Interdisciplinary Center Psychopathology and Emotion Regulation, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
Department of Primary and Community Care, Radboud University Medical Center, Donders Institute for Brain Cognition and Behaviour, Nijmegen, The Netherlands.
Fam Pract. 2020 Feb 19;37(1):124-130. doi: 10.1093/fampra/cmz032.
General practice is the centre of care for patients with medically unexplained symptoms (MUS). Providing explanations for MUS, i.e. making sense of symptoms, is considered to be an important part of care for MUS patients. However, little is known how general practitioners (GPs) do this in daily practice.
This study aimed to explore how GPs explain MUS to their patients during daily general practice consultations.
A thematic content analysis was performed of how GPs explained MUS to their patients based on 39 general practice consultations involving patients with MUS.
GP provided explanations in nearly all consultations with MUS patients. Seven categories of explanation components emerged from the data: defining symptoms, stating causality, mentioning contributing factors, describing mechanisms, excluding explanations, discussing the severity of symptoms and normalizing symptoms. No pattern of how GPs constructed explanations with the various categories was observed. In general, explanations were communicated as a possibility and in a patient-specific way; however, they were not very detailed.
Although explanations for MUS are provided in most MUS consultations, there seems room for improving the explanations given in these consultations. Further studies on the effectiveness of explanations and on the interaction between patients and GP in constructing these explanations are required in order to make MUS explanations more suitable in daily primary care practice.
全科医学是患有无法解释的医学症状（MUS）患者护理的中心。为 MUS 患者提供解释，即理解症状，被认为是 MUS 患者护理的重要组成部分。然而，对于全科医生（GP）在日常实践中如何做到这一点，我们知之甚少。
本研究旨在探讨全科医生在日常全科医疗咨询中如何向 MUS 患者解释 MUS。
对 39 次涉及 MUS 患者的全科医疗咨询中全科医生向患者解释 MUS 的方式进行了主题内容分析。
全科医生在几乎所有与 MUS 患者的咨询中都提供了解释。从数据中出现了七类解释组成部分：定义症状、说明因果关系、提及促成因素、描述机制、排除解释、讨论症状严重程度和使症状正常化。没有观察到全科医生如何用各种类别构建解释的模式。一般来说，解释是以一种可能性并以患者特异性的方式传达的；然而，它们不是很详细。
尽管在大多数 MUS 咨询中都提供了 MUS 的解释，但似乎还有改进这些咨询中提供的解释的空间。为了使 MUS 解释在日常初级保健实践中更适用，需要进一步研究解释的有效性以及患者和 GP 在构建这些解释方面的相互作用。
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