Titel: Warum wirken Placebos ohne Täuschung? Erklärungsansätze und Erfahrungen von Studienteilnehmerinnen mit menopausalen Hitzewallungen
Sprache: Deutsch
Autor*in: Frank, Miriam Lea
Erscheinungsdatum: 2021
Tag der mündlichen Prüfung: 2022-08-08
The purpose of this work was to gain a better understanding of the subjective experiences of women with menopausal hot flushes, as well as the mechanisms of open label placebo. Proposed mechanisms in the literature to date have included expectations, hopes, conditioning, desire for relief, social learning, uncertainty, predictive error processing, and the doctor-patient relationship (Price and Vase, 2013, Schedlowski et al., 2015, Charlesworth et al., 2017). In addition, to better understand the relationship between individual presumed mechanisms of action, qualitative interviews were conducted with seven women from the main study on "OLP for hot flushes during menopause." Interpretative Phenomenological Analysis was selected as the method of choice to be able to ask questions in as much depth as possible and to keep the interview guide flexible with leading questions. In the analysis of the seven interviews, it was found that low expectations were expressed by all women at the beginning of the study, as well as, in contrast, strong hopes for the study and the effect of OLP. Conditioning may have played a minor role, as almost all women had previous negative experiences with treatments for hot flushes. Two novel aspects in considering the mechanisms of OLP were the uncertainty and associated neutral basic attitude toward the study described by the women, and the sense of activity and positive change resulting from study participation. At this point, the model of predictive error processing could apply, as a constant comparison of the actual and target state, based on curiosity and simultaneous uncertainty towards the study possibly took place. This may have led to the increased perception of positive signals from the body and associated new expectations of OLP. In particular, women's perceptions of hot flushes changed as a result of study participation, leading to enhanced self-esteem and increased self-efficacy among participants. It remains to be seen whether a specific OLP personality is a condition for the efficacy of openlabel placebo and to what extent OLP might improve other menopausal symptoms. Similarly, the effect in healthy subjects without acute symptoms is possible but has not been studied in this context. While the doctor-patient relationship seems to be beneficial, it is not a condition for the efficacy of OLP. Without knowledge of the exact mechanism of action of OLP, its use in clinical practice is not yet foreseeable, but OLP may offer an adjunct to existing treatment options or alternative for menopausal women suffering from severe hot flushes.
URL: https://ediss.sub.uni-hamburg.de/handle/ediss/9804
URN: urn:nbn:de:gbv:18-ediss-103055
Dokumenttyp: Dissertation
Betreuer*in: Pan, Yiqi
Enthalten in den Sammlungen:Elektronische Dissertationen und Habilitationen

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