Overcoming the barriers to the diagnosis and management of chronic fatigue syndrome/ME in primary care: a meta synthesis of qualitative studies.
| Autor: | Bayliss, Kerin, Goodall, Mark, Chisholm, Anna, Fordham, Beth, Chew-Graham, Carolyn, Riste, Lisa, Fisher, Louise, Lovell, Karina, Peters, Sarah, Wearden, Alison |
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| Předmět: |
CHRONIC fatigue syndrome diagnosis
ATTITUDE (Psychology) CHRONIC fatigue syndrome CINAHL database CURRICULUM ETHNIC groups HEALTH services accessibility PSYCHOLOGY information storage & retrieval systems MEDICAL personnel PATIENT-professional relations MEDICAL protocols STUDY & teaching of medicine MEDLINE MINORITIES ONLINE information services PRIMARY health care SYSTEMATIC reviews QUALITATIVE research THEMATIC analysis DISEASE prevalence HEALTH literacy META-synthesis SYMPTOMS PREVENTION |
| Zdroj: | BMC Family Practice; 2014, Vol. 15 Issue 1, p44-64, 21p, 1 Diagram, 1 Chart |
| Abstrakt: | Background: The NICE guideline for Chronic Fatigue Syndrome/ Myalgic Encephalomyelitis (CFS/ME) emphasises the need for an early diagnosis in primary care with management tailored to patient needs. However, GPs can be reluctant to make a diagnosis and are unsure how to manage people with the condition. Methods: A meta synthesis of published qualitative studies was conducted, producing a multi-perspective description of barriers to the diagnosis and management of CFS/ME, and the ways that some health professionals have been able to overcome them. Analysis provided second-order interpretation of the original findings and developed third-order constructs to provide recommendations for the medical curriculum. Results: Twenty one qualitative studies were identified. The literature shows that for over 20 years health professionals have reported a limited understanding of CFS/ME. Working within the framework of the biomedical model has also led some GPs to be sceptical about the existence of the condition. GPs who provide a diagnosis tend to have a broader, multifactorial, model of the condition and more positive attitudes towards CFS/ME. These GPs collaborate with patients to reach agreement on symptom management, and use their therapeutic skills to promote self care. Conclusions: In order to address barriers to the diagnosis and management of CFS/ME in primary care, the limitations of the biomedical model needs to be recognised. A more flexible bio-psychosocial approach is recommended where medical school training aims to equip practitioners with the skills needed to understand, support and manage patients and provide a pathway to refer for specialist input. [ABSTRACT FROM AUTHOR] |
| Databáze: | Complementary Index |
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