scholarly journals Patients’ descriptions of the relation between physical symptoms and negative emotions: a qualitative analysis of primary care consultations

2019 ◽  
Vol 70 (691) ◽  
pp. e78-e85 ◽  
Author(s):  
Ella Bekhuis ◽  
Janna Gol ◽  
Christopher Burton ◽  
Judith Rosmalen
Keyword(s):  
Primary Care ◽  
Qualitative Analysis ◽  
Negative Emotions ◽  
Management Strategies ◽  
Secondary Analysis ◽  
Physical Symptoms ◽  
Persistent Symptoms ◽  
Medically Unexplained ◽  
Care Guidelines ◽  
The Patient’S View

BackgroundPrimary care guidelines for the management of persistent, often ‘medically unexplained’, physical symptoms encourage GPs to discuss with patients how these symptoms relate to negative emotions. However, many GPs experience difficulties in reaching a shared understanding with patients.AimTo explore how patients with persistent symptoms describe their negative emotions in relation to their physical symptoms in primary care consultations, in order to help GPs recognise the patient’s starting points in such discussions.Design and settingA qualitative analysis of 47 audiorecorded extended primary care consultations with 15 patients with persistent physical symptoms.MethodThe types of relationships patients described between their physical symptoms and their negative emotions were categorised using content analysis. In a secondary analysis, the study explored whether patients made transitions between the types of relations they described through the course of the consultations.ResultsAll patients talked spontaneously about their negative emotions. Three main categories of relations between these emotions and physical symptoms were identified: separated (negation of a link between the two); connected (symptom and emotion are distinct entities that are connected); and inseparable (symptom and emotion are combined within a single entity). Some patients showed a transition between categories of relations during the intervention.ConclusionPatients describe different types of relations between physical symptoms and negative emotions in consultations. Physical symptoms can be attributed to emotions when patients introduce this link themselves, but this link tends to be denied when introduced by the GP. Awareness of the ways patients discuss these relations could help GPs to better understand the patient’s view and, in this way, collaboratively move towards constructive explanations and symptom management strategies.

scholarly journals Identifying Treatment Modalities for a Multidisciplinary and Blended Care Intervention for Patients With Moderate Medically Unexplained Physical Symptoms: Qualitative Study Among Professionals

10.2196/12203 ◽  
2019 ◽  
Vol 6 (4) ◽  
pp. e12203 ◽  
Author(s):  
Paula Elisabeth van Westrienen ◽  
Martijn F Pisters ◽  
Marloes Gerrits ◽  
Cindy Veenhof ◽  
Niek J de Wit
Keyword(s):  
Primary Care ◽  
Focus Groups ◽  
Physical Symptoms ◽  
Nominal Group ◽  
Treatment Modalities ◽  
Medically Unexplained Physical Symptoms ◽  
Care Intervention ◽  
Medically Unexplained ◽  
Unexplained Physical Symptoms ◽  
Blended Intervention

Background Medically unexplained physical symptoms (MUPS) are a substantial health problem in primary care with a high burden for patients, general practitioners, and the health care system. Most studies focus on chronic MUPS patients. Little research is conducted in patients with moderate MUPS, and an effective primary care intervention for prevention of chronic MUPS is lacking. Objective The objective of our study was to identify treatment modalities based on expert opinions for the development of a multidisciplinary and blended intervention for patients with moderate MUPS to prevent chronicity. Methods Two focus groups with 8 and 6 experts (general practitioners, physical therapists, psychologists, and mental health nurses) were carried out. The focus groups were structured using the nominal group technique. Results A total of 70 ideas were generated from two nominal group meetings, and 37 of these got votes, were included in the rank order, and were sorted into 8 separate themes. According to the participants, the most important treatment modalities for a multidisciplinary and blended intervention in patients with moderate MUPS were (1) coaching to a healthier lifestyle, (2) education regarding psychosocial factors, (3) therapeutic neuroscience education, (4) multidisciplinary intake, (5) multidisciplinary cooperation and coordination, (6) relaxation or body awareness exercises, (7) clear communication by professionals to the patient, and (8) graded activity. Five independent researchers checked the ideas and linked them to themes to confirm the content analysis and check the validity of the themes. Conclusions From professional expert perspectives, 8 themes should be included in a multidisciplinary and blended intervention to prevent chronicity. These themes provide a first step in developing an intervention for patients with moderate MUPS. Future research should focus on further development steps in which patients with moderate MUPS should be involved to determine if the intervention matches their needs.

scholarly journals Experts' opinions on the management of medically unexplained symptoms in primary care. A qualitative analysis of narrative reviews and scientific editorials

2011 ◽  
Vol 28 (4) ◽  
pp. 444-455 ◽  
Author(s):  
M. Heijmans ◽  
T. C. olde Hartman ◽  
E. van Weel-Baumgarten ◽  
C. Dowrick ◽  
P. L. B. J. Lucassen ◽  
...  
Keyword(s):  
Primary Care ◽  
Qualitative Analysis ◽  
Medically Unexplained Symptoms ◽  
Medically Unexplained ◽  
Unexplained Symptoms

Idiopathic Physical Symptoms: A Common Manifestation of Psychiatric Disorders in Primary Care

CNS Spectrums ◽  
2006 ◽  
Vol 11 (3) ◽  
pp. 201-210 ◽  
Author(s):  
Javier I. Escobar ◽  
Angelica Dìaz-Martínez ◽  
Michael Gara
Keyword(s):  
Primary Care ◽  
Mental Disorders ◽  
Psychiatric Disorders ◽  
Somatoform Disorders ◽  
Common Mental Disorders ◽  
Psychiatric Patients ◽  
Physical Symptoms ◽  
Medical Specialties ◽  
Assessment And Treatment ◽  
Medically Unexplained

ABSTRACTWorldwide, patients with common mental disorders, such as depression and anxiety, have a tendency to present first to primary care exhibiting idiopathic physical symptoms. Typically, these symptoms consist of pain and other physical complaints that remain medically unexplained. While in the past, traditional psychopathology emphasized the relevance of somatic presentations for disorders, such as depression, in the last few decades, the “somatic component” has been neglected in the assessment and treatment of psychiatric patients. Medical specialties have come up with a variety of “fashionable” labels to characterize these patients and the new psychiatric nomenclatures, such as the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, attempt to classify these patients into a separate “somatoform disorders” category. These efforts fall short, and revisionists are asking altogether for the elimination of “somatoform disorders” from future nomenclatures.This review emphasizes the importance of idiopathic physical symptoms to the clinical phenomenology of many psychiatric disorders, offers suggestions to the diagnostic conundrum, and provides some hints for the proper assessment and management of patients with these common syndromes.

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