Walstock, E.R. (Ella) (2020) Patients’ perspective on fluctuations in the course of Medically Unexplained Symptoms: a qualitative study. thesis, Medicine.
Full text available on request.Abstract
Background: Medically Unexplained Symptoms (MUS) are highly prevalent. A large section of the patients report clinically significant fluctuations in de severity of the symptoms in previous research. The aim of this study was to acquire an overview of how MUS-patients experience the course of their symptoms, with a special focus on fluctuations in severity and factors of importance they identify when it comes to these fluctuations. Methods: This explorative study is part of the PROSPECTS-study, a prospective cohort study, which aims to assess the course and prognosis of MUS. We conducted semi-structured interviews. Some of the interviewees had reported clinically relevant fluctuations in symptom severity and/or mental and physical functioning. In comparison we purposively selected participants who seemed stable on one, two or all three. All interviews were transcribed and analyzed according to an approach based on thematic analysis, using Atlas.ti. Results: All patients reported a certain level of fluctuation, some throughout the day, others during the week or in the long term. We identified three themes of relevance with regard to the course of symptoms: boundaries, recognition and gaining self-control. Most of the patients experienced a marked increase of symptoms when crossing their boundaries, resulting in a continuous search for balance. Lack of recognition by their surroundings resulted in patients crossing their boundaries over and over again. When it comes to physicians, patients experienced little support and guidance. Conclusion: Patients are in a continuous search for balance, a balance between their aims and abilities, between pushing their bounds but not crossing them. Patients mostly established a connection between crossing boundaries and worsening of symptoms on their own, after all kinds of unavailing diagnostics tests and therapy. Patients then started to focus more on functioning on their own. Physicians should provide more guidance and support in this process, offer more specific advice and offer treatments that focus on functioning rather than curing.
| Item Type: | Thesis (Thesis) |
|---|---|
| Supervisor name: | Facultair begeleider: and Burger, H. and Huisartsgeneeskunde en Ouderengeneeskunde, UMCG |
| Supervisor name: | Tweede begeleider: and Barends, H. and Huisartsgeneeskunde Amsterdam UMC, locatie VUMC |
| Faculty: | Medical Sciences |
| Date Deposited: | 25 Jun 2020 10:48 |
| Last Modified: | 25 Jun 2020 10:48 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/903 |
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