperative" OR "surgery"). All English and German articles were selected. In addition, the bibliographies of the articles found were examined and incorporated.
A total of 158 articles were found, 49 of which investigate expectations and include postoperative treatment outcomes. Most articles investigate expectations only at baseline to ensure that groups do not differ preoperatively. The studies that prospectively examine the influence of expectations apply very different measurement methods to investigate expectancy constructs. Thus, comparison across studies is difficult. There are few studies examining whether and how expectations can be influenced perioperatively, and who developed practice-relevant interventions to change them.
Valid and reliable measurement tools should be applied in clinical trials for a more robust investigation of treatment expectations. Further studies should address possible intervention options so that treatment expectations can also be incorporated into standard clinical care.
术前治疗期望对术后疼痛和治疗结果有重大影响。积极期望是安慰剂效应的重要机制，消极期望是反安慰剂效应的重要机制。
治疗期望有何影响，在临床环境中如何评估它们，以及如何将这些发现应用于临床实践？
使用关键词“期望”以及（“术后”或“手术”）进行文献检索。所有英文和德文文章均被选中。此外，对所找到文章的参考文献进行了检查并纳入其中。
共找到158篇文章，其中49篇研究期望并包括术后治疗结果。大多数文章仅在基线时研究期望，以确保术前各组无差异。前瞻性研究期望影响的研究采用了非常不同的测量方法来研究期望结构。因此，跨研究比较很困难。很少有研究探讨期望在围手术期是否以及如何受到影响，以及谁开发了与实践相关的干预措施来改变期望。
在临床试验中应应用有效且可靠的测量工具，以便更有力地研究治疗期望。进一步的研究应探讨可能的干预选项，以便治疗期望也能纳入标准临床护理中。
