An effective way to reduce negative experiences such as stress, anxiety, and pain in hospitalized children is by implementing placebo applications. A placebo application is a procedure without...Show moreAn effective way to reduce negative experiences such as stress, anxiety, and pain in hospitalized children is by implementing placebo applications. A placebo application is a procedure without active elements that can elicit a positive treatment outcome. Despite its beneficial outcomes placebo applications are not frequently used in pediatric healthcare. Gaining insights in the opinions of healthcare providers on placebo applications will help to understand why placebo applications are not used frequently and offer suggestions to optimize usage. The aim of this cross-sectional observational study was to investigate whether the healthcare provider characteristics optimism, anxiety, and knowledge on placebos were associated with their opinions on the effectiveness, acceptability, and utilization of placebo applications. A differentiation is made between treatment-enhancing (e.g. music, Virtual Reality, comfort talk) and treatment-replacing (e.g. open treatment without active elements) placebo applications. Through an online questionnaire, data was collected from 121 healthcare providers (106 female, 15 male). Being more optimistic was negatively correlated with being less anxious (r = -0.43, p < 0.001). Multiple regression analyses showed that having more knowledge was associated with finding placebos applications more effective (β = 0.23, p = 0.012) and acceptable (β = 0.29, p = 0.001), but not with a higher utilization of placebo applications (p = 0.096). No significant associations were found of the amount of optimism and anxiety of healthcare providers with the opinions and use of placebo applications. Treatment-enhancing placebos applications were considered significantly more effective, acceptable, and utilized more often than treatment-replacing placebos (p-values < 0.001). The results of this study imply that more knowledge of placebos is associated with more positive opinions on placebo applications. The positive opinions and higher use of treatment-enhancing placebo applications indicate that implementing these in pediatric care is within reach. In this study, the reluctance to use placebos in pediatric care can be explained by the common assumption that placebo applications always replace the treatment, not knowing about the treatment-enhancing placebos that can be useful and ethically sound. It is recommended to offer education on treatment-enhancing and open treatment-replacing applications to examine if this increases use in pediatric care.Show less
Research master thesis | Psychology (research) (MSc)
closed access
Background: Between 10-15% of women have a pathological fear of childbirth. An expectation of fear might contribute to an actual fearful childbirth experience, which is known as a nocebo effect....Show moreBackground: Between 10-15% of women have a pathological fear of childbirth. An expectation of fear might contribute to an actual fearful childbirth experience, which is known as a nocebo effect. Likewise, positive thoughts about childbirth may lead to positive experiences, known as a placebo effect. Negative expectations surrounding childbirth mainly occurs in women who are known with anxiety and depression. As a result of these negative expectations, women could have a prolonged labor and obstetric complications which can evoke traumatic symptoms. The purpose of this study was to research whether there is a predictive association between positive or negative expectations surrounding childbirth and the experience of childbirth and whether this differs in women with or without psychiatric problems. This is relevant because most research on women’s expectations of childbirth are focused on fear of childbirth and its potential impact in medical aspects, whereas in this study the focus is on a broader expectation base, including positive expectations and also the subjective experience of childbirth. Methods: In this prospective study we included in total 150 women from both the Psychiatric Obstetric Pediatric (POP) outpatient clinics, a clinic for pregnant women with psychiatric vulnerability, and the general obstetric clinic, between January 2020 and January 2022. All participants filled in the Wijma Delivery Expectancy (version A at T1) and Experience (version B at T2) questionnaire after providing an informed consent. Also, all participants filled in the Hospital Anxiety and Depression scale (HADS) and the PTSS checklist for DSM-5 (PCL-5), to evaluate current psychiatric complaints. Results: The expectation surrounding childbirth was a significant predictor for the childbirth experience after controlling for parity and pain relief, p <.001, whereas positive expectations are related to a positive childbirth experience (placebo effect) and negative expectations are related to a negative childbirth experience (nocebo effect). This was not different for women with or without psychiatric problems, p =.841. Conclusions: Women’s negative and positive expectations of childbirth are related to the childbirth experience, showing indications for both a nocebo and placebo effect. These results can be important for future experimental research to see whether changing the expectation of childbirth in a positive way, could improve the experience of childbirth.Show less
Behandelversterkende en behandel-vervangende placebotoepassingen kunnen ingezet worden voor zowel acute als chronische aandoeningen bij volwassenen en kinderen. Behandelversterkende...Show moreBehandelversterkende en behandel-vervangende placebotoepassingen kunnen ingezet worden voor zowel acute als chronische aandoeningen bij volwassenen en kinderen. Behandelversterkende placebotoepassingen versterken een lopende medische behandeling terwijl behandel-vervangend een placebotoepassing is een op zichzelf staande behandeling. Om placebotoepassingen in te zetten in de pediatrische zorg is het belangrijk om te onderzoeken hoe ouders en zorgverleners tegenover placebotoepassingen staan. Ondanks een algemene positieve attitude is er nog weinig kennis over de acceptatie van placebotoepassingen onder ouders en zorgverleners en mogelijke verschillen tussen acute en chronische aandoeningen en behandelversterkende tegenover behandel-vervangende placebotoepassingen. In deze thesis is het verschil in acceptatie onderzocht van placebotoepassingen onder ouders en zorgverleners tussen pediatrische patiënten met een acute of chronische aandoening. Van 178 participanten waren er 28 ouders en 150 zorgverleners. Het onderzoek had een cross-sectioneel observationeel design. Bij geen van de acht placebotoepassingen was een verschil in acceptatie tussen acute en chronische aandoeningen. Onder zorgverleners werd de behandelversterkende (t(125) = -3.655, p < .001) en de behandel-vervangende (t(121) = -8.724, p < .001) placebotoepassing meer geaccepteerd voor chronische aandoeningen. Tot slot bleek dat er een significant verschil was tussen de acceptatie aan het begin en aan het eind van de vragenlijst bij zowel ouders als zorgverleners (t(19) = -2.949, p = .004; t(120) = -4.534, p < .001). Als er een vorm van misleiding gebruikt wordt bij de placebotoepassingen kan dit samengaan met een lagere acceptatie terwijl meer informatie over concrete placebotoepassingen samengaat met een hogere acceptatie van het inzetten ervan in de ziekenhuiszorg voor kinderen.Show less
Placebo applications could be a positive addition next to regular treatment in the pediatric health care. Previous studies have mainly focused on placebo applications as a replacement of regular...Show morePlacebo applications could be a positive addition next to regular treatment in the pediatric health care. Previous studies have mainly focused on placebo applications as a replacement of regular treatment and focus on adults despite the promising results for using placebo effects in pediatric care. Pediatric health care professionals and parents’ knowledge and opinions about the use of placebo applications could be related to placebo use in pediatric healthcare. To examine differences in and associations between placebo knowledge and expected effectiveness of potential placebo applications between healthcare professions and parents, an online questionnaire was used in 150 pediatric health care professionals and 28 parents of children who have undergone a medical procedure or treatment in the past year. Professionals had more knowledge about placebo effects than parents (t(176 =3.146, p =.002), and a higher expected effectivity, (t(147)=3.59, p<.001) of placebo effects than parents. More knowledge about placebo effects was associated with higher expected effectivity in both groups, which did not significantly differ between the two groups (z=1.79, p=.073, r(127)=.18, p=.047 (professionals), r(18)=.57, p=.009 (parents). The current study showed that knowledge and opinions on placebo effects are lower in parents than healthcare professions but are related in both groups. Future research could examine whether educating pediatric healthcare professionals and parents on placebo effects in child healthcare leads to more favorable opinions about placebo applications in pediatric care, allowing a larger use of non-invasive optimization strategies within child healthcare.Show less
Placebo-toepassingen in de pediatrie zijn schaars onderzocht en de kijk daarop vanuit zorgverleners is een belangrijke invalshoek. In deze studie is onderzocht welke kenmerken van placebo...Show morePlacebo-toepassingen in de pediatrie zijn schaars onderzocht en de kijk daarop vanuit zorgverleners is een belangrijke invalshoek. In deze studie is onderzocht welke kenmerken van placebo-toepassingen (behandelversterkend/behandelvervangend), het ziektebeeld (acuut/chronisch, oncologisch/cardiologisch/migraine), het kind (leeftijd en sekse) en de zorgverlener (kennis en gebruik van placebo-toepassingen) samenhangen met de acceptatie door drie typen zorgverleners (artsen/verpleegkundigen/medisch psychologen) van placebo-toepassingen in de medische pediatrische zorg. Een online vragenlijst is afgenomen onder 62 pediatrisch zorgverleners. De placebo-kennis van de zorgverleners was groot (M = 6.31; SD = 0.71), met een hogere kennis bij artsen dan verpleegkundigen (p = .04). De typen zorgverleners verschilden niet (p-waarden ≥ .07) in hun gemiddeld hoge acceptabiliteit (M = 8.23; SD = 1.09) en gebruik (M = 7.42; SD = 1.77) van behandelversterkende placebo-toepassingen. Bij een relatief laag gemiddeld gebruik van behandelvervangende placebo-toepassingen (M =2.23; SD = 2.63) gebruikten psychologen dit meer dan artsen (p = .04). Voor geen van de zorgverleners hing placebo-kennis en gebruik van placebo-toepassingen samen met acceptabiliteit (p-waarden ≥ .11). Behandelversterkende placebo-toepassingen werden voor alle ziekte- en kindkenmerken acceptabeler gevonden dan behandelvervangende placebo-toepassingen (p-waardes < .001). Placebo-toepassingen werden als acceptabeler gezien voor chronische versus acute patiënten (p < .001), migraine versus oncologische/cardiologische aandoening (p < .001) en meisjes versus jongens (p = .01). Concluderend laten deze voorlopige data in een kleine steekproef zorgverleners zien dat het type placebo-toepassing en ziekte- en kindkenmerken een verschil kunnen maken in acceptabiliteit. In vervolgonderzoek zou de redenatie van de zorgverleners achter dit verschil in acceptabiliteit kunnen worden onderzocht.Show less
