De siste dagene har jeg lest to flotte innlegg om placebo. Det første her – The morality of magic kisses: Ethics and placebo in Physiotherapy – av Neil O’Connell. Idag fulgte bloggen Healthskills opp med posten – What do we do about placebo?. Som helsearbeider er dette god lesning….slik jeg ser det da 😉
So much of what we do as clinicians, particularly physical and occupational therapies, has a limited evidence base. At the same time, some of the ‘active ingredients’ that have been identified in ‘placebo’ are the very things we are taught to develop – like active listening, instilling positive expectations, helping people re-evaluate their situation. It’s incredibly difficult to disentangle the ‘active’ from the inactive components of the treatment.
Like Neil, I have concerns about encouraging, even inadvertently, any belief in a mystical, magical ingredient – chi anyone? I also have concerns about any intervention that suggests the need for an ongoing relationship with a clinician – six-weekly ‘adjustments’ sir? Or interventions that leave the power (or locus of control to be pedantic) with a gadget or device or substance that someone else needs to operate – three monthly infusions madam?
Les hele postene her: