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Yeung VWL. Enhancing placebo analgesia: Unravelling the powerful interplay of ownership and verbal suggestion. Eur J Pain 2024. [PMID: 38923640 DOI: 10.1002/ejp.2303] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Revised: 04/21/2024] [Accepted: 06/05/2024] [Indexed: 06/28/2024]
Abstract
BACKGROUND Placebo analgesic research demonstrates pain reduction after using a placebo analgesic. Recent studies have documented that sometimes possessing a placebo analgesic induces placebo analgesia. These prior studies used a 'cream' as the stimulus and proposed that the effect is driven by an expectancy of obtaining benefits from the owned analgesic. This paper examines three pivotal components of placebo analgesia: placebo form, ownership and expectancy induced by verbal suggestion. We investigate analgesic expectancy between cream versus oil form of placebo stimulus and systematically isolate the effects of ownership, verbal suggestion and their interaction, comparing with the effect of use, to decipher the dynamics of placebo analgesia. METHODS Study 1 (N = 46) evaluated analgesic expectancy between cream and oil. Study 2 (N = 119) exposed participants to a placebo analgesic oil and randomized them into PU (possess and use), PA (possess and anticipate), P (possess-only) or A (anticipate-only) conditions. Pain outcomes were assessed using a cold pressor test. Comparing PA and P conditions assessed the verbal suggestion effect, comparing PA and A conditions evaluated the possession effect, while comparing PU and PA conditions shed light on the use effect. RESULTS In Study 1, participants showed comparable analgesic expectancy for cream and oil. In Study 2, both PA and PU groups performed equally well, reporting higher pain threshold, F(3, 115) = 5.14, p = 0.002,η p 2 $$ {\eta}_p^2 $$ = 0.12; and a greater probability of persistent hand submersion than P and A groups, X2(3) = 8.06, p = 0.045. CONCLUSION The findings highlight the significance of integrating possession with expectancy to induce placebo analgesia, which has clinical implications. SIGNIFICANCE This study delves into the intricate dynamics of placebo analgesia, shedding light on the significant influence of ownership and verbal suggestion. Through a meticulous exploration of the relationship between ownership and expectancy induced by verbal suggestion, we propose novel avenues for enhancing placebo responses. This research has implications for clinical practice and pain management strategies, potentially revolutionizing approaches to pain relief and therapeutic outcomes. Our findings contribute to a paradigm shift in understanding placebo analgesia, emphasizing the pivotal interaction between ownership and verbal suggestion.
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Tastemel Ozturk T, Kanbur N, Ozmert EN, Gulhan B, Ozaltin F, Topaloglu R, Duzova A. Predictors for the use of herbal and dietary supplements in children and adolescents with kidney and urinary tract diseases. Eur J Pediatr 2021; 180:253-262. [PMID: 32761383 DOI: 10.1007/s00431-020-03757-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2020] [Revised: 07/21/2020] [Accepted: 07/27/2020] [Indexed: 10/23/2022]
Abstract
Complementary and alternative medicine are treatments administered alone or in combination with conventional medical treatments. Data on complementary and alternative medicine use in children with kidney and urinary tract diseases are limited. In this cross-sectional study, the frequency and preferred methods of complementary and alternative medicine use and factors associated with their use were evaluated in 201 patients (48% female; median age, 11 years; median disease duration, 5.1 years) with kidney and urinary tract diseases and 260 healthy (without chronic disease) controls. Data were collected through a questionnaire-based interview and patients' medical records. Herbal and dietary supplements, including fish oil, were the most commonly used complementary and alternative medicine agents in both groups. There was no difference in herbal and dietary supplement use between the groups when fish oil was excluded (29% vs. 28%; p = 0.88). Herbal and dietary supplements were mainly used to improve/mitigate renal disease (52%). Logistic regression analysis revealed that disease duration > 7 years (odds ratio (OR), 3.70; 95% confidence interval (CI), 1.48-9.20), current use of six or more drugs (OR, 5.6; 95% CI, 1.28-24.41), and recurrent urinary tract infection or nephrolithiasis (OR, 3.92; 95% CI, 1.02-15.09) were the independent risk factors for herbal and dietary supplement use, except fish oil. Middle socioeconomic status was associated with decreased herbal and dietary supplement use, except fish oil, compared with low socioeconomic status (OR, 0.30; 95% CI, 0.11-0.81). Herbal and dietary supplements were used by 78% patients, despite knowing that these products could have side effects; only 42% of the patients shared the information about herbal and dietary supplement use with their doctors.Conclusion: Herbal and dietary supplement use is frequent in children with kidney and urinary tract diseases. Educating health professionals regarding such use is mandatory for developing strategies to prevent critical consequences. What is Known: • Complementary and alternative medicine (CAM) practices are therapeutic approaches that do not have sufficient efficacy and safety evidence. • CAM is widely used in healthy children and in certain chronic diseases. What is New: • Herbal and dietary supplements (HDSs) were the most commonly used method in kidney and urinary tract diseases. • Duration of disease, number of drugs, and socioeconomic status are determinants of HDS use except fish oil.
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Affiliation(s)
- Tugba Tastemel Ozturk
- Division of Pediatric Nephrology, Hacettepe University Faculty of Medicine, Sihhiye, 06100, Ankara, Turkey
| | - Nuray Kanbur
- Division of Adolescent Medicine, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Elif Nursel Ozmert
- Division of Social & Developmental Pediatrics, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Bora Gulhan
- Division of Pediatric Nephrology, Hacettepe University Faculty of Medicine, Sihhiye, 06100, Ankara, Turkey
| | - Fatih Ozaltin
- Division of Pediatric Nephrology, Hacettepe University Faculty of Medicine, Sihhiye, 06100, Ankara, Turkey
| | - Rezan Topaloglu
- Division of Pediatric Nephrology, Hacettepe University Faculty of Medicine, Sihhiye, 06100, Ankara, Turkey
| | - Ali Duzova
- Division of Pediatric Nephrology, Hacettepe University Faculty of Medicine, Sihhiye, 06100, Ankara, Turkey.
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Kalaci O, Giangioppo S, Leung G, Radhakrishnan A, Fleischer E, Lyttle B, Price A, Radhakrishnan D. Complementary and alternative medicine use in children with asthma. Complement Ther Clin Pract 2019; 35:272-277. [PMID: 31003669 DOI: 10.1016/j.ctcp.2019.02.017] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2018] [Revised: 02/14/2019] [Accepted: 02/26/2019] [Indexed: 11/30/2022]
Abstract
PURPOSE To estimate the overall prevalence of complementary and alternative medicine and specific modalities used among children with asthma, identify predictors of use, and perceived positive or negative effects of therapies. RESULTS Of the 161 children enrolled in the study, 76.4% had ever used complementary and alternative medicine. Humidifiers, air purifiers, and multivitamins were the most common modalities used. Complementary and alternative medicine use in children was associated with family use, younger child age, and disease severity, indicated by recent asthma exacerbation. The majority of participants perceived benefit from their complementary and alternative medicine use, with very few reporting negative side effects. Only 36.7% of participants reported discussing their complementary and alternative medicine use with the asthma clinic healthcare team. CONCLUSIONS The prevalence of complementary and alternative medicine use in children with asthma is high, with the majority of families perceiving benefit from its use. This study offers clinicians a reference to inform families regarding the subjective helpfulness of various types of complementary and alternative medicine modalities that can facilitate the dialogue between health care professionals and families interested in complementary and alternative medicine use.
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Affiliation(s)
- Odion Kalaci
- Schulich School of Medicine and Dentistry, Western University, 1151 Richmond St, London, ON, N6A 5C1, Canada.
| | - Sandra Giangioppo
- Schulich School of Medicine and Dentistry, Western University, 1151 Richmond St, London, ON, N6A 5C1, Canada.
| | - Garvin Leung
- Faculty of Medicine at the University of Ottawa, Ottawa, ON, K1H 8M5, Canada.
| | - Arun Radhakrishnan
- Department of Family and Community Medicine, University of Toronto, 500 University Ave, Toronto, ON, M5G 1V7, Canada.
| | - Erin Fleischer
- Children's Hospital, London Health Sciences Centre, 800 Commissioners Road East, London, ON, N6A 5W9, Canada.
| | - Brian Lyttle
- Schulich School of Medicine and Dentistry, Western University, 1151 Richmond St, London, ON, N6A 5C1, Canada; Children's Hospital, London Health Sciences Centre, 800 Commissioners Road East, London, ON, N6A 5W9, Canada.
| | - April Price
- Schulich School of Medicine and Dentistry, Western University, 1151 Richmond St, London, ON, N6A 5C1, Canada; Children's Hospital, London Health Sciences Centre, 800 Commissioners Road East, London, ON, N6A 5W9, Canada.
| | - Dhenuka Radhakrishnan
- Schulich School of Medicine and Dentistry, Western University, 1151 Richmond St, London, ON, N6A 5C1, Canada; Children's Hospital, London Health Sciences Centre, 800 Commissioners Road East, London, ON, N6A 5W9, Canada.
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Ramdzan SN, Pinnock H, Liew SM, Sukri N, Salim H, Hanafi NS, Hussein N, Suhaimi J, Lee PY, Cheong AT, Ahad AM, Cunningham S, Khoo EM. Perceptions of complementary/alternative medicine use and influence on evidence-based asthma medicine adherence in Malaysian children. NPJ Prim Care Respir Med 2019; 29:5. [PMID: 30804340 PMCID: PMC6389881 DOI: 10.1038/s41533-019-0118-x] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2018] [Accepted: 01/29/2019] [Indexed: 02/06/2023] Open
Abstract
Complementary and alternative medicine (CAM) is widely used especially in Asia including for childhood asthma. The use of CAM could influence adherence to evidence-based (E-B) medicine. We explored the views of carers of Malaysian children with asthma regarding the use of CAM for childhood asthma, and its relationship with self-reported adherence to E-B medicine. We used a screening questionnaire to identify children diagnosed with asthma from seven suburban primary schools in Malaysia. Informed consent was obtained prior to the interviews. We conducted the interviews using a semi-structured topic guide in participants' preferred language (Malay, Mandarin, or Tamil). All interviews were audio-recorded, transcribed verbatim and coded using Nvivo. Analysis was performed thematically, informed by the Necessity-Concerns Framework. A total of 46 carers (16 Malays, 21 Indians, 9 Chinese) contributed to 12 focus groups and one individual interview. We categorised participants' as 'Non-CAM'; 'CAM'; or 'combination' user. Cultural practices and beliefs in the efficacy of CAM resulted in widespread use of CAM. Most carers used CAM as 'complementary' to E-B medicine. Concerns about dependence on or side effects of E-B treatment influenced carers' decisions to rely on CAM as an 'alternative', with an important minority of accounts describing potentially harmful CAM-use. Healthcare professionals should discuss beliefs about the necessity for and concerns about use of both E-B medicine and CAM, and provide balanced information about effectiveness and safety. The aim is to improve adherence to regular E-B preventer medication and prevent delays in seeking medical advice and harmful practices associated with CAM.
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Affiliation(s)
- Siti Nurkamilla Ramdzan
- Department of Primary Care Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia. .,NIHR Global Health Research Unit on Respiratory Health (RESPIRE), Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, UK.
| | - Hilary Pinnock
- NIHR Global Health Research Unit on Respiratory Health (RESPIRE), Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, UK
| | - Su May Liew
- Department of Primary Care Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Nursyuhada Sukri
- Department of Primary Care Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Hani Salim
- NIHR Global Health Research Unit on Respiratory Health (RESPIRE), Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, UK.,Universiti Putra Malaysia, Selangor, Malaysia
| | - Nik Sherina Hanafi
- Department of Primary Care Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Norita Hussein
- Department of Primary Care Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Julia Suhaimi
- Department of Primary Care Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | | | | | | | - Steve Cunningham
- NIHR Global Health Research Unit on Respiratory Health (RESPIRE), Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, UK
| | - Ee Ming Khoo
- Department of Primary Care Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
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Mammen J, Rhee H, Norton SA, Butz AM, Halterman JS, Arcoleo K. An integrated operational definition and conceptual model of asthma self-management in teens. J Asthma 2018; 55:1315-1327. [PMID: 29351005 PMCID: PMC6053334 DOI: 10.1080/02770903.2017.1418888] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2017] [Revised: 12/05/2017] [Accepted: 12/14/2017] [Indexed: 01/06/2023]
Abstract
OBJECTIVES A previous definition of adolescent asthma self-management was derived from interviews with clinicians/researchers and published literature; however, it did not incorporate perspectives of teens or parents. Therefore, we conducted in-depth interviews with teens and parents and synthesized present findings with the prior analysis to develop a more encompassing definition and model. METHODS Focal concepts were qualitatively extracted from 14-day self-management voice-diaries (n = 14) and 1-hour interviews (n = 42) with teens and parents (28 individuals) along with concepts found in the previous clinical/research oriented analysis. Conceptual structure and relationships were identified and key findings synthesized to develop a revised definition and model of adolescent asthma self-management. RESULTS There were two primary self-management constructs: processes of self-management and tasks of self-management. Self-management was defined as the iterative process of assessing, deciding, and responding to specific situations in order to achieve personally important outcomes. Clinically relevant asthma self-management tasks included monitoring asthma, managing active issues through pharmacologic and non-pharmacologic strategies, preventing future issues, and communicating with others as needed. Self-management processes were reciprocally influenced by intrapersonal factors (both cognitive and physical), interpersonal factors (family, social and physical environments), and personally relevant asthma and non-asthma outcomes. CONCLUSION This is the first definition of asthma self-management incorporating teen, parent, clinician, and researcher perspectives, which suggests that self-management processes and behaviors are influenced by individually variable personal and interpersonal factors, and are driven by personally important outcomes. Clinicians and researchers should investigate teens' symptom perceptions, medication beliefs, current approaches to symptom management, relevant outcomes, and personal priorities.
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Affiliation(s)
- Jennifer Mammen
- a University of Rochester School of Nursing, School of Nursing , Rochester , USA
| | - Hyekyun Rhee
- a University of Rochester School of Nursing, School of Nursing , Rochester , USA
| | - Sally A Norton
- a University of Rochester School of Nursing, School of Nursing , Rochester , USA
| | - Arlene M Butz
- b Johns Hopkins University, Pediatrics , Freeland , USA
| | - Jill S Halterman
- c University of Rochester School of Medicine and Dentistry, Pediatrics , Rochester , USA
| | - Kimberly Arcoleo
- a University of Rochester School of Nursing, School of Nursing , Rochester , USA
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Lartey G, Sturgeon LP, Garrett-Wright D, Kabir UY, Eagle S. A Survey of School Nurses' Perceptions of Complementary, Alternative, and Integrative Therapies. J Sch Nurs 2018; 35:256-261. [PMID: 29681230 DOI: 10.1177/1059840518770521] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
Complementary, alternative, and integrative therapies (CAIs) involve the use of practices outside of mainstream, conventional medicine. Few studies have been conducted on nurses' perception and knowledge of CAI therapies. There is limited information on the protocols school nurses must follow in their practice on CAI use. The purpose of this study is to assess school nurses' perception and knowledge of CAI therapies. A cross-sectional, nonexperimental survey study design was used, and participants were sampled with a cross-sectional convenience method. Members of four state School Nurses Associations were invited to participate in the study. Of the 290 participants, 100% of certified school nurses and 63% of non-certified school nurses believed CAI therapies have a place in their current practice (χ2 = 1.83, df = 1, p < .05). The study found that school nurses believe CAI therapies have a role in the school setting; however, the participants were not comfortable with assessing and administering these therapies.
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Affiliation(s)
- Grace Lartey
- 1 Western Kentucky University, Bowling Green, KY, USA
| | | | | | - Umar Y Kabir
- 1 Western Kentucky University, Bowling Green, KY, USA
| | - Susan Eagle
- 1 Western Kentucky University, Bowling Green, KY, USA
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Mammen JR, Rhee H, Norton SA, Butz AM. Perceptions and experiences underlying self-management and reporting of symptoms in teens with asthma. J Asthma 2017; 54:143-152. [PMID: 27337035 PMCID: PMC5182183 DOI: 10.1080/02770903.2016.1201835] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2016] [Revised: 06/08/2016] [Accepted: 06/09/2016] [Indexed: 01/01/2023]
Abstract
BACKGROUND Teens often have inadequate asthma self-management and control. However, little is known of their perceptions of or rationales for self-management behaviors. OBJECTIVES To explore how teens self-manage asthma, including experiences, perceptions, responses to and reporting of symptoms. METHODS A case-based, qualitative-descriptive design was used. Data were collected from minority and non-minority teens with controlled and uncontrolled asthma and their respective parents (N = 28). There were four data-collection points, including: (1) a primary teen interview; (2) parent interview; (3) 2-week self-management voice-diary; and (4) follow-up teen interview, incorporating symptom-response card-sorting to map symptoms and associated self-management responses. Seventy data sources were included in the analysis. RESULTS Teens thought of their asthma symptoms as normal or unusual relative to their personal baseline symptom pattern; Those with uncontrolled asthma normalized higher levels of asthma symptoms than their counterparts with controlled asthma. Second, teens' decisions to treat symptoms of asthma with rescue medication were based on perceived benefits, burdens and accessibility of treatment balanced against perceived normalcy of symptoms. Teens with uncontrolled asthma had substantially higher treatment thresholds and delayed responses to symptoms compared to controlled peers. Third, teens never reported perceived normal symptoms of asthma to parents or providers, who were thus only aware of unusual or visible/audible symptoms. CONCLUSIONS Teen's perceptions of symptoms and understanding of what is normal is the basis for self-management decisions. Improving self-management will likely entail modifying perceptions of symptoms and benefits/burdens of treatment to achieve healthier self-management patterns.
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Affiliation(s)
| | - Hyekyun Rhee
- a University of Rochester School of Nursing , Rochester , NY , USA
| | - Sally A Norton
- a University of Rochester School of Nursing , Rochester , NY , USA
| | - Arlene M Butz
- b Johns Hopkins University, School of Medicine , Baltimore , MD , USA
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