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Available from: Jo Hart, Apr 04, 2014
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    ABSTRACT: There is growing evidence that early treatment with antiretroviral therapy (ART) confers benefit to HIV-infected persons and may reduce the risk of transmission. Among an urban poor sample living with HIV who meet guidelines for but are not taking ART, we explored treatment beliefs at baseline and subsequent ART uptake over the following 12 months. Most demographic/background characteristics did not differ between ART initiators and noninitiators, but baseline beliefs of expectancies about treatment ease, efficacy, and readiness sensitively predicted ART initiation. Treatment-related stigma/social concerns did not. Results offer direction for interventions to optimize treatment among those most in need.
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    ABSTRACT: Patients' affect and expectancies can set off placebo effects and thus impact patients' health. We assessed the relative effects of physicians' affect-oriented communication style and raising expectations on patients' affective state and outcome expectancies. Thirty healthy women presented severe menstrual pain in a scripted consultation with a general practitioner (GP). In a 2x2 randomized controlled trial, the GP communicated in a warm, empathic or cold, formal way and raised positive or uncertain expectations. Effects on subjects' state anxiety, affective state and outcome expectancies were assessed. Only warm, empathic communication combined with positive expectations led to a significant and relevant decrease in state anxiety. Subjects' positive and negative affects were influenced by GPs affect-oriented communication style. Negative affect and outcome expectancies are influenced by GP suggestions about outcomes. Manipulations in physicians' affect-oriented and expectancy-related communication can have a large impact on patients' affective state and outcome expectations. A combination of a warm, empathic communication style and raising positive expectations resulted in optimal subject outcomes. Physicians should take into account that communicating in warm, empathic way combined with raising positive expectations seems to lead to the most favorable effects on patients' state anxiety and outcome expectancies.
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    ABSTRACT: Placebo effects have an ambiguous reputation, as they are associated with sham treatment and deceit on the one hand and as interesting phenomena, which might be clinically relevant on the other. The goal of this paper is to demonstrate that placebo effects are relevant and can be used as an effective part of many treatments by using communication targeting placebo effect mechanisms. We examined the history of placebos and the placebo effect, addressing common misconceptions and disentangling ambiguities. We then reviewed whether the placebo effect can be robustly shown in the current literature, and zoomed in on the plausible mechanisms (conditioning, expectancies and affect manipulation) through which the placebo effect might be produced. Observing the link with the doctor-patient communication literature, and pleading for a better integration of the two research traditions we conclude by setting out a research agenda for testing the role of communication in placebo effects.
    Patient Education and Counseling 09/2010; 80(3):293-9. DOI:10.1016/j.pec.2010.05.033 · 2.60 Impact Factor