Placebo effect in disease treatment

Abstract

Placebo i placebo učinak oduvijek su prisutni u povijesti medicine, no kroz stoljeća nisu dobivali uvijek istu pažnju. Spomen placeba nalazimo u svih poznatih civilizacija još od rane antike. Dugo vremena između umjetnosti i znanosti, koncept placeba je u mnogim slučajevima povezan s velikim brojem mitova i pogrešnih shvaćanja, od kojih je najpopularniji onaj u kojem je placebo koristan samo u psihjatrijskim poremećajima, te da je to “onaj lijek” koji koristi liječnik kada nema ništa bolje za ponuditi (Jopling 2008). S razvojem moderne znanosti, sredinom prošlog stoljeća, postaje važan metodološki alat u klinički kontroliranim studijama, glavnom elementu medicine zasnovane na dokazima i zlatnom standardu za određivanje učinkovitosti novih terapija. Placebo učinak je promatran u različitih stanja bolesnika kao što su depresija, poremećaji spavanja, bol, Parkinsonova bolest kao i njegov utjecaj na imunološki i endokrini sustav (Bystad et al 2015). Bez obzira na način primjene, od placebo ultrazvuka do tretmana stresnih ulkusa, placebo kirurgije u liječenju osteoartritisa, te do tretmana bolova u leđima i placebo implantata u prevenciji simptoma menopauze, jedno je neupitno: placebo učinak je prisutan u radu liječnika. (Macedo et al 2003). Pristup koji bolesnika stavlja u središte zanimanja i doprinosi stvaranju povjerenja može pomoći aktivaciji placebo učinka pri čemu je najvažnija komunikacija između medicinskog osoblja i bolesnika. Poznavanje koncepta placebo učinka i njegove povijesti olakšava shvaćanje njegove uloge u radu svih koji sudjeluju u liječenju bolesti.Placebo and placebo effect have always been present throughout the entire history of medicine, however, they did not receive the equal amount of attention through the centuries. Placebo was a familiar term in all known civilisations ever since early classical period. Having been caught between popular art and science, placebo has been often connected with a large amount of myths and misrepresentations. The most popular misrepresentation is that placebo is only effective when utilised in pscyhiatric disorders, and that it is „the cure“ used by a doctor when he has nothing better to offer (Jopling 2008). With the development of modern science, in the middle of the last century, it became an important methodological tool for controlled clinical trials, the major element of evidence-based medicine and the golden standard for determining the effectiveness of new therapies. Placebo effect has been examined in various conditions, such as depression, sleep disorders, pain, Parkinson's disease as well as its effect on immunological and endocrine system (Bystad et al 2015). Regardless of the manner of its application, ranging from placebo ultrasound to the treatment of stress ulcuses, placebo surgery in treatment of osteoarthritis, to treating backpain and placebo implantants in the prevention of menopause symptoms, one thing is undeniably true: placebo effect is a present in the daily physicians' work (Macedo et al 2003). The approach that places the patient in the center of interest and contributes to the building of trust can aid the activation of placebo effect where the most important factor is the communication between medical staff and the patient. Familiarity with the concept of placebo effect and its history improves the understanding of its role in the work of everyone involved in disease treatment

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oai:zir.nsk.hr:mef_981Last time updated on 5/7/2019

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