De placebo-effecten van goede communicatie

• Good communication is important for patients and can elicit placebo effects: true psychobiological effects not attributable to the medical-technical intervention.
• It is, however, often unclear which communication behaviours influence specific patient outcomes.
• In this article we present insights into the potential effect of specific communication, via specific mechanisms, on specific patient outcomes, including patients’ perception of pain.
• A recent systematic review and additional literature demonstrate that (a) manipulating patients’ expectations, (b) demonstrating empathy, and (c) providing procedural information, might influence patient outcomes.
• These placebo effects probably occur via (a) neurobiological responses comparable to the effects of pain medication, (b) reduction of anxiety and stress, and (c) increased feelings of self-efficacy (feelings of control and knowing what is going to happen).
• More research is needed into the effects of specific communication, including, for example, in the clinical setting, and into possible harmful effects.

Conflict of interest and financial support: this article was written as part of the programme for the Spinoza Prize, awarded to J. M. Bensing by the NWO (Netherlands Organisation for Scientific Research).