. 2022 Sep 27;12:16112. doi: 10.1038/s41598-022-19729-w

Table 2.

Nocebo information and empathy manipulations as used in the video vignettes.

Nocebo-information manipulation (nocebo explanation)	Empathy manipulations (reassurance of continuing support)
Oncologist: What not everyone knows is that side effects are not only caused by the medication itself. If people expect a side effect, have previously had a troubling side effect, or are anxious about that happening—all these things can make side effects worse. This has been shown by scientific research, so it’s not at all unusual for this to happen. Patient: Like you sometimes get a headache as soon as you read the information leaflet about certain medication? Oncologist: Yes, exactly—that’s a good example. And it doesn’t make the headache any less real or not as bad. Negative experiences, expectations, and anxieties can worsen physical reactions and side effects, such as headaches. Maybe knowing this will help make sure you suffer less from these side effects in the future. Or that you can cope better with them. And maybe this will be because you succeed in paying less attention to those side effects or because you are less anxious about them Patient: Ok. That’s good to know.	(Reassurance 1) Oncologist: I want you to know we will really look out for you, support and guide you throughout the chemotherapy process. And by ‘we’ I mean myself but also the entire team of breast-cancer nurses and doctors. (Reassurance 2) Oncologist: And please do know, whether it’s better or worse than anticipated, that you are not alone. We will take good care of you, the best possible care. (Reassurance 3) Oncologist: And once again: when you do start chemotherapy, if you run into any issues at all, you can always call us. Within or outside office hours.

Nocebo-information manipulation (nocebo explanation)

Empathy manipulations (reassurance of continuing support)

Oncologist: What not everyone knows is that side effects are not only caused by the medication itself. If people expect a side effect, have previously had a troubling side effect, or are anxious about that happening—all these things can make side effects worse. This has been shown by scientific research, so it’s not at all unusual for this to happen.

Patient: Like you sometimes get a headache as soon as you read the information leaflet about certain medication?

Oncologist: Yes, exactly—that’s a good example. And it doesn’t make the headache any less real or not as bad. Negative experiences, expectations, and anxieties can worsen physical reactions and side effects, such as headaches. Maybe knowing this will help make sure you suffer less from these side effects in the future. Or that you can cope better with them. And maybe this will be because you succeed in paying less attention to those side effects or because you are less anxious about them

Patient: Ok. That’s good to know.

(Reassurance 1)

Oncologist: I want you to know we will really look out for you, support and guide you throughout the chemotherapy process. And by ‘we’ I mean myself but also the entire team of breast-cancer nurses and doctors.

(Reassurance 2)

Oncologist: And please do know, whether it’s better or worse than anticipated, that you are not alone. We will take good care of you, the best possible care.

(Reassurance 3)

Oncologist: And once again: when you do start chemotherapy, if you run into any issues at all, you can always call us. Within or outside office hours.