Stortenbeker2020

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Stortenbeker2020
BibType ARTICLE
Key Stortenbeker2020
Author(s) Inge Stortenbeker, Wyke Stommel, Sandra van Dulmen, Peter Lucassen, Enny Das, Tim olde Hartman
Title Linguistic and Interactional Aspects That Characterize Consultations about Medically Unexplained Symptoms: A Systematic Review
Editor(s)
Tag(s) EMCA, Consultations, Medical EMCA, Systematic review, Symptoms, Unexplained symptoms, Doctor-patient interaction
Publisher
Year 2020
Language English
City
Month
Journal Journal of Psychosomatic Research
Volume 132
Number
Pages eid: 109994
URL Link
DOI 10.1016/j.jpsychores.2020.109994
ISBN
Organization
Institution
School
Type
Edition
Series
Howpublished
Book title
Chapter

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Abstract

Objective The apparent absence of any specific underlying diseases challenges patient-provider communication about medically unexplained symptoms (MUS). Previous research focused on general communication patterns in these interactions; however, an overview of more detailed interactional and linguistic aspects is lacking. This review aims to gain a detailed understanding of communicative challenges in MUS consultations by synthesizing evidence from conversation and discourse analytic research.

Methods A systematic review of publications using eight databases (PubMed, Embase, CINAHL, PsychINFO, Web of Science, MLA International Bibliography, LLBA and Communication Abstracts). Search terms included ‘MUS’, ‘linguistics’ and ‘communication’. Additional studies were identified by contacting experts and searching bibliographies. We included linguistic and/or interactional analyses of natural patient-provider interactions about MUS. Two authors independently extracted the data, and quality appraisal was based on internal and external validity.

Results We identified 18 publications that met the inclusion criteria. The linguistic and interactional features of MUS consultations pertained to three dimensions: 1) symptom recognition, 2) double trouble potential (i.e. patients and providers may have differing views on symptoms and differing knowledge domains), and 3) negotiation and persuasion (in terms of acceptable explanations and subsequent psychological treatment). We describe the recurrent linguistic and interactional features of these interactions.

Conclusions Despite the presence of a double trouble potential in MUS consultations, validation of symptoms and subtle persuasive conduct may facilitate agreement on illness models and subsequent (psychological) treatment.

Notes