Patienten mit chronischen Schmerzen: Placebo- und Noceboeffekte kennen und nutzen

Zusammenfassung

Das Wissen um die Placeboanalgesie ist in den letzten Jahren stark gestiegen. Die dahinterliegenden Wirkmechanismen sind nachvollziehbar darstellbar und können zur Steigerung der Placeboreaktionen in allen aktiven Schmerzbehandlungen genutzt werden. Im Zentrum steht die Erwartung des Patienten, die über Lernprozesse und Instruktionen gezielt beeinflusst werden kann, sowohl in positiver Richtung (Placeboreaktion) als auch negativer Richtung (Noceboreaktion). In der Gesprächsführung können diese Prinzipien berücksichtigt werden, um die Erwartung in Bezug auf ein Behandlungsergebnis zu optimieren und negative Kognitionen zu reduzieren.

Abstract

In recent years, the knowledge behind placebo analgesia has strongly increased. The underlying mechanisms are depictable in a comprehensive way. They can be used to enhance placebo responses in all active pain treatments. Expectations of the patient are pivotal and can be influenced specifically by learning processes and instructions, both in the positive direction (placebo response), as well as in the negative direction (nocebo response). In conversations, these principles can be considered to optimize the expectation with respect to treatment outcome and to reduce negative cognitions.

Schlüsselwörter

Placebo - Nocebo - Gesprächstechniken - Analgetika - chronischer Schmerz

Keywords

placebo - nocebo - dialogue techniques - analgetics - chronic pain

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