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医疗保健在支持与压力相关的疲惫障碍患者康复方面的未开发潜力——创造一种普遍的安全感。

The untapped potential for healthcare to support recovery for patients with stress-related exhaustion disorder - creating an experience of generalised safety.

作者信息

Ellbin Susanne, Lindegård Agneta, Bååthe Fredrik

机构信息

Institute of Stress Medicine at Region Västra Götaland, Gothenburg, Sweden.

School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden.

出版信息

Scand J Prim Health Care. 2025 Sep;43(3):594-601. doi: 10.1080/02813432.2025.2480869. Epub 2025 Apr 1.

Abstract

BACKGROUND

Exhaustion disorder (ED) is one of the most rapidly increasing causes of sick leave in Sweden. The prolonged recovery time from ED creates a dilemma on both the societal and individual level. How patients experience the encounter with health care is critical for the recovery from ED. The aim of this study was to explore how patients with ED experience the encounter with health care.

METHOD

Data from 23 semi‑structured interviews with ED patients were analysed using content analysis.

RESULTS

One of the main findings was that patients want to be listened to and taken seriously in the encounter with health care. However, patients experience that healthcare struggles to meet these expectations. Several informants reported not being listened to, worrying symptoms were overlooked, an individualised care plan was lacking, and patients experienced that they were prematurely dismissed. This created an experience of unsafety, and that could inadvertently maintain the stress response and negatively influence recovery for patients with stress‑related disorders.

CONCLUSION

It is paramount to convey an experience of predictability, despite the fact that patients undergo an unpredictable process related to their ED illness. By combining the traditional load‑recovery theory with the generalised unsafety theory of stress, we can tap into the potential to enhance recovery for patients with ED. We suggest that if the encounter with healthcare provides an experience of generalised safety, the conditions for patients with stress‑related disorders to recover would be distinctly enhanced.

摘要

背景

疲惫症(ED)是瑞典病假增长最为迅速的原因之一。从疲惫症中恢复所需的漫长时间在社会层面和个人层面都造成了困境。患者如何体验与医疗保健的接触对于从疲惫症中恢复至关重要。本研究的目的是探讨疲惫症患者如何体验与医疗保健的接触。

方法

使用内容分析法对23名疲惫症患者的半结构化访谈数据进行分析。

结果

主要发现之一是患者希望在与医疗保健的接触中被倾听并得到认真对待。然而,患者感到医疗保健难以满足这些期望。几名受访者表示未被倾听,令人担忧的症状被忽视,缺乏个性化护理计划,患者觉得自己被过早打发。这造成了一种不安全的体验,这可能会无意中维持应激反应,并对患有应激相关障碍的患者的康复产生负面影响。

结论

尽管患者经历与疲惫症相关的不可预测过程,但传达可预测性的体验至关重要。通过将传统的负荷-恢复理论与广义的应激不安全理论相结合,我们可以挖掘提高疲惫症患者康复的潜力。我们建议,如果与医疗保健的接触能提供一种广义的安全感,那么患有应激相关障碍的患者的康复条件将得到显著改善。

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