Can nocebo information and empathy alleviate symptoms in advanced cancer?
Subtitle
An video-vignette study
Publication date
2023-03-23
Document type
Meeting Abstract
Author
Meijers, Maartje
Stouthard, Jacqueline
Evers, Andrea
Das, Enny
Plum, Nicole
Drooger, Elrike
Jansen, Sophie
Francke, Anneka
Van der Wall, Elsken
Dusseldorp, Elise
Organisational unit
ISSN
Series or journal
Patient Education and Counseling
Periodical volume
109
Periodical issue
Supplement
First page
82
Last page
82
Peer-reviewed
✅
Part of the university bibliography
✅
Abstract
Introduction
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 i) nocebo information about the (non)pharmacological origin of side effects, and ii) 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.
Methods
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.
Results
Anxiety was not influenced by empathy or information (Stai-state: p=.295; p=.390, VAS p=.399; p=.823). Information improved (specific) side-effect coping expectations (p<.01). Empathy improved side-effect intensity expectations (p<.01=specific; p<.05=non-specific/partial) and specific side-effect probability expectations(p<.01), and increased satisfaction, trust, and self-efficacy (p<.001). No mediating effects were found of anxiety on expectations.
Conclusion
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.
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 i) nocebo information about the (non)pharmacological origin of side effects, and ii) 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.
Methods
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.
Results
Anxiety was not influenced by empathy or information (Stai-state: p=.295; p=.390, VAS p=.399; p=.823). Information improved (specific) side-effect coping expectations (p<.01). Empathy improved side-effect intensity expectations (p<.01=specific; p<.05=non-specific/partial) and specific side-effect probability expectations(p<.01), and increased satisfaction, trust, and self-efficacy (p<.001). No mediating effects were found of anxiety on expectations.
Conclusion
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.
Version
Published version
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