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The meaning of learning to live with medically unexplained symptoms as narrated by patients in primary care: a phenomenological-hermeneutic study.

Lidén E, Björk-Brämberg E, Svensson S - Int J Qual Stud Health Well-being (2015)

Bottom Line: Possibilities and obstacles, on an individual as well as a structural level, for promoting patients' capacity and learning were illuminated.Their efforts to describe their symptoms to healthcare professionals are part of this reflection and search for meaning.The role of healthcare professionals in the interpretative process should be acknowledged as a conventional and necessary care activity.

View Article: PubMed Central - PubMed

Affiliation: Institute of Health and Care Sciences, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; eva.liden@gu.se.

ABSTRACT

Background: Although research about medically unexplained symptoms (MUS) is extensive, problems still affect a large group of primary care patients. Most research seems to address the topic from a problem-oriented, medical perspective, and there is a lack of research addressing the topic from a perspective viewing the patient as a capable person with potential and resources to manage daily life. The aim of the present study is to describe and interpret the experiences of learning to live with MUS as narrated by patients in primary health-care settings.

Methods: A phenomenological-hermeneutic method was used. Narrative interviews were performed with ten patients suffering from MUS aged 24-61 years. Data were analysed in three steps: naive reading, structural analysis, and comprehensive understanding.

Findings: The findings revealed a learning process that is presented in two themes. The first, feeling that the symptoms overwhelm life, involved becoming restricted and dependent in daily life and losing the sense of self. The second, gaining insights and moving on, was based on subthemes describing the patients' search for explanations, learning to take care of oneself, as well as learning to accept and becoming mindful. The findings were reflected against Antonovsky's theory of sense of coherence and Kelly's personal construct theory. Possibilities and obstacles, on an individual as well as a structural level, for promoting patients' capacity and learning were illuminated.

Conclusions: Patients suffering from MUS constantly engage in a reflective process involving reasoning about and interpretation of their symptoms. Their efforts to describe their symptoms to healthcare professionals are part of this reflection and search for meaning. The role of healthcare professionals in the interpretative process should be acknowledged as a conventional and necessary care activity.

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Related in: MedlinePlus

Flowchart of the data collection process.
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Figure 0001: Flowchart of the data collection process.

Mentions: Potential participants were identified by screening incoming telephone calls from patients to the healthcare centre (identification carried out by SS). Patients deemed suitable were later contacted by one member of the research team (EL or EBB), who asked them if they would be willing to participate in the study. The request was formulated in everyday language: “I am part of a research group investigating how patients with symptoms for which there is no specific medical explanation manage their daily life. Would you be willing to participate in such a study?” A total of 20 patients agreed to participate in one or more of the studies in the SCPHC project. Most participants were recruited during the extensive data collection period between September and November 2011 (see flow chart in Fig. 1). In the present study, ten individuals (three men and seven women) aged 24 to 61, seven of whom had an immigrant background, agreed to participate.


The meaning of learning to live with medically unexplained symptoms as narrated by patients in primary care: a phenomenological-hermeneutic study.

Lidén E, Björk-Brämberg E, Svensson S - Int J Qual Stud Health Well-being (2015)

Flowchart of the data collection process.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4401824&req=5

Figure 0001: Flowchart of the data collection process.
Mentions: Potential participants were identified by screening incoming telephone calls from patients to the healthcare centre (identification carried out by SS). Patients deemed suitable were later contacted by one member of the research team (EL or EBB), who asked them if they would be willing to participate in the study. The request was formulated in everyday language: “I am part of a research group investigating how patients with symptoms for which there is no specific medical explanation manage their daily life. Would you be willing to participate in such a study?” A total of 20 patients agreed to participate in one or more of the studies in the SCPHC project. Most participants were recruited during the extensive data collection period between September and November 2011 (see flow chart in Fig. 1). In the present study, ten individuals (three men and seven women) aged 24 to 61, seven of whom had an immigrant background, agreed to participate.

Bottom Line: Possibilities and obstacles, on an individual as well as a structural level, for promoting patients' capacity and learning were illuminated.Their efforts to describe their symptoms to healthcare professionals are part of this reflection and search for meaning.The role of healthcare professionals in the interpretative process should be acknowledged as a conventional and necessary care activity.

View Article: PubMed Central - PubMed

Affiliation: Institute of Health and Care Sciences, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; eva.liden@gu.se.

ABSTRACT

Background: Although research about medically unexplained symptoms (MUS) is extensive, problems still affect a large group of primary care patients. Most research seems to address the topic from a problem-oriented, medical perspective, and there is a lack of research addressing the topic from a perspective viewing the patient as a capable person with potential and resources to manage daily life. The aim of the present study is to describe and interpret the experiences of learning to live with MUS as narrated by patients in primary health-care settings.

Methods: A phenomenological-hermeneutic method was used. Narrative interviews were performed with ten patients suffering from MUS aged 24-61 years. Data were analysed in three steps: naive reading, structural analysis, and comprehensive understanding.

Findings: The findings revealed a learning process that is presented in two themes. The first, feeling that the symptoms overwhelm life, involved becoming restricted and dependent in daily life and losing the sense of self. The second, gaining insights and moving on, was based on subthemes describing the patients' search for explanations, learning to take care of oneself, as well as learning to accept and becoming mindful. The findings were reflected against Antonovsky's theory of sense of coherence and Kelly's personal construct theory. Possibilities and obstacles, on an individual as well as a structural level, for promoting patients' capacity and learning were illuminated.

Conclusions: Patients suffering from MUS constantly engage in a reflective process involving reasoning about and interpretation of their symptoms. Their efforts to describe their symptoms to healthcare professionals are part of this reflection and search for meaning. The role of healthcare professionals in the interpretative process should be acknowledged as a conventional and necessary care activity.

Show MeSH
Related in: MedlinePlus