The use of placebo and non-specific therapies and their relation to basic professional attitudes and the use of complementary therapies among German physicians--a cross-sectional survey.
The use of placebo and non-specific therapies and their relation to basic professional attitudes and the use of complementary therapies among German physicians--a cross-sectional survey.
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DOI：
10.1371/journal.pone.0092938
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发表时间：
2014
期刊：
影响因子：
3.7
通讯作者：
Schneider A
中科院分区：
文献类型：
--
作者：
Linde K;Friedrichs C;Alscher A;Wagenpfeil S;Meissner K;Schneider A
我们的目的是调查在德国私人诊所工作的医生使用安慰剂（如生理盐水注射）和非特异性治疗（如维生素补充剂在没有相关缺陷的个人），以及这种使用如何与补充和替代治疗的信念和使用，以及基本的专业态度。一份四页的调查问卷被发送到全国范围内随机抽样的全科医生（GP），内科医生和骨科医生在私人执业。回复率为46%（2018年的935份）。24%的全科医生，44%的内科医生和57%的骨科医生在过去12个月内既没有使用纯安慰剂也没有使用非特异性治疗。11%的全科医生、12%的内科医生和7%的骨科医生仅使用纯安慰剂;分别有30%、33%和26%的人仅使用非特异性治疗; 35%、12%和9%的人两种治疗都使用。年龄、性别和同意医生应利用安慰剂效应的声明与任何使用模式均无显著相关。纯安慰剂的独家使用与全科医生、内科医生和非正统专业观点有关。除了这三个因素，CAM治疗的使用率较低和希望有更多的时间与非特异性治疗的专门使用有关。在同时使用纯安慰剂和非特异性治疗的医生中，非正统观点也更为明显。然而，在这一组中，GP（比值比11.6（95%CI 6.41; 21.3））和正统观点（比值比0.10（95%CI 0.06; 0.18））的相关性特别强。总之，安慰剂和非特异性治疗的使用在医学专业之间存在很大差异，并且与基本的专业态度有关。研究结果支持这样一种观点，即使用安慰剂，特别是非特异性治疗，主要是一种应对困难和不确定情况的行为。
We aimed to investigate the use of placebos (e.g. saline injections) and non-specific treatments (e.g. vitamin supplements in individuals without a relevant deficiency) among physicians working in private practices in Germany, and how such use is associated with the belief in and the use of complementary and alternative treatments, and basic professional attitudes. A four-page questionnaire was sent to nationwide random samples of general practitioners (GP), internists and orthopaedists working in private practices. The response rate was 46% (935 of 2018). 24% of GPs, 44% of internists and 57% of orthopaedists had neither used pure placebos nor non-specific therapies in the previous 12 months. 11% percent of GPs, 12% of internists and 7% of orthopaedists had exclusively used pure placebos; 30%, 33% and 26%, respectively, had exclusively used non-specific therapies; 35%, 12% and 9% had used both. Age, sex and agreement to the statement that physicians should harness placebo effects were not significantly associated with any pattern of use. Exclusive use of pure placebos was associated with being a GP, being an internist, and having unorthodox professional views. In addition to these three factors, a lower use of CAM therapies and a wish for having more time was associated with the exclusive use of non-specific therapies. Among physicians using both pure placebo and non-specific therapies, heterodox views were also somewhat more pronounced. However, associations were particularly strong for being a GP (Odds ratio 11.6 (95%CI 6.41; 21.3)) and having orthodox views (Odds ratio 0.10 (95%CI 0.06; 0.18)) among this group. In conclusion, the use of placebos and non-specific treatments varies strongly between medical specialties and is associated with basic professional attitudes. The findings support the view that the use of placebos and, in particular, of non-specific therapies is primarily a coping behaviour for difficult and uncertain situations.
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影响因子：
2.2
作者：
Meissner, Karin;Hoefner, Lisa;Linde, Klaus
通讯作者：
Linde, Klaus
影响因子：
3.7
作者：
Howick J;Bishop FL;Heneghan C;Wolstenholme J;Stevens S;Hobbs FD;Lewith G
通讯作者：
Lewith G
影响因子：
105.7
作者：
Tilburt, Jon C.;Emanuel, Ezekiel J.;Kaptchuk, Ted J.;Curlin, Farr A.;Miller, Franklin G.
通讯作者：
Miller, Franklin G.
影响因子：
2.8
作者：
Fässler M;Gnädinger M;Rosemann T;Biller-Andorno N
通讯作者：
Biller-Andorno N
影响因子：
5.4
作者：
SCHWARTZ, RK;SOUMERAI, SB;AVORN, J
通讯作者：
AVORN, J