Recent evidence suggests that how anaesthesia information is presented may influence patient treatment outcomes. We conducted an observational study of anaesthetic-based patient information leaflets across NHS Trusts in England for their nocebo terms vs. therapeutic terms, and how adverse effects were presented. In this study, ‘nocebo’ is wording that may predispose the patient to expect adverse events such as pain or nausea. Data were extracted and analysed for word frequency, weighted proportion and thematic analysis. In total, 42 patient information leaflets from 61 NHS Trusts were analysed. ‘Pain’ was the second most common word across the leaflets, median (IQR [range]) 0.82 (0.50–1.0 [0.12–1.47]) per 100 words, second only to ‘anaesthesia’. In comparison, ‘safe’ was the most common positively valanced word which featured eight times less frequently than ‘pain’ 0.10 (0.07–0.18 [0.0–0.84]) and ‘comfort’ featured 16.5 times less than ‘pain’ 0.02 (0.0–0.05 [0.0–0.13]). Multiple examples of phrasing that could have potential nocebo effects included, ‘you will need strong painkillers’ suggesting ‘strong pain’ and the need for ‘painkillers’ rather than using therapeutic terms focusing on ‘comfort’, ‘healing’ and ‘recovery’. Our results suggest a dominance of phrases with negative content in the presentation of anaesthesia information provided to patients. Clinicians need to be aware of inadvertent generation of nocebo-weighted vs. comfort-weighted communication with patients. Our study findings suggest an opportunity for more emphasis to be placed on therapeutic outcomes and effective mitigation strategies of anaesthesia risks to avoid potential unintended nocebo effects of anaesthesia information leaflets or websites.

中文翻译：

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麻醉患者书面信息中的 Nocebo 语言

最近的证据表明，麻醉信息的呈现方式可能会影响患者的治疗结果。我们对英格兰 NHS 信托基金中基于麻醉的患者信息传单进行了一项观察性研究，了解他们的反安慰剂术语与治疗术语，以及如何呈现不良反应。在这项研究中，“nocebo”是一种可能使患者容易发生诸如疼痛或恶心等不良事件的措辞。提取数据并分析词频、加权比例和主题分析。总共分析了来自 61 个 NHS 信托的 42 份患者信息传单。“疼痛”是传单中第二常见的词，中位数（IQR [范围]）每 100 个词为 0.82（0.50-1.0 [0.12-1.47]），仅次于“麻醉”。相比下，“安全”是最常见的正价词，其出现频率比“疼痛”0.10 (0.07–0.18 [0.0–0.84]) 低 8 倍，“舒适”比“疼痛”0.02 (0.0–0.05 [0.0]) 少 16.5 倍–0.13]）。可能具有潜在反安慰剂效应的多个措辞示例包括，“您将需要强效止痛药”暗示“强烈疼痛”和需要“止痛药”，而不是使用专注于“舒适”、“治愈”和“恢复”的治疗术语。我们的结果表明，在向患者提供的麻醉信息呈现中，具有负面内容的短语占主导地位。临床医生需要注意无意中产生的反安慰剂加权与舒适加权与患者的沟通。