Medically Unexplained Symptoms

Question: Discuss about theMedically Unexplained Symptoms. Answer: Background of the Study a) Briefly describe the issue on which the study is focused. In the research article, Lidn, Bjrk-Brmberg Svensson, (2015) highlighted the issue of the patients suffering and living with medically unexplained symptoms (MUS) in a primary healthcare setting. The article also shows the perceptions of the MUS patients in coping with the condition and living with it. The issue related with the condition of MUS is that it is viewed as the fault of the medical diagnosis and not the potential of the patients living with the condition in their daily life. The issues addressed in the research also encompass the frustrations of the physicians and nurses in providing the patient centred care in MUS. b) What is the significance of the study? The significance of the study is that it illustrates the perceptions and consequences that the patients face suffering from MUS. As MUS is a very serious condition that affects the quality of life of the people, this research holds significance as there is lack of extensive research made in this field. This research is also significant as it focuses on the capabilities and possibilities for the mental and physical well-being of the MUS patients. This study also demonstrates the perceptions of the MUS patients in coping with the condition and in leading a normal life. Overview of research design a) What was the aim of the research? The aim of the study was to interpret and describe the experiences of the patients suffering from MUS in primary healthcare setting. The research is focused on understanding the ways in which the MUS patients learn to live with their condition. It also encompasses the coping attitude in the patients in leading a normal life. Despite of having a frustrated life, they try to live with the condition and move on with their life while taking care of themselves. b) What research design was used? Phenomenological-hermeneutic method is the research design used for the study. This method revolves around themes like interpretation, textual, dialogue, tradition, pre-understanding and meaning. This method is employed in qualitative research where the authors described the perceptions of the patients living with MUS as the phenomena. These phenomena are described and interpreted even after the method is unending and tentative. Another research conducted by Kornelsen et al., (2016) also illustrated the use of phenomenological-hermeneutic method in explaining the consequences and perceptions of the patients living with MUS. c) Was it appropriate? Why/why not? This method is appropriate as it helps to understand the perceptions of the patients living with MUS from a phenomenological perspective in a primary healthcare setting. This method is very advantageous as it is highly flexible to the emerging issues that might arise due to MUS in the patients. This method is highly relevant and natural in fulfilling the aims of the research study. This method is appropriate as it provides a better understanding of the perceptions of the people who are living with the MUS condition. It gives a philosophical movement that fulfills the objectives of the research. Sampling a) Who were the study participants? The study participants comprise of the MUS patients of the age group of 24-61 years. The patients were chosen from the two suburban primary healthcare centres situated in Sweden. In the final sample size, majority were from the immigrant background. b) What are the inclusion and exclusion criteria of the sample? The inclusion and exclusion data collection was adopted by the researchers for the sampling method. During the inclusion method, the patients of the age 18-65 years who had eight visits in a primary healthcare setting with a physician or a nurse during the previous twelve methods in Sweden. The patients were also included based on the criteria where they have no psychiatric or organic reason for frequent visits to the primary healthcare centres. Moreover, it also comprises of the 50% of the patients who reported MUS. The potential subjects were screened through the incoming telephone calls from the patients to the primary healthcare centres. After the screening procedure, the patients were contacted through telephone asking for their participation in the research method. Around 20 patients were selected after they agreed to participate in the research process. However, through the exclusion criteria, many recruited participants were excluded through extensive data collection method. Out of 1379 participants, 1328 were excluded and 51 were included. On the other hand, through the inclusion method, out of 1010 participants, 87 were included and 923 excluded through the minimal data collection method. At last, 10 participants were chosen as the sample size of the age 24 to 61 years. Among the sample size, seven were women and three were men The majority of the participants were from immigrant backgrounds. c) Why is it important to have these criteria identified before recruitment? This criterion is important as it determines the scope for the research and validity of the findings. This also aids the researchers in the proper designing of the research and in the execution of the study in a correct manner. The inclusion criteria helped the researchers to include the subjects that are suitable for the study and in excluding the participants who were disqualified from the inclusion in the study. d) What sampling technique was employed in this study? Purposeful sampling method was employed by the researchers where the subjects were chosen after the pre-selection fulfilling the criteria for the aim of the research. e) Was it appropriate for the research design? Why/why not? The employed technique was appropriate as the subjects were pre-determined. They were selected based on the fulfilling criteria for the research objective. The data was collected from the patients of the age 24-61 years living with MUS. f) How was the sample size determined? The sample size was determined by the criteria of exclusion and inclusion. The minimal and extensive data collection was applied according to which the sample size was selected. The sample size is of the age 24-61 years old suffering from MUS in the primary healthcare setting. g) Was it appropriate? Why/why not? This method was appropriate as the sample size that was selected fulfilled the criteria of the research study. The data collected was relevant and ensured validity. Data collection a) How was the data collected? In the given article, the data was collected via primary data collection method. The data was collected directly from the participants that were the patients suffering from MUS in a primary healthcare setting. This ensured reliability as the data was collected directly from the subjects. b) Was the data collection method appropriate for the study question and the research design? Why/why not? This primary data collection method was appropriate as it was taken directly from the patients who were selected from the age group of 24-61 years. Through this method, 10 patients suffering from MUS were selected through narrations and interviews. c) Define the concept of rigor. In qualitative research, rigor was used to show the research tools that fulfilled the criteria of objectives and aims of the research. The trust worthiness is also determined through rigor that helps to identify the questions that are important and needs to be addressed. The rigor also consists of the research philosophy that was also used in the data collection. d) Discuss two measures taken/not taken to ensure rigor. In the given article, measures were taken for ensuring rigor in the data collection method. The collection of data was done in an authentic way and the participants who were selected were pre-determined in terms of age that is 24-6 years old and criteria of MUS in a primary healthacre setting. Data analysis/results a) Identify and describe the method of data analysis. The analysis of data was done in three steps that comprises of naive reading, structural analysis and comprehensive understanding. The narrations that the patients provided were read many a times to analyze the text called the naive understanding. After that, through structural analysis, the texts were validated and interpretation was done where the text was divided into themes and subthemes that illustrated the criteria of the research study. Another study conducted by Stone, (2013) where the author had also used the thematic analysis for the interpretation of the data. In the article, the researcher had interviewed the general practitioners of Australia in explaining the management of the physical and emotional symptoms MUS patients. Was it appropriate? Why/why not? It was not appropriate for the research study that helped in analysing the texts of the narratives of the patients and in decoding to understand the perceptions of the MUS patients. The systematic text condensation method is appropriate as works under a phenomenological framework that comprises of identification, condensation, total impression and meaning units to draw conclusion. What were the findings? The findings showed that the results were divided into subthemes and themes concluded from the narratives of the patients. The naive understanding illustrated that the patients were shattered as they were unable to lead a normal life. They struggled as they try to interpret their symptoms and also try to manage their life. The themes comprises of the patients feelings in leading a normal life where they feel overwhelmed because of the symptoms and accept the condition and try to live with it. The sense of self is lost due to MUS condition. They keep searching for the reasons of their unexplained symptoms and in the meanwhile, learn self-care. They also become mindful and try to accept and move on with their life. Can the study findings be used in other settings? Why/why not? These findings can be used in other settings for the psychological interventions that would help the healthcare professionals in delivering the patient centred care to the MUS patients. Evidence utilization Would you recommend the findings of this study be implemented in clinical practice? Why/why not? These findings can be implemented in the designing of the psychological interventions that would help them to cope up with the unexplained symptoms and lead their lives (Stone, 2013). The understanding and interpretation of the perceptions of the MUS patients is important as it helps the healthcare professionals in the primary healthcare setting in providing patient centred care and in addressing the psychological needs of the MUS patients. References Kornelsen, J., Atkins, C., Brownell, K., Woollard, R. (2016). The meaning of patient experiences of medically unexplained physical symptoms. Qualitative health research, 26(3), 367-376. Lidn, E., Bjrk-Brmberg, E., Svensson, S. (2015). The meaning of learning to live with medically unexplained symptoms as narrated by patients in primary care: A phenomenological-hermeneutic study. International journal of qualitative studies on health and well-being, 10. Stone, L. (2013). Making sense of medically unexplained symptoms in general practice: a grounded theory study. Mental health in family medicine, 10(2), 101. Stone, L. (2013). Reframing chaos. AustrAliAn FAmily PhysiciAn, 42(7), 1.