Dataset Information

Patients' experiences with fluctuations in persistent physical symptoms: a qualitative study.

ABSTRACT:

Objectives

To explore patients' experiences with fluctuations in persistent physical symptoms (PPS) and to understand which factors-from their viewpoint-play a role in these fluctuations.

Design

Qualitative study using semistructured interviews and thematic content analysis.

Setting

This qualitative study is part of a multicentre prospective cohort study on the course of PPS. Patients were recruited in general practices and specialised treatment facilities for PPS throughout the Netherlands.

Participants

Interviews were conducted with a sample of fifteen patients with PPS to explore their experiences with fluctuations in symptom severity.

Results

We identified three themes in the analysis: (1) patterns in symptom fluctuations (2) perceived causes of symptom exacerbations and (3) Patients' strategies in gaining control over symptom exacerbations. Daily and weekly fluctuations in symptoms were an important element in patients' experiences. In particular anticipating on the worsening of symptoms impacted their daily routines and posed various challenges. Symptom exacerbations were attributed to overstepping physical limits and/or the impact of negative emotions. Resigning to physical limits, adjusting ones daily planning, weighing personal needs and learning to say 'no' were described as different strategies in gaining control over symptom exacerbations.

Conclusions

Fluctuations in the severity of symptoms-and in particular daily and weekly symptom exacerbations-are an important element of the symptom experience in patients with PPS and poses various challenges. Patients attributed symptom exacerbation to overstepping physical limits and/or negative emotions. Patients described different strategies in gaining control over symptom exacerbations.

SUBMITTER: Barends H

PROVIDER: S-EPMC7359057 | biostudies-literature | 2020 Jul

REPOSITORIES: biostudies-literature

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Publications

Patients' experiences with fluctuations in persistent physical symptoms: a qualitative study.

Barends Hieke H Walstock Ella E Botman Femke F de Kruif Anja A Claassen Nikki N van der Wouden Johannes C JC Olde Hartman Tim T Dekker Joost J van der Horst Henriette H

BMJ open 20200713 7

<h4>Objectives</h4>To explore patients' experiences with fluctuations in persistent physical symptoms (PPS) and to understand which factors-from their viewpoint-play a role in these fluctuations.<h4>Design</h4>Qualitative study using semistructured interviews and thematic content analysis.<h4>Setting</h4>This qualitative study is part of a multicentre prospective cohort study on the course of PPS. Patients were recruited in general practices and specialised treatment facilities for PPS throughou ...[more]

PMID: 32665345

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Project description:ObjectivesTo explore the perceived working mechanisms of psychosomatic therapy according to patients with persistent somatic symptoms (PSS) and their psychosomatic therapists.DesignQualitative study using semistructured face-to-face interviews and focus groups. All interviews were audiorecorded, transcribed verbatim and analysed, by two researchers independently, based on the thematic analysis.SettingAlongside a randomised controlled trial to establish the (cost-)effectiveness of psychosomatic therapy in patients with PSS in primary care, we conducted a process evaluation with a qualitative study. Patients were recruited in general practice in three regions in the Netherlands.ParticipantsInterviews were conducted with twenty patients with PSS who received psychosomatic therapy and 25 psychosomatic therapists. In addition, two focus groups were conducted with six and seven psychosomatic therapists, respectively.InterventionPsychosomatic therapy, delivered by specialised exercise and physical therapists, is a multimodal and tailored treatment based on the biopsychosocial model.Outcome measuresExperiences, opinions and views from patients' and therapists' perspective on psychosomatic therapy were identified.ResultsA total of 37 interviews with patients, 25 interviews and two focus groups with therapists were analysed. Three main themes emerged from the data of the patients: (1) continuous alternation of psychosocial conversations and body-oriented exercises; (2) awareness of body-mind connection and (3) good relationship with therapist. Four main themes emerged from the data of the therapists (1) building rapport; (2) continuously searching for common ground; (3) making patients aware of the interaction between body and mind; and (4) continuous alternation between exploration and treatment.ConclusionAccording to patients as well as therapists, the continuous alternation of psychosocial conversations and body-oriented exercises to provide awareness of the interaction between body and mind are the perceived working mechanism of psychosomatic therapy. Therapeutic alliance and finding common ground between patient and therapist are prerequisites for the success of psychosomatic therapy.Trial registration numberNL7157 (NTR7356).

Dataset Information

Patients' experiences with fluctuations in persistent physical symptoms: a qualitative study.

Objectives

Design

Setting

Participants

Results

Conclusions

Publications

Patients' experiences with fluctuations in persistent physical symptoms: a qualitative study.

Similar Datasets

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