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- Title
Overcoming the barriers to the diagnosis and management of chronic fatigue syndrome/ME in primary care: a meta synthesis of qualitative studies.
- Authors
Bayliss, Kerin; Goodall, Mark; Chisholm, Anna; Fordham, Beth; Chew-Graham, Carolyn; Riste, Lisa; Fisher, Louise; Lovell, Karina; Peters, Sarah; Wearden, Alison
- Abstract
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.
- Subjects
UNITED Kingdom; UNITED States; 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
- Publication
BMC Family Practice, 2014, Vol 15, Issue 1, p44
- ISSN
1471-2296
- Publication type
Article
- DOI
10.1186/1471-2296-15-44