Patients with medically unexplained symptoms: Sources of patients' authority and implications for demands on medical care

Peters, Sarah; Stanley, Ian; Rose, Michael; Salmon, Peter

doi:10.1016/s0277-9536(97)00200-1

Cited by 172 publications

(130 citation statements)

References 18 publications

Supporting

Mentioning

124

Contrasting

Unclassified

Order By: Relevance

“…The view that these patients are transparent about psychological needs predicts that their desire for emotional support will correlate with the amount of their speech that concerns psychosocial problems or psychosocial causes for their symptoms 25 . Patients with MUS sometimes suggest physical diseases as symptom explanations, and we predicted that this indicates not belief in the need for physical intervention, but desire for explanation 19,25 . MUS patients sometimes prompt the GP to offer somatic intervention or to provide information about somatic interventions 3 , and we predicted that how much they do this indicates their desire for somatic intervention.…”

Section: Introductionmentioning

confidence: 96%

“…Before consultation, patients presenting MUS selfreport that they want more emotional support from GPs than other patients 18 . They freely discuss psychological explanations for their symptoms with researchers [19][20][21] . Like other patients 22 , many offer psychosocial cues in consultation, either as explanations for their symptoms or as separate problems, and most provide cues to their need for explanation for their symptoms 3,23 .…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Primary Care Consultations About Medically Unexplained Symptoms: How Do Patients Indicate What They Want?

et al. 2009

Self Cite

View full text Add to dashboard Cite

Section: Introductionmentioning

confidence: 96%

Section: Introductionmentioning

confidence: 99%

Primary Care Consultations About Medically Unexplained Symptoms: How Do Patients Indicate What They Want?

et al. 2009

Self Cite

View full text Add to dashboard Cite

“…10 When a clear biomedical cause is lacking, pain sufferers may feel disbelieved, misunderstood or unaccepted by others. 1,29,43 Others (e.g., health care practitioners) may feel uncertain about the genuineness of the pain symptoms 24 and/or may feel ineffective in caregiving. 28 To understand the struggle that patients and others experience when dealing with pain in these situations, a focus upon others" reactions and responses is important.…”

Section: Introductionmentioning

confidence: 99%

We Discount the Pain of Others When Pain Has No Medical Explanation

Ruddere

Goubert

Vervoort

et al. 2012

The Journal of Pain

View full text Add to dashboard Cite

and PerspectiveThe present studies investigated the impact of medical and psychosocial information upon observer"s estimations of pain, emotional responses and behavioral tendencies towards another person in pain. Participants were recruited from the community (study 1: N = 39; 10 men; study 2: N = 41; 12 men), and viewed videos of 4 patients expressing pain, paired with vignettes describing absence or presence of a) medical evidence for the pain and b) psychosocial influences upon the pain experience. A similar methodology was used for study 1 and 2, except for the explicit manipulation of the presence/absence of psychosocial influences in study 2. For each patient video, participant estimations of the patient"s pain, their own distress, sympathy and inclination to help (VAS) were assessed. In both studies, results indicated lower ratings on all measures when medical evidence for pain was absent.Overall, no effect of psychosocial influences was found, except in study 2 where participants indicated to feel less distress when psychosocial influences were present. The findings suggest that pain is taken less seriously when there is no medical evidence for the pain. The findings are discussed in terms of potential mechanisms underlying pain estimations as well as implications for caregiving behavior.Perspective: The present studies indicate that observers take the pain of others less seriously in the absence of clear medical evidence for the pain. These findings are important to further understand the social context in which pain for which there is no clear medical explanation is experienced.

show abstract

“…Although research is scarce concerning the actual relationship between observer behavior and patient outcomes, there is no question that patients with pain for which there is no clear medical evidence feel frustrated and disbelieved by others. 2,28,45,58,63 Some limitations, each of which point to directions for further research, need attention. First, our study provided only an analogue of the clinical setting in order to use the power of an experimental investigation.…”

mentioning

confidence: 99%

Health Care Professionals' Reactions to Patient Pain: Impact of Knowledge About Medical Evidence and Psychosocial Influences

Ruddere

Goubert

Stevens

et al. 2014

The Journal of Pain

View full text Add to dashboard Cite

AND PERSPECTIVEThis study examined the impact of evidence concerning the presence of: a) a biomedical basis for pain, and b) psychosocial influences, on practitioner appraisals of patient pain experiences.Further, the potential moderating role of patient pain behaviour was examined. In an online study, 52 general practitioners (GPs) and 46 physiotherapists (PTs) viewed video sequences of 4 patients manifesting pain, with accompanying vignettes describing presence or absence of medical evidence and psychosocial influences. Participants estimated pain intensity, daily interference, felt sympathy, effectiveness of pain medication, self-efficacy, their likability and suspicions of deception. Primary findings indicated lower perceived pain and daily interference, less sympathy, lower expectations of medication impact, and less self-efficacy when medical evidence was absent. The same results were found when psychosocial influences were present, but only when the patient displayed higher levels of pain behavior.Further, absence of medical evidence was related to less positive evaluations of the patients and to higher beliefs in deception in both professions. The presence of psychosocial influences was related to less positive evaluations and higher beliefs in deception in both professions. In sum, a range of contextual factors influence healthcare practitioner responses to patient pain. Implications for caregiving behavior are discussed.Perspective: The present study indicates that in the absence of clear medical evidence and in the presence of psychosocial influences patient pain might be taken less seriously by healthcare practitioners. These findings are important to further understand the difficulties that relate to the clinical encounter between pain patients and healthcare practitioners.

show abstract

Patients with medically unexplained symptoms: Sources of patients' authority and implications for demands on medical care

Cited by 172 publications

References 18 publications

Primary Care Consultations About Medically Unexplained Symptoms: How Do Patients Indicate What They Want?

Primary Care Consultations About Medically Unexplained Symptoms: How Do Patients Indicate What They Want?

We Discount the Pain of Others When Pain Has No Medical Explanation

Health Care Professionals' Reactions to Patient Pain: Impact of Knowledge About Medical Evidence and Psychosocial Influences

Contact Info

Product

Resources

About