Coping with Medically Unexplained Physical Symptoms: the Role of Illness Beliefs and Behaviors

Abstract Background: Increasingly, healthcare policies have changed focus from cure and care to behaviour and health. Prevention is becoming more important, which requires a change in the role of healthcare professionals. Healthcare professionals’ role is changing from being a therapist to taking on the role of a coach. To prevent chronicity in Medically Unexplained Physical Symptoms (MUPS), an integrated blended care program was developed. To apply this new program in daily practice, it is important to gain insight into the usability. From the healthcare professionals’ point of view the concept of usability consists of performance, satisfaction and acceptability. Methods: Data were collected from semi-structured interviews, which were recorded and transcribed. Data were analysed manually and independently by two researchers. Results: Ten healthcare professionals (six physical therapists and four mental health nurses) were interviewed. Six core themes on usability were identified: (1) selection and motivation of patients, (2) training and doing, (3) program procedure, (4) maturity of the e-Coaching application, 5) interprofessional collaboration and (6) expectations and experiences. Conclusion: An integrated blended care program offers the possibility to personalize treatment. This study gathered healthcare professionals’ experiences with and attitudes towards integrating healthcare and offering blended care programs. Findings show attention should be given to the new responsibilities of healthcare professionals, and their role in integrated and blended care. This new approach of delivering healthcare can facilitate interprofessional collaboration. Achieving sustainable change in patients however still requires instruction and support for healthcare professionals implementing behavioural change techniques. Trail registration: The study was approved by the Medical Ethical Committee Utrecht, by number 17/391. Registered 14 June 2017, https://www.metc-utrecht.nl/

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Opinion paper: the role of work in the management of medically unexplained physical symptoms

Acta Clinica Belgica ◽

10.1080/17843286.2018.1462754 ◽

2018 ◽

Vol 74 (3) ◽

pp. 151-156

Author(s):

Els Tobback ◽

An Mariman ◽

Lies Clauwaert ◽

Lode Godderis ◽

Stefan Heytens ◽

...

Keyword(s):

Physical Symptoms ◽

Medically Unexplained Physical Symptoms ◽

Medically Unexplained ◽

Unexplained Physical Symptoms

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Recognition of patients with medically unexplained physical symptoms by family physicians: results of a focus group study

BMC Family Practice ◽

10.1186/s12875-016-0451-x ◽

2016 ◽

Vol 17 (1) ◽

Cited By ~ 6

Author(s):

Madelon den Boeft ◽

Danielle Huisman ◽

Johannes C. van der Wouden ◽

Mattijs E. Numans ◽

Henriette E. van der Horst ◽

...

Keyword(s):

Focus Group ◽

Family Physicians ◽

Physical Symptoms ◽

Focus Group Study ◽

Medically Unexplained Physical Symptoms ◽

Medically Unexplained ◽

Unexplained Physical Symptoms

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Medically unexplained physical symptoms.

BMJ ◽

10.1136/bmj.304.6818.52-b ◽

1992 ◽

Vol 304 (6818) ◽

pp. 52-53 ◽

Cited By ~ 2

Author(s):

R. Jones

Keyword(s):

Physical Symptoms ◽

Medically Unexplained Physical Symptoms ◽

Medically Unexplained ◽

Unexplained Physical Symptoms

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Medically unexplained physical symptoms - a multidisciplinary approach

European Psychiatry ◽

10.1016/s0924-9338(11)73277-1 ◽

2011 ◽

Vol 26 (S2) ◽

pp. 1573-1573

Author(s):

V. Pais ◽

D. Correia ◽

F. Ramalho e Silva

Keyword(s):

Multidisciplinary Approach ◽

Somatoform Disorders ◽

Physical Symptoms ◽

Medically Unexplained Physical Symptoms ◽

Daily Work ◽

Medline Search ◽

Effective Interventions ◽

Medically Unexplained ◽

Unexplained Physical Symptoms

BackgroundMedically unexplained physical symptoms (MUPS) can be defined as physical symptoms that have no currently known physical pathological cause. MUPS account for one in five new consultations in primary care and for one third of new patients when neurology consultations are considered.Patients with MUPS present significant distress and impaired function and their diagnosis is sometimes hard to establish. The classification of somatoform disorders has been found to be insufficiently useful for therapeutic and scientific purposes. Some authors suggest that new classifications should attend to clinical utility, defined as (1) the extent to which a diagnosis can help clinicians understand or conceptualize a disorder in their daily work; (2) the extent to which a diagnosis can help the clinician communicate useful information to others, including practitioners, family members, patients, and administrators; (3) the extent to which the presence of a disorder helps the clinician choose effective interventions, and (4) the extent to which a disorder can predict future clinical management needs.AimThis review aims to discuss the management of MUPS in mental health services, attending to the importance of a multidisciplinary approach.MethodsPubmed Medline search on MUPS and review of recent literature.DiscussionThe management of MUPS implies a multidisciplinary approach that can offer different solutions for different degrees of disorder severity and takes into account the perception of the patient about his own illness. New classifications of somatoform disorders that include comprehensible explanations about these symptoms could be helpful for patients and health professionals.

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The Fish Can Sing by Halldór Laxness: Holding fast against vanity and illusion

BJPsych Advances ◽

10.1192/apt.bp.116.016675 ◽

2017 ◽

Vol 23 (6) ◽

pp. 428-430

Author(s):

David S. Baldwin

Keyword(s):

Alcohol Use ◽

Alcohol Use Disorders ◽

Nobel Laureate ◽

Physical Symptoms ◽

The Novel ◽

Medically Unexplained Physical Symptoms ◽

Celebrity Suicide ◽

Medically Unexplained ◽

Adaptive Resilience ◽

Unexplained Physical Symptoms

SummaryIn his early novels, the Icelandic Nobel laureate Halldór Laxness portrayed troubled individuals beset by familial, societal and economic challenges within an unpredictable and often unforgiving landscape; his later work addressed humanistic concerns regarding a well-lived life and the harmony of individual and environment. His 1957 novel The Fish Can Sing lies at the cusp of these preoccupations. Laxness contrasts the economic privations experienced by hard-pressed Icelanders with the ostentatious displays of their Danish colonial overloads; he also portrays individuals afflicted by psychosis, alcohol use disorders and medically unexplained physical symptoms, and delineates the path towards a ‘celebrity’ suicide. The novel warns against self-deceptive vanity and community-endorsed illusions, and celebrates the persistent benefits of nurturing relationships, all within a lyric contemplation of individual adaptive resilience and quotidian domestic pleasures.

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