Placebo use in clinical practice by nurses in an Iranian teaching hospital

Abstract

The present study was carried out to explore Iranian nurses' use of placebos in clinical practice and their knowledge and attitude towards its use. A cross-sectional, descriptive study was conducted using self-report questionnaires. All nurses working in a university hospital in Arak (n=342) were invited to participate in the study. Among 295 respondents, 221 (75%) reported that they had used at least one placebo within the past year and 179 (81%) told patients they were receiving actual medication. The most common reason and symptom for placebo use were after unjustified demand for medication and pain, respectively. Only 60 (20.33%) of the nurses believed that placebos should never be used. Results showed that most nurses in our study had used placebos and probably will continue to use them. Placebo use is viewed as ethically permissible among nurses. Some patients benefit from the placebos, but their use raises ethical questions. The role of placebo treatment, its mechanisms, and its ethics issues should be taught to nurses.

Placebo Effect of Saline in Pain Management: Compared Study with Hemodialysis and Non-hemodialysis Nurses' Experiences

“…Most of the others considered placebo use such as permitted if the experience in the department supports its efficiency (141, or 47.76%), or permitted if research supports its efficiency (91, or 30.84%). [20] In this study; 86.2% of hemodialysis nurses stated that their patients report pain relief and it had a therapeutic effect in 30 minutes after saline injection. In non-hemodialysis nurses, this ratio was found 68.6 percent.…”

“…[12] Baghcheghi and Koohestani (2011) found that 23.07% of the nurses use placebo once a week on average and 63.08% use placebo once in a month on average. [20] In this study, 21.7% of hemodialysis nurses were using placebo mostly and 77.6% of them always preferred placebo for pain management for the first step of analgesia.…”

Placebo disclosure does not result in negative changes in mood or attitudes towards health care or the provider

“…Despite these ethical concerns, the use of placebo treatment in clinical practice is common both internationally and across disciplines [21][22][23][24][25]. For example, 75% of nurses in Iran [21], 88% of general practitioners in Germany [24], and 50% of internists and rheumatologists in the United States [25] admit to the deceptive use of placebo treatment in clinical practice.…”

“…For example, 75% of nurses in Iran [21], 88% of general practitioners in Germany [24], and 50% of internists and rheumatologists in the United States [25] admit to the deceptive use of placebo treatment in clinical practice. Reasons for the use of placebo treatment by health care providers appear well intentioned and include calming the patient, as supplemental treatment, to control pain, and as a bridge to the next regular dosage of medication [26].…”

Contextual factors triggering placebo and nocebo effects in nursing practice: Findings from a national cross‐sectional study

“…In the nursing discipline, available studies have measured the perceived effectiveness of placebo as inert medication among rheumatology, haemodialysis and non‐haemodialysis nurses (Alaloul et al, ; Berthelot, Maugars, Abgrall, & Prost, ; Unver, Yildirim, & Unal, ); and also among the managerial (Nitzan & Lichtenberg, ) and clinical nurses (Baghcheghi & Koohestani, ) regarding their aptitudes in adopting placebo, mainly by using monocentric cross‐sectional surveys. Therefore, no large‐scale data have been published to date regarding the daily use of different CFs by nurses as well as their clinical decision process of implementation, such as in which conditions they are mostly effective and their ethical implications.…”