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Medically explained symptoms: a mixed methods study of diagnostic, symptom and support experiences of patients with lupus and related systemic autoimmune diseases
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James Brimicombe,
Caroline Gordon
Rheumatology Advances in Practice, Volume: 4, Issue: 1
Swansea University Author: RUPERT HARWOOD
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Copyright: The Author(s) 2020. This is an Open Access article distributed under the terms of the Creative Commons Attribution License.
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DOI (Published version): 10.1093/rap/rkaa006
Abstract
ObjectivesThe aim was to explore patient experiences and views of their symptoms, delays in diagnosis, misdiagnoses and medical support, to identify common experiences, preferences and unmet needs.MethodsFollowing a review of LUPUS UK’s online forum, a questionnaire was posted online during December...
| Published in: | Rheumatology Advances in Practice |
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| ISSN: | 2514-1775 |
| Published: |
Oxford University Press (OUP)
2020
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| Online Access: |
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| URI: | https://cronfa.swan.ac.uk/Record/cronfa71734 |
| Abstract: |
ObjectivesThe aim was to explore patient experiences and views of their symptoms, delays in diagnosis, misdiagnoses and medical support, to identify common experiences, preferences and unmet needs.MethodsFollowing a review of LUPUS UK’s online forum, a questionnaire was posted online during December 2018. This was an exploratory mixed methods study, with qualitative data analysed thematically and combined with descriptive and statistically analysed quantitative data.ResultsThere were 233 eligible respondents. The mean time to diagnosis from first experiencing symptoms was 6 years 11 months. Seventy-six per cent reported at least one misdiagnosis for symptoms subsequently attributed to their systemic autoimmune rheumatic disease. Mental health/non-organic misdiagnoses constituted 47% of reported misdiagnoses and were indicated to have reduced trust in physicians and to have changed future health-care-seeking behaviour. Perceptions of physician knowledge and listening skills were highly correlated with patient ratings of trust. The symptom burden was high. Fatigue had the greatest impact on activities of daily living, yet the majority reported receiving no support or poor support in managing it. Assessing and treating patients holistically and with empathy was strongly felt to increase diagnostic accuracy and improve medical relationships.ConclusionPatient responses indicated that timely diagnosis could be facilitated if physicians had greater knowledge of lupus/related systemic autoimmune diseases and were more amenable to listening to and believing patient reports of their symptoms. Patient priorities included physicians viewing them holistically, with more emotional support and assistance in improving quality of life, especially in relation to fatigue. |
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| Keywords: |
systemic lupus erythematosus, patient views, quality of life, patient–physician interaction, misdiagnoses, symptoms, UCTD, diagnostic delays, medical support |
| College: |
Faculty of Medicine, Health and Life Sciences |
| Funders: |
This work was supported by LUPUS UK. |
| Issue: |
1 |