Possible alleviation of symptoms and side effects through clinicians' nocebo information and empathy in an experimental video vignette study

TY - JOUR

T1 - Possible alleviation of symptoms and side effects through clinicians' nocebo information and empathy in an experimental video vignette study

AU - Meijers, M C

AU - Stouthard, J

AU - Evers, A W M

AU - Das, E

AU - Drooger, H J

AU - Jansen, S J A J

AU - Francke, A L

AU - Plum, N

AU - van der Wall, E

AU - Nestoriuc, Y

AU - Dusseldorp, E

AU - van Vliet, L M

N1 - © 2022. The Author(s).

PY - 2022/9/27

Y1 - 2022/9/27

N2 - To alleviate anti-cancer treatment burden in advanced breast cancer, patient-clinician communication strategies based on nocebo-effect mechanisms are promising. We assessed distinct/combined effects on psychological outcomes (e.g. anxiety; main outcome) and side-effect expectations of (1) nocebo information about the (non)pharmacological origin of side effects, and (2) clinician-expressed empathy through reassurance of continuing support. Furthermore, we explored whether information and empathy effects on side-effect expectations were mediated by decreased anxiety. In a two-by-two experimental video-vignette design, 160 cancer patients/survivors and healthy women watched one of four videos differing in level of nocebo information (±) and empathy (±). Regression and mediation analysis were used to determine effects of information/empathy and explore anxiety's mediating role. Anxiety was not influenced by empathy or information (Stai-state: p = 0.295; p = 0.390, VAS p = 0.399; p = 0.823). Information improved (specific) side-effect coping expectations (p < 0.01). Empathy improved side-effect intensity expectations (p < 0.01 = specific; p < 0.05 = non-specific/partial) and specific side-effect probability expectations (p < 0.01), and increased satisfaction, trust, and self-efficacy (p < 0.001). No mediating effects were found of anxiety on expectations. Mainly empathy, but also nocebo information improved psychological outcomes and-mainly specific-side-effect expectations. Exploring the power of these communication elements in clinical practice is essential to diminish the anti-cancer treatment burden in advanced breast cancer.

AB - To alleviate anti-cancer treatment burden in advanced breast cancer, patient-clinician communication strategies based on nocebo-effect mechanisms are promising. We assessed distinct/combined effects on psychological outcomes (e.g. anxiety; main outcome) and side-effect expectations of (1) nocebo information about the (non)pharmacological origin of side effects, and (2) clinician-expressed empathy through reassurance of continuing support. Furthermore, we explored whether information and empathy effects on side-effect expectations were mediated by decreased anxiety. In a two-by-two experimental video-vignette design, 160 cancer patients/survivors and healthy women watched one of four videos differing in level of nocebo information (±) and empathy (±). Regression and mediation analysis were used to determine effects of information/empathy and explore anxiety's mediating role. Anxiety was not influenced by empathy or information (Stai-state: p = 0.295; p = 0.390, VAS p = 0.399; p = 0.823). Information improved (specific) side-effect coping expectations (p < 0.01). Empathy improved side-effect intensity expectations (p < 0.01 = specific; p < 0.05 = non-specific/partial) and specific side-effect probability expectations (p < 0.01), and increased satisfaction, trust, and self-efficacy (p < 0.001). No mediating effects were found of anxiety on expectations. Mainly empathy, but also nocebo information improved psychological outcomes and-mainly specific-side-effect expectations. Exploring the power of these communication elements in clinical practice is essential to diminish the anti-cancer treatment burden in advanced breast cancer.

KW - Breast Neoplasms/drug therapy

KW - Communication

KW - Drug-Related Side Effects and Adverse Reactions

KW - Empathy

KW - Female

KW - Humans

KW - Nocebo Effect

U2 - 10.1038/s41598-022-19729-w

DO - 10.1038/s41598-022-19729-w

M3 - SCORING: Journal article

C2 - 36167876

VL - 12

SP - 16112

JO - SCI REP-UK

JF - SCI REP-UK

SN - 2045-2322

IS - 1

ER -