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      Patients’ experiences of chronic non-malignant musculoskeletal pain: a qualitative systematic review

      Author(s): , , , , , ,
      Publication date Created:
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      Journal: British Journal of General Practice
      Publisher: Royal College of General Practitioners

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          Abstract

          Musculoskeletal (MSK) pain is one of the most predominant types of pain and accounts for a large portion of the primary care workload.

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          Evaluating meta-ethnography: a synthesis of qualitative research on lay experiences of diabetes and diabetes care

          Rona Campbell, Pandora Pound, Catherine Pope … (2003)
          Article 0 comments Cited 172 times – based on 0 reviews     Review now
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            Patient perspectives on the impact of fibromyalgia.

            T. Martin, Leslie Crofford, Lesley Arnold … (2008)
            The objective of this study was to elicit and assess important symptom domains and the impact of fibromyalgia on patients' quality of life and functioning from a patient's perspective. The intention was to collect this information as part of an overall effort to overcome shortcomings of existing outcome measures in fibromyalgia. This was a qualitative study in which six focus group sessions with 48 women diagnosed with fibromyalgia were conducted to elicit concepts and ideas to assess the impact of fibromyalgia on their lives. The focus groups conducted with fibromyalgia patients identified symptom domains that had the greatest impact on their quality of life including pain, sleep disturbance, fatigue, depression, anxiety, and cognitive impairment. Fibromyalgia had a substantial negative impact on social and occupational function. Patients reported disrupted relationships with family and friends, social isolation, reduced activities of daily living and leisure activities, avoidance of physical activity, and loss of career or inability to advance in careers or education. The findings from the focus groups revealed that fibromyalgia has a substantial negative impact on patients' lives. A comprehensive assessment of the multiple symptoms domains associated with fibromyalgia and the impact of fibromyalgia on multidimensional aspects of function should be a routine part of the care of fibromyalgia patients.
            Article 0 comments Cited 147 times – based on 0 reviews     Review now
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              "Medication career" or "moral career"? The two sides of managing antidepressants: a meta-ethnography of patients' experience of antidepressants.

              Alice Malpass, Alison Shaw, Debbie Sharp … (2009)
              The UK National Institute for Clinical Excellence (NICE) Clinical Guidelines recommend routine prescription of antidepressants for moderate to severe depression. While many patients accept a prescription, one in three do not complete treatment. We carried out a meta-ethnography of published qualitative papers since 1990 whose focus is patients' experience of antidepressant use for depression, in order to understand barriers and facilitators to concordance and inform a larger qualitative study investigating antidepressant use over time. A systematic search of five databases was carried out, supported by hand searches of key journals, writing to first authors and examining reference lists. After piloting three critical appraisal tools, a modified version of the CASP (Critical Appraisal Skills Programme) checklist was used to appraise potentially relevant and qualitative papers. We carried out a synthesis using techniques of meta-ethnography involving translation and re-interpretation. Sixteen papers were included in the meta-ethnography. The papers fall into two related groups: (1) Papers whose focus is the decision-making relationship and the ways patients manage their use of antidepressants, and (2) Papers whose focus is antidepressants' effect on self-concept, ideas of stigma and its management. We found that patients' experience of antidepressants is characterised by the decision-making process and the meaning-making process, conceptualised here as the 'medication career' and 'moral career'. Our synthesis indicates ways in which general practitioners (GPs) can facilitate concordant relationships with patients regarding antidepressant use. First, GPs can enhance the potential for shared decision-making by reviewing patients' changing preferences for involvement in decision-making regularly throughout the patient's 'medication career'. Second, if GPs familiarise themselves with the competing demands that patients may experience at each decision-making juncture, they will be better placed to explore their patients' preferences and concerns--i.e. their 'moral career' of medication use. This may lead to valuable discussion of what taking antidepressants means for patients' sense of self and how their treatment decisions may be influenced by a felt sense of stigma.
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                Author and article information

                Journal
                Title: British Journal of General Practice
                Abbreviated Title: Br J Gen Pract
                Publisher: Royal College of General Practitioners
                ISSN (Print): 0960-1643
                ISSN (Electronic): 1478-5242
                Publication date Created: December 01 2013
                Publication date Created: December 2013
                Publication date (Print): December 2013
                Publication date (Electronic): December 01 2013
                Volume: 63
                Issue: 617
                Pages: e829-e841
                Article
                DOI: 10.3399/bjgp13X675412
                PMC ID: 3839392
                PubMed ID: 24351499
                SO-VID: 7affc71b-5b0d-40e6-adc8-00748bc7017f
                Copyright © © 2013
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