Institute of Health and Care Sciences, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden;
Institute of Environmental Medicine, Karolinska Institutet, Solna, Sweden.
Int J Qual Stud Health Well-being. 2015 Apr 16;10:27191. doi: 10.3402/qhw.v10.27191. eCollection 2015.
Although research about medically unexplained symptoms (MUS) is extensive, problems still affect a large group of primary care patients. Most research seems to address the topic from a problem-oriented, medical perspective, and there is a lack of research addressing the topic from a perspective viewing the patient as a capable person with potential and resources to manage daily life. The aim of the present study is to describe and interpret the experiences of learning to live with MUS as narrated by patients in primary health-care settings.
A phenomenological-hermeneutic method was used. Narrative interviews were performed with ten patients suffering from MUS aged 24-61 years. Data were analysed in three steps: naive reading, structural analysis, and comprehensive understanding.
The findings revealed a learning process that is presented in two themes. The first, feeling that the symptoms overwhelm life, involved becoming restricted and dependent in daily life and losing the sense of self. The second, gaining insights and moving on, was based on subthemes describing the patients' search for explanations, learning to take care of oneself, as well as learning to accept and becoming mindful. The findings were reflected against Antonovsky's theory of sense of coherence and Kelly's personal construct theory. Possibilities and obstacles, on an individual as well as a structural level, for promoting patients' capacity and learning were illuminated.
Patients suffering from MUS constantly engage in a reflective process involving reasoning about and interpretation of their symptoms. Their efforts to describe their symptoms to healthcare professionals are part of this reflection and search for meaning. The role of healthcare professionals in the interpretative process should be acknowledged as a conventional and necessary care activity.
尽管对医学无法解释的症状（MUS）的研究已经很广泛，但仍有很大一部分初级保健患者存在问题。大多数研究似乎都从以问题为导向的医学角度来解决这个问题，而缺乏从以患者为有能力和资源来管理日常生活的人的角度来研究这个问题。本研究的目的是描述和解释初级保健环境中患有 MUS 的患者叙述的学习与 MUS 共存的经历。
采用现象学-解释学方法。对 10 名年龄在 24-61 岁的患有 MUS 的患者进行了叙事访谈。数据分三步进行分析：初步阅读、结构分析和全面理解。
研究结果揭示了一个学习过程，该过程表现为两个主题。第一个主题是“症状使生活不堪重负”，涉及日常生活中的限制和依赖，以及自我意识的丧失。第二个主题是“获得洞察力并继续前进”，基于描述患者寻求解释、学会照顾自己以及学会接受和保持正念的子主题。研究结果反映了 Antonovsky 的意义感理论和 Kelly 的个人建构理论。个体和结构层面上促进患者能力和学习的可能性和障碍都得到了阐明。
患有 MUS 的患者不断地进行涉及对症状进行推理和解释的反思过程。他们努力向医疗保健专业人员描述他们的症状是这种反思和寻求意义的一部分。医疗保健专业人员在解释过程中的作用应该被承认是一种常规和必要的护理活动。
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