Phillips L Alison, McAndrew Lisa M
Department of Psychology, Iowa State University, Ames, USA.
War Related Illness and Injury Study Center (WRIISC), Veterans Affairs New Jersey Healthcare System, East Orange, USA.
Couns Psychol. 2019 Jul 1;47(5):770-795. doi: 10.1177/0011000019890317.
Medically unexplained symptoms (MUS) are common among veterans and are difficult to treat. Optimal treatment entails continued care from providers, including primary care and counseling psychologists. Non-concordance between veterans' and providers' views of MUS may contribute to poor veteran satisfaction with care and possibly disengagement with care (e.g., non-adherence to treatment recommendations, including counseling and graded exercise). The current study surveyed 243 veterans with MUS post-deployment and evaluated the degree of non-concordance perceived by veterans with their primary care providers regarding their MUS and the effect of perceived non-concordance on treatment behaviors and outcomes. Many veterans in the current sample perceived non-concordance with their provider regarding their MUS (19% reporting quite a bit or complete disagreement). Perceived non-concordance (regarding MUS overall and specific causal perceptions) predicted important outcomes of interest, particularly veterans' satisfaction with their provider. Perceived concordance with primary care doctors may be required for sufficient adherence to MUS treatment recommendations, such as seeking and maintaining psychological counseling. Research should evaluate the effect of perceived concordance with the counseling psychologist on adherence to and outcomes from counseling for MUS.
医学上无法解释的症状（MUS）在退伍军人中很常见，且难以治疗。最佳治疗需要医护人员持续提供护理，包括初级护理和咨询心理学家。退伍军人与医护人员对MUS的看法不一致，可能导致退伍军人对护理的满意度较低，并可能导致他们不再接受护理（例如，不遵守治疗建议，包括咨询和分级运动）。本研究对243名部署后出现MUS的退伍军人进行了调查，评估了退伍军人认为自己与初级护理提供者在MUS方面的不一致程度，以及这种感知到的不一致对治疗行为和结果的影响。在当前样本中，许多退伍军人认为自己与提供者在MUS方面存在不一致（19%的人表示有很大分歧或完全不同意）。感知到的不一致（总体上关于MUS以及特定的因果认知）预测了感兴趣的重要结果，特别是退伍军人对提供者的满意度。为了充分遵守MUS治疗建议，如寻求并持续接受心理咨询，可能需要与初级护理医生达成共识。研究应评估与咨询心理学家达成共识对MUS咨询的依从性和结果的影响。
