Bellman Val, Zolnikov Tara Rava
School of Behavioral Sciences, California Southern University, Chandler, USA.
Department of Psychiatry, University of Missouri Kansas City School of Medicine, Kansas City, USA.
Cureus. 2022 Dec 25;14(12):e32915. doi: 10.7759/cureus.32915. eCollection 2022 Dec.
Medically unexplained symptoms (MUS) is an umbrella term used for chronic and often disabling health symptoms and conditions that remain unexplained after standard medical examinations, testing, and/or appropriate workup. Patients with MUS tend to receive little to no treatment but remain distressed, stigmatized, and disabled by symptoms and iatrogenic factors.
A qualitative phenomenological study was conducted to explore daily challenges and psychosocial and iatrogenic factors affecting the management of MUS.
The analysis of the interviews revealed that MUS could cause significant distress to patients, impairing their functioning and leading to permanent disability. Conventional healthcare cannot meet the medical needs of these patients and might be a potential source of harm to them. It should be noted that confirmation of conditions associated with clinically significant psychiatric premorbidity was not provided.
Inconsistent diagnostic criteria, lack of proper training and research, diagnostic overshadowing, and implicit bias in healthcare professionals can lead to negative patient outcomes and the overuse of alternative or non-evidence-based services. Guidance, practice-based improvement ideas, and suggestions specific to improving patient-provider relationships can be applied to generate positive health effects.
医学上无法解释的症状(MUS)是一个统称,用于描述那些在经过标准医学检查、检测和/或适当的检查后仍无法解释的慢性且常常导致功能障碍的健康症状和病症。患有医学上无法解释的症状的患者往往很少或根本得不到治疗,但仍会因症状和医源性因素而感到痛苦、受到污名化并出现功能障碍。
开展了一项质性现象学研究,以探讨影响医学上无法解释的症状管理的日常挑战以及心理社会和医源性因素。
对访谈的分析表明,医学上无法解释的症状会给患者带来极大痛苦,损害其功能并导致永久性残疾。传统医疗保健无法满足这些患者的医疗需求,可能对他们造成潜在伤害。需要注意的是,文中未提供与具有临床显著意义的精神疾病前期相关病症的确认信息。
诊断标准不一致、缺乏适当培训和研究、诊断遮蔽以及医疗保健专业人员的隐性偏见可能导致患者出现负面结果,并过度使用替代或非循证服务。可应用相关指导、基于实践的改进思路以及改善医患关系的具体建议来产生积极的健康效果。