ArticleJournal of general internal medicine2007
Why do general practitioners decline training to improve management of medically unexplained symptoms?
Article in Journal of general internal medicine, 2007. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02444520 (Persistent Physical Symptoms Reduction Intervention), which is not on this map. Cited by 37 papers, 3 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Persistent Physical Symptoms Reduction Intervention: a Systems Change and Evaluation (PRINCE) - Integrated GP Care for Persistent Physical Symptoms: a Feasibility & Cluster Randomised Controlled Trial
Who cites it
37 citing papers in PubMed, 3 syntheses or guidelines pooled it, 139 citations in OpenAlex.
- Clinical skills development for healthcare practitioners working with patients with persistent physical symptoms (PPS) in healthcare settings: a systematic review and narrative synthesis.BMC medical education · 2024Pooled it
- Behavioural modification interventions for medically unexplained symptoms in primary care: systematic reviews and economic evaluation.Health technology assessment (Winchester, England) · 2020Pooled it
- Enhanced care by generalists for functional somatic symptoms and disorders in primary care.The Cochrane database of systematic reviews · 2013Pooled it
- BMC family practice integrated GP care for patients with persistent physical symptoms: feasibility cluster randomised trial.BMC family practice · 2020Trial
- Open Trial of Integrated Primary Care Consultation for Medically Unexplained Symptoms.The journal of behavioral health services & research · 2017Trial
- Trial
- Making the diagnosis of Chronic Fatigue Syndrome/Myalgic Encephalitis in primary care: a qualitative study.BMC family practice · 2010Trial
- General practitioners' views on reattribution for patients with medically unexplained symptoms: a questionnaire and qualitative study.BMC family practice · 2008Trial
- Illness anxiety disorder: A qualitative study of people with health anxiety and their experiences seeking and avoiding medical care.The British journal of clinical psychology · 2026Article
- Experiences with a structured conversation tool: a qualitative study on feasibility in general practice in Norway.Scandinavian journal of primary health care · 2022Article
- Article
- Under-recognition of medically unexplained symptom conditions among US Veterans with Gulf War Illness.PloS one · 2021Article
- Ten Vestibular Tools for Primary Care.Frontiers in neurology · 2021Article
- Which difficulties do GPs experience in consultations with patients with unexplained symptoms: a qualitative study.BMC family practice · 2019Article
- Article
- Medically Unexplained Physical Symptoms: What They Are and Why Counseling Psychologists Should Care about Them.The Counseling psychologist · 2019Article
- Article
- Motivations and Experiences of Canadians Seeking Treatment for Lyme Disease Outside of the Conventional Canadian Health-Care System.Journal of patient experience · 2018Article
- How general practitioners understand and handle medically unexplained symptoms: a focus group study.BMC family practice · 2018Article
- 'If it's a medical issue I would have covered it by now': learning about fibromyalgia through the hidden curriculum: a qualitative study.BMC medical education · 2017Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
9 authors at 4 institutions in 1 country.
Funding
Abstract
backgroundGeneral practitioners' (GPs) communication with patients presenting medically unexplained symptoms (MUS) has the potential to somatize patients' problems and intensify dependence on medical care. Several reports indicate that GPs have negative attitudes about patients with MUS. If these attitudes deter participation in training or other methods to improve communication, practitioners who most need help will not receive it.
objectiveTo identify how GPs' attitudes to patients with MUS might inhibit their participation with training to improve management.
designQualitative study.
participantsGPs (N = 33) who had declined or accepted training in reattribution techniques in the context of a research trial. APPROACH: GPs were interviewed and their accounts analysed qualitatively.
resultsAlthough attitudes that devalued patients with MUS were common in practitioners who had declined training, these coexisted, in the same practitioners, with evidence of intuitive and elaborate psychological work with these patients. However, these practitioners devalued their psychological skills. GPs who had accepted training also described working psychologically with MUS but devalued neither patients with MUS nor their own psychological skills.
conclusionsGPs' attitudes that suggested disengagement from patients with MUS belied their pursuit of psychological objectives. We therefore suggest that, whereas negative attitudes to patients have previously been regarded as the main barrier to involvement in measures to improve patient management, GPs devaluing of their own psychological skills with these patients may be more important.
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.