Healthcare professionals’ views on healthcare-related factors influencing symptom course in persistent somatic symptoms: a qualitative study of four European countries

Abstract Background The care trajectory for patients with Persistent Somatic Symptoms (PSS) is complex due to variability in diagnoses and treatments, with differences across European healthcare systems. Existing findings predominantly come from individual Western European countries, and comparative...

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Main Authors: Aleksandra Kustra-Mulder, Brodie McGhie-Fraser, Tara Petzke, Karolina Fila-Pawłowska, Judith Rosmalen, Fiammetta Cosci, Bernd Löwe, Angelika Weigel
Format: Article
Language:English
Published: BMC 2025-06-01
Series:BMC Health Services Research
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Online Access:https://doi.org/10.1186/s12913-025-12986-1
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author Aleksandra Kustra-Mulder
Brodie McGhie-Fraser
Tara Petzke
Karolina Fila-Pawłowska
Judith Rosmalen
Fiammetta Cosci
Bernd Löwe
Angelika Weigel
author_facet Aleksandra Kustra-Mulder
Brodie McGhie-Fraser
Tara Petzke
Karolina Fila-Pawłowska
Judith Rosmalen
Fiammetta Cosci
Bernd Löwe
Angelika Weigel
author_sort Aleksandra Kustra-Mulder
collection DOAJ
description Abstract Background The care trajectory for patients with Persistent Somatic Symptoms (PSS) is complex due to variability in diagnoses and treatments, with differences across European healthcare systems. Existing findings predominantly come from individual Western European countries, and comparative studies are lacking. This study aimed to explore how healthcare systems are perceived to influence PSS courses across four European countries and how professionals view their respective systems regarding PSS. Methods We used semi-structured interviews to conduct a qualitative study with healthcare professionals from Germany, Italy, the Netherlands, and Poland. Sixteen participants were recruited purposively through international and national networks focusing on PSS, ensuring representation from primary care, secondary care medical specialists, mental health, and other healthcare fields. Results We found that the interaction of structural and interpersonal factors within the healthcare system influenced the course of PSS symptoms. Systemic barriers such as limited consultation times and issues in care pathways or insurance coverage were prevalent in Germany and the Netherlands, while access and trust issues were more prominent in Italy and Poland. Key improvements suggested included reimbursement and treatment eligibility for PSS, establishing collaborative care pathways, and sufficient consultation times. Additionally, enhancing professional-patient relationships and improving education for healthcare professionals and patients were identified as crucial steps. Conclusions The results show that although expertise is improving, current healthcare system structures prevent professionals from using them effectively. Therefore, systemic reforms and better professional training are needed to improve care for patients with PSS.
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spelling doaj-art-a7a901b042854e5487d3de597e0802d82025-08-20T02:06:27ZengBMCBMC Health Services Research1472-69632025-06-0125111510.1186/s12913-025-12986-1Healthcare professionals’ views on healthcare-related factors influencing symptom course in persistent somatic symptoms: a qualitative study of four European countriesAleksandra Kustra-Mulder0Brodie McGhie-Fraser1Tara Petzke2Karolina Fila-Pawłowska3Judith Rosmalen4Fiammetta Cosci5Bernd Löwe6Angelika Weigel7Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Hamburg-EppendorfDepartment of Primary and Community Care, Radboud University Medical Center, Research Institute for Medical InnovationDepartment of Clinical Psychology, Psychotherapy, and Experimental Psychopathology, Johannes-Gutenberg-University MainzDepartment of Clinical Neuroscience, Wrocław University of Science and TechnologyDepartments of Psychiatry and Internal Medicine, University of Groningen, University Medical Center GroningenDepartment of Health Sciences, University of FlorenceDepartment of Psychosomatic Medicine and Psychotherapy, University Medical Center Hamburg-EppendorfDepartment of Psychosomatic Medicine and Psychotherapy, University Medical Center Hamburg-EppendorfAbstract Background The care trajectory for patients with Persistent Somatic Symptoms (PSS) is complex due to variability in diagnoses and treatments, with differences across European healthcare systems. Existing findings predominantly come from individual Western European countries, and comparative studies are lacking. This study aimed to explore how healthcare systems are perceived to influence PSS courses across four European countries and how professionals view their respective systems regarding PSS. Methods We used semi-structured interviews to conduct a qualitative study with healthcare professionals from Germany, Italy, the Netherlands, and Poland. Sixteen participants were recruited purposively through international and national networks focusing on PSS, ensuring representation from primary care, secondary care medical specialists, mental health, and other healthcare fields. Results We found that the interaction of structural and interpersonal factors within the healthcare system influenced the course of PSS symptoms. Systemic barriers such as limited consultation times and issues in care pathways or insurance coverage were prevalent in Germany and the Netherlands, while access and trust issues were more prominent in Italy and Poland. Key improvements suggested included reimbursement and treatment eligibility for PSS, establishing collaborative care pathways, and sufficient consultation times. Additionally, enhancing professional-patient relationships and improving education for healthcare professionals and patients were identified as crucial steps. Conclusions The results show that although expertise is improving, current healthcare system structures prevent professionals from using them effectively. Therefore, systemic reforms and better professional training are needed to improve care for patients with PSS.https://doi.org/10.1186/s12913-025-12986-1Persistent somatic symptomsFunctional disordersHealthcareDiagnosisTreatmentPsychotherapy
spellingShingle Aleksandra Kustra-Mulder
Brodie McGhie-Fraser
Tara Petzke
Karolina Fila-Pawłowska
Judith Rosmalen
Fiammetta Cosci
Bernd Löwe
Angelika Weigel
Healthcare professionals’ views on healthcare-related factors influencing symptom course in persistent somatic symptoms: a qualitative study of four European countries
BMC Health Services Research
Persistent somatic symptoms
Functional disorders
Healthcare
Diagnosis
Treatment
Psychotherapy
title Healthcare professionals’ views on healthcare-related factors influencing symptom course in persistent somatic symptoms: a qualitative study of four European countries
title_full Healthcare professionals’ views on healthcare-related factors influencing symptom course in persistent somatic symptoms: a qualitative study of four European countries
title_fullStr Healthcare professionals’ views on healthcare-related factors influencing symptom course in persistent somatic symptoms: a qualitative study of four European countries
title_full_unstemmed Healthcare professionals’ views on healthcare-related factors influencing symptom course in persistent somatic symptoms: a qualitative study of four European countries
title_short Healthcare professionals’ views on healthcare-related factors influencing symptom course in persistent somatic symptoms: a qualitative study of four European countries
title_sort healthcare professionals views on healthcare related factors influencing symptom course in persistent somatic symptoms a qualitative study of four european countries
topic Persistent somatic symptoms
Functional disorders
Healthcare
Diagnosis
Treatment
Psychotherapy
url https://doi.org/10.1186/s12913-025-12986-1
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