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患有无法用医学解释的躯体症状是怎样的体验?一项定性元分析综述。

What is it like to live with medically unexplained physical symptoms? A qualitative meta-summary.

机构信息

Faculty of Social Studies, Department of Psychology, Masaryk University, Brno, Czech Republic.

出版信息

Psychol Health. 2022 May;37(5):580-596. doi: 10.1080/08870446.2021.1901900. Epub 2021 Apr 19.

Abstract

Medically unexplained physical symptoms (MUPS) are a frequent phenomenon. Understanding adults and adolescents' lived experience with MUPS is essential for providing adequate care, yet a rigorous synthesis of existing studies is missing. This study aimed to summarize findings from primary qualitative studies focused on adults' and adolescents' experience of living with MUPS. Qualitative studies were searched in the PsycINFO, PsycARTICLES, and Medline databases and manually. A total of 23 resources met the inclusion criteria and were subjected to a qualitative meta-summary. Eight themes were found across the set of primary studies, namely, the need to feel understood, struggling with isolation, 'sense of self' in strain, facing uncertainty, searching for explanations, ambivalence about diagnosis, disappointed by healthcare, and active coping. The eight themes represent the core struggles adults' and adolescents' with MUPS face in their lives, psychologically and socially. Although these themes appear to be universal, the analysis also revealed considerable variability of experience in terms of expectations from healthcare professionals, attitude towards formal diagnoses, ability to cope with the illness, or potential to transform the illness experience into personal growth. Addressing this diversity of needs represents a significant challenge for the healthcare system.

摘要

未明原因的躯体症状是一种常见现象。了解成年人和青少年经历未明原因躯体症状的体验对于提供充分的医疗照护至关重要,但目前缺乏对现有研究的严格综合分析。本研究旨在总结聚焦于成年人和青少年经历未明原因躯体症状的主要定性研究的结果。在 PsycINFO、PsycARTICLES 和 Medline 数据库中进行了定性研究检索,并进行了人工检索。共有 23 项资源符合纳入标准,并进行了定性元分析。在这组主要研究中发现了 8 个主题,即需要被理解、与孤立作斗争、“自我感”的紧张、面对不确定性、寻找解释、对诊断的矛盾态度、对医疗保健的失望以及积极应对。这 8 个主题代表了成年人和青少年在生活中面临的与未明原因躯体症状相关的核心心理和社会困扰。尽管这些主题似乎是普遍存在的,但分析也显示出在从医疗保健专业人员那里获得的期望、对正式诊断的态度、应对疾病的能力或将疾病经历转化为个人成长的潜力方面存在相当大的体验差异。满足这种多样性的需求对医疗保健系统来说是一个重大挑战。

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