Have you ever heard of “The Nocebo Effect?“
The nocebo effect is a pervasive problem that occurs when features of a treatment context elicit adverse health reactions. Reference
We often emphasize the importance of good communication with our patients. On the other hand, negative language can have a detrimental impact on care outcomes.
Numerous research studies have demonstrated that improper use of language can have a negative impact on clinical outcomes…and here’s yet another study about this topic: Negative language use of the physiotherapist in low back pain education impacts anxiety and illness beliefs: A randomised controlled trial in healthy respondents
Some of the take-home points provided by the authors include:
- Negative communication has an effect on state anxiety and illness beliefs in the recipient of the message.
- Nocebo communication (e.g., vague descriptions, negative language) resulted in higher state anxiety.
- Nocebo communication led to higher rates of concerns, and the belief that complaints would last longer.
- Nocebo communications led participants to believe that the treatment would be more successful.
Here’s a Summary of the Research from Our Point of View
This is the first study we’ve found that indicates that the use of negative language, when educating patients about their lower back pain, had an effect on the recipients’ levels of anxiety and their views about their condition. The participants who saw the educational video with the nocebo communication exhibited a greater state anxiety compared to those who watched the control video with positive or neutral messages.
The participants’ perceptions of their illnesses also differed, with those in the nocebo condition reporting higher rates of worry and a perception that their ailments would last for a longer period of time.
Previous research on the relationship between negative language usage, negative expectancies, and nocebo effects has found that these findings are consistent with those findings.
An Unusual Result of Nocebo Communication was Discovered
Surprisingly, the authors also discovered that participants who provided with the negative or nocebo video presentation thought that their treatment would be more successful. (“To what extent do you believe that your therapy can assist with your illness?”) It’s possible that individuals in the nocebo group just thought they needed more treatment than they actually did.
Interestingly, these findings demonstrated that even in those who do not currently have back pain, relatively little communication is needed for pain-free individuals to develop negative views regarding LBP. When considered in conjunction with data from other studies indicating that nocebo effects have the potential to increase care seeking, pain, and bad outcomes, this provides significant cause for concern and calls for more inquiry.
In addition, once such expectations have been accepted as certain, it is difficult to reverse them.
It’s Imperative that You Consider Proper Use of Language When Treating Your Patients
The findings of this study need to serve as motivation for physiotherapists (and all other healthcare personnel) to refrain from using language that is negative expectancy-enhancing toward their patients during consultations and treatment.
There is a lack of understanding and awareness among physical therapists regarding the environmental elements that affect musculoskeletal illnesses and their use in therapy.
Musculoskeletal problems are frequently and traditionally defined using negative phrases. Understanding the impact of positive and negative language is likely to result in better patient outcomes – the results that we are looking for when treating all of our patients.
Let this Research by Your Motivation to Improve Your Communication Skills
If it is your desire to learn more about how communication can positively affect your treatment outcomes, we encourage you to contact us to learn more about our educational offerings.