<p>Investigating Knowledge, Attitude, and Beliefs Regarding Placebo Interventions in Clinical Practice: A Comparative Study of Nursing and Medical University Students</p>

Abstract

Background Placebo interventions are commonly used in medical practice for alleviating symptoms of illnesses. Placebo is considered a pseudo-medication and its use is debatable ethically, professionally, and legally. Despite that there is also a lack of evidence on understanding of placebo interventions among health profession students. Further, no previous studies have been conducted to investigate whether future nurses and physicians differ in their knowledge, attitudes, and beliefs regarding placebo intervention. Materials and Methods A comparative cross-sectional study was carried out for exploring knowledge, attitude, and beliefs about placebo interventions among a convenient sample of 187 medical and nursing students at King Saud bin Abdulaziz University for Health Sciences. Data were collected using a sociodemographic data sheet and a 32-item placebo knowledge, beliefs, and attitude scale, which was developed from the evidence-based literature. Validity and reliability were ensured through utilizing a panel of experts and internal consistency analysis. Results Overall mean participants’ knowledge score was 7.68±2.07 (out of 15). Nursing students showed significantly higher knowledge than medical students ( P =0.028). More nursing than medical students believed in the effectiveness of placebo ( P ˂0.001). Medical students had a stronger belief that the placebo effect is mental, while nursing students reported that it is both mental and physiologic ( P ˂0.006). Concerning placebo attitude, medical students significantly pointed out that it should generally be prohibited and should not be permitted unless research supports its use ( P ˂0.001). Both groups agreed that impure placebo intervention involves deception. Conclusion Participants’ overall placebo knowledge was low. Inconsistencies in attitude and beliefs were shown among students. Current study findings offered a unique opportunity to better study misunderstandings for placebo, which might open the gate for misuse and place patients at risk of deception. Additionally, study findings were imperative as a relevant evidence-based recommendation for nursing and medical educators could be achieved.

Placebo: a brief updated review

“…The medical use of placebos is under permanent debate, as it is considered an inert substance with no effect, and when a placebo effect occurs, it is thought to be an illusory perception. It has always been under suspicion as to whether or not it is ethically acceptable for clinical use outside of medical research (Bernstein et al 2020 ; Bayoumy et al 2020 ). There are authors (Maher et al 2021 ) who do not recommend the use of placebo in clinical practice because it does not provide any clear benefit, as well as being weak and erratic (as in case of pain and nausea) as reported in the aforementioned Cochrane review (Hróbjartsson and Gøtzsche 2010 ).…”

“…Due to the mistrust of prescribing an inert substance, placebo is not well accepted by doctors and nurses (Bernstein et al 2020 ; Haas et al 2022a , b ). A recent study conducted with medical and nursing students showed that more than 80% of participants either were unaware of it or believed it was unethical to use on patients (Bayoumy et al 2020 ). However, the reality is that placebo also encompasses substances with and without pharmacological activity, the so-called impure placebo, which are frequently prescribed in the clinic (Linde et al 2018 ).…”

Dental Researchers' Knowledge About Helsinki Ethical Principles At Mansoura University In Egypt

“…The knowledge level in this was higher than the level reported by Hadir et al (2011), who revealed an overall knowledge score of 40.2%. On the other hand, Bayoumy et al (2020) presented an overall participant mean knowledge score of 7.68. Moreover, Tarboush et al (2020) reported an understanding level of research ethics of 62%.…”

Placebo Studies and Patient Care: Where Are the Nurses?

“…In January 2021 we conducted a systematic literature search in PubMed using the terms “nursing,” “placebo effects,” and “education.” The search identified 178 results published in the last 10 years, of which only four papers were judged to be relevant. Of these, only one study (based in Saudi Arabia) compared the views of medical and nursing students on the placebo effect and found that nursing students had significantly higher knowledge of placebo effects and were more likely to believe in the effectiveness of placebos, compared with medical students ( 33 ).…”