Experiences of general practitioners explaining central sensitisation to patients with persistent physical symptoms: a focus group study
Objective Patients with persistent physical symptoms (PPS) require an explanation that is acceptable and comprehensible to them. Central sensitisation (CS) is an explanatory model for PPS and chronic pain that has been broadly applied in the context of pain medicine, but, until recently, not by gene...
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| Language: | English |
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BMJ Publishing Group
2022-07-01
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| Series: | BMJ Open |
| Online Access: | https://bmjopen.bmj.com/content/12/7/e060063.full |
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| author | Henriëtte E van der Horst Johannes C van der Wouden Berend Terluin Annette H Blankenstein Carine den Boer |
| author_facet | Henriëtte E van der Horst Johannes C van der Wouden Berend Terluin Annette H Blankenstein Carine den Boer |
| author_sort | Henriëtte E van der Horst |
| collection | DOAJ |
| description | Objective Patients with persistent physical symptoms (PPS) require an explanation that is acceptable and comprehensible to them. Central sensitisation (CS) is an explanatory model for PPS and chronic pain that has been broadly applied in the context of pain medicine, but, until recently, not by general practitioners (GPs). We explored how GPs used the CS model in their consultations with patients with PPS.Design and setting A qualitative focus group study among GPs in the Netherlands.Methods We instructed 33 GPs on how to explain CS to patients with PPS. After 0.5–1.5 years of using the CS model, 26 GPs participated in focus groups and interviews to report and discuss their experiences with CS as an explanatory model. Audio recordings were transcribed and two researchers independently analysed the data. The text was coded, codes were organised into themes and discussed until consensus was reached.Results We identified eleven themes and grouped these into four categories.The GPs regarded the CS model as evidence-based, credible and giving recognition to the patient. On the other hand, they found explaining the CS model difficult and time-consuming. They tailored the CS model to their patients’ needs and used multiple consultations to explain the model. The GPs reported that the use of the CS model seemed to improve the understanding and acceptance of the symptoms by the patients and seemed to reduce their need for more diagnostic tests. Furthermore, patients seemed to become more motivated to accept appropriate therapy.Conclusion GPs reported that they were able to provide explanations with the CS model to their patients with PPS. They regarded the model as evidence-based, credible and giving recognition to the patient, but explaining it difficult and time-consuming. |
| format | Article |
| id | doaj-art-c59d6ca6eb7a4262b3a064198f187101 |
| institution | Kabale University |
| issn | 2044-6055 |
| language | English |
| publishDate | 2022-07-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open |
| spelling | doaj-art-c59d6ca6eb7a4262b3a064198f1871012025-01-31T00:10:10ZengBMJ Publishing GroupBMJ Open2044-60552022-07-0112710.1136/bmjopen-2021-060063Experiences of general practitioners explaining central sensitisation to patients with persistent physical symptoms: a focus group studyHenriëtte E van der Horst0Johannes C van der Wouden1Berend Terluin2Annette H Blankenstein3Carine den Boer4Amsterdam Public Health research institute, Amsterdam, The NetherlandsDepartment of General Practice, Amsterdam UMC, Vrije Universiteit, Amsterdam, The NetherlandsVrije Universiteit Medical Centre Amsterdam, Department of General Practice, Amsterdam, NetherlandsAmsterdam UMC location Vrije Universiteit Amsterdam, Department of General Practice, Boelelaan 1117, Amsterdam, The NetherlandsAmsterdam UMC location Vrije Universiteit Amsterdam, Department of General Practice, Boelelaan 1117, Amsterdam, The NetherlandsObjective Patients with persistent physical symptoms (PPS) require an explanation that is acceptable and comprehensible to them. Central sensitisation (CS) is an explanatory model for PPS and chronic pain that has been broadly applied in the context of pain medicine, but, until recently, not by general practitioners (GPs). We explored how GPs used the CS model in their consultations with patients with PPS.Design and setting A qualitative focus group study among GPs in the Netherlands.Methods We instructed 33 GPs on how to explain CS to patients with PPS. After 0.5–1.5 years of using the CS model, 26 GPs participated in focus groups and interviews to report and discuss their experiences with CS as an explanatory model. Audio recordings were transcribed and two researchers independently analysed the data. The text was coded, codes were organised into themes and discussed until consensus was reached.Results We identified eleven themes and grouped these into four categories.The GPs regarded the CS model as evidence-based, credible and giving recognition to the patient. On the other hand, they found explaining the CS model difficult and time-consuming. They tailored the CS model to their patients’ needs and used multiple consultations to explain the model. The GPs reported that the use of the CS model seemed to improve the understanding and acceptance of the symptoms by the patients and seemed to reduce their need for more diagnostic tests. Furthermore, patients seemed to become more motivated to accept appropriate therapy.Conclusion GPs reported that they were able to provide explanations with the CS model to their patients with PPS. They regarded the model as evidence-based, credible and giving recognition to the patient, but explaining it difficult and time-consuming.https://bmjopen.bmj.com/content/12/7/e060063.full |
| spellingShingle | Henriëtte E van der Horst Johannes C van der Wouden Berend Terluin Annette H Blankenstein Carine den Boer Experiences of general practitioners explaining central sensitisation to patients with persistent physical symptoms: a focus group study BMJ Open |
| title | Experiences of general practitioners explaining central sensitisation to patients with persistent physical symptoms: a focus group study |
| title_full | Experiences of general practitioners explaining central sensitisation to patients with persistent physical symptoms: a focus group study |
| title_fullStr | Experiences of general practitioners explaining central sensitisation to patients with persistent physical symptoms: a focus group study |
| title_full_unstemmed | Experiences of general practitioners explaining central sensitisation to patients with persistent physical symptoms: a focus group study |
| title_short | Experiences of general practitioners explaining central sensitisation to patients with persistent physical symptoms: a focus group study |
| title_sort | experiences of general practitioners explaining central sensitisation to patients with persistent physical symptoms a focus group study |
| url | https://bmjopen.bmj.com/content/12/7/e060063.full |
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