Getting help with persistent physical symptoms: An exploration of accessing healthcare for support.

Abstract

This thesis explores how healthcare is delivered for people experiencing persistent physical symptoms (PPS). Chapter one is a systematic review which investigates what beliefs physical healthcare clinicians hold towards people with PPS. Although negative attitudes are reported in the literature, there is less detail around what these beliefs are and how beliefs differ across professional groups. Sixteen papers were identified. Thematic synthesis was used to analyse the data. Three analytic themes were developed based on findings: 1) that’s not my patient: healthcare professionals do not see people with PPS as having a legitimate medical issue which requires treatment in a healthcare system; 2) people with PPS as the “villain” and 3) a parallel narrative: PPS as a positive experience. Little variation was noted across professionals, however professionals in secondary care settings more commonly reported beliefs that people with PPS did not belong in their service. Results and implications for service development and future research are discussed.
Chapter two is an investigation of patient experiences of accessing secondary NHS healthcare in North Wales for support with PPS. A narrative inquiry design was used with narrative analysis to analyse findings. Six participants were involved in the study. The findings were that participants’ experienced stigmatisation on multiple levels, and this was felt to be driving much of their experiences. A model is developed and explained which outlines how stigmatisation and healthcare culture influences peoples experience and maintains PPS. Some more positive experiences were identified, which showed an alternative, more positive model outlining the beneficial impacts of psychologically informed care.
Chapter three is a discussion of the clinical and research implications of these findings, with particular consideration to the role of specialist services, training and teaching for qualified and student clinicians and development of guidelines and policy for supporting people with PPS.

Date of Award	26 Sept 2024
Original language	English
Awarding Institution	Bangor University
Supervisor	Samantha Owen (Supervisor) & Rachel Skippon (Supervisor)