Publication

The importance of contextual aspects in the care for patients with functional somatic symptoms

Gol, J. M., Rosmalen, J. G. M., Gans, R. O. B. & Voshaar, R. C. O., Sep-2020, In : Medical Hypotheses. 142, 5 p., 109731.

Research output: Contribution to journalArticleAcademicpeer-review

APA

Gol, J. M., Rosmalen, J. G. M., Gans, R. O. B., & Voshaar, R. C. O. (2020). The importance of contextual aspects in the care for patients with functional somatic symptoms. Medical Hypotheses, 142, [109731]. https://doi.org/10.1016/j.mehy.2020.109731

Author

Gol, J M ; Rosmalen, J G M ; Gans, R O B ; Voshaar, R C Oude. / The importance of contextual aspects in the care for patients with functional somatic symptoms. In: Medical Hypotheses. 2020 ; Vol. 142.

Harvard

Gol, JM, Rosmalen, JGM, Gans, ROB & Voshaar, RCO 2020, 'The importance of contextual aspects in the care for patients with functional somatic symptoms', Medical Hypotheses, vol. 142, 109731. https://doi.org/10.1016/j.mehy.2020.109731

Standard

The importance of contextual aspects in the care for patients with functional somatic symptoms. / Gol, J M; Rosmalen, J G M; Gans, R O B; Voshaar, R C Oude.

In: Medical Hypotheses, Vol. 142, 109731, 09.2020.

Research output: Contribution to journalArticleAcademicpeer-review

Vancouver

Gol JM, Rosmalen JGM, Gans ROB, Voshaar RCO. The importance of contextual aspects in the care for patients with functional somatic symptoms. Medical Hypotheses. 2020 Sep;142. 109731. https://doi.org/10.1016/j.mehy.2020.109731


BibTeX

@article{421d9157f7bc4281a08beb84f4d9342c,
title = "The importance of contextual aspects in the care for patients with functional somatic symptoms",
abstract = "Functional somatic symptoms refer to physical symptoms that cannot be (bio) medically explained. The pattern or clustering of such symptoms may lead to functional syndromes like chronic fatigue syndrome, fibromyalgia, irritable bowel syndrome, among many others. Since the underlying pathophysiology remains unknown, several explanatory models have been proposed, nearly all including social and psychological parameters. These models have stimulated effectiveness studies of several psychological and psychopharmacological therapies. While the evidence for their effectiveness is steadily growing, effect-sizes are at most moderate and many patients do not benefit. We hypothesize that the context in which interventions for functional somatic symptoms are delivered substantially influences their effectiveness. Although this hypothesis is in line with explanatory models of functional somatic symptoms, to our knowledge, studies primarily focusing on the influence of contextual aspects on treatment outcome are scarce. Contextual research in the field of somatic symptoms has (irrespective whether these symptoms can be medically explained or not), however, just begun and already yielded some valuable results. These findings can be organized according to Duranti's and Goodwin's theoretical approach to context in order to substantiate our hypothesis. Based on this approach, we categorized empirical findings in three contextual aspects, i.e. 1) the setting, 2) the behavioural environment, and 3) the language environment. Collectively, some support is found for the fact that early identification of patients with functional somatic symptoms, starting treatment as soon as possible, having a neat appearance and an organized office interior, a warm and friendly nonverbal approach and a language use without defensiveness are contextual parameters which enhance the assessment by the patient of the physician's competence to help. Nonetheless, in vivo studies addressing the most aspects, i.e. nonverbal behaviour and language, are needed for better understanding of these contextual aspect. Moreover, future research should address to what extent optimizing contextual aspects improve care for functional somatic symptoms.",
author = "Gol, {J M} and Rosmalen, {J G M} and Gans, {R O B} and Voshaar, {R C Oude}",
note = "Copyright {\circledC} 2020 The Authors. Published by Elsevier Ltd.. All rights reserved.",
year = "2020",
month = "9",
doi = "10.1016/j.mehy.2020.109731",
language = "English",
volume = "142",
journal = "Medical Hypotheses",
issn = "0306-9877",
publisher = "Churchill Livingstone",

}

RIS

TY - JOUR

T1 - The importance of contextual aspects in the care for patients with functional somatic symptoms

AU - Gol, J M

AU - Rosmalen, J G M

AU - Gans, R O B

AU - Voshaar, R C Oude

N1 - Copyright © 2020 The Authors. Published by Elsevier Ltd.. All rights reserved.

PY - 2020/9

Y1 - 2020/9

N2 - Functional somatic symptoms refer to physical symptoms that cannot be (bio) medically explained. The pattern or clustering of such symptoms may lead to functional syndromes like chronic fatigue syndrome, fibromyalgia, irritable bowel syndrome, among many others. Since the underlying pathophysiology remains unknown, several explanatory models have been proposed, nearly all including social and psychological parameters. These models have stimulated effectiveness studies of several psychological and psychopharmacological therapies. While the evidence for their effectiveness is steadily growing, effect-sizes are at most moderate and many patients do not benefit. We hypothesize that the context in which interventions for functional somatic symptoms are delivered substantially influences their effectiveness. Although this hypothesis is in line with explanatory models of functional somatic symptoms, to our knowledge, studies primarily focusing on the influence of contextual aspects on treatment outcome are scarce. Contextual research in the field of somatic symptoms has (irrespective whether these symptoms can be medically explained or not), however, just begun and already yielded some valuable results. These findings can be organized according to Duranti's and Goodwin's theoretical approach to context in order to substantiate our hypothesis. Based on this approach, we categorized empirical findings in three contextual aspects, i.e. 1) the setting, 2) the behavioural environment, and 3) the language environment. Collectively, some support is found for the fact that early identification of patients with functional somatic symptoms, starting treatment as soon as possible, having a neat appearance and an organized office interior, a warm and friendly nonverbal approach and a language use without defensiveness are contextual parameters which enhance the assessment by the patient of the physician's competence to help. Nonetheless, in vivo studies addressing the most aspects, i.e. nonverbal behaviour and language, are needed for better understanding of these contextual aspect. Moreover, future research should address to what extent optimizing contextual aspects improve care for functional somatic symptoms.

AB - Functional somatic symptoms refer to physical symptoms that cannot be (bio) medically explained. The pattern or clustering of such symptoms may lead to functional syndromes like chronic fatigue syndrome, fibromyalgia, irritable bowel syndrome, among many others. Since the underlying pathophysiology remains unknown, several explanatory models have been proposed, nearly all including social and psychological parameters. These models have stimulated effectiveness studies of several psychological and psychopharmacological therapies. While the evidence for their effectiveness is steadily growing, effect-sizes are at most moderate and many patients do not benefit. We hypothesize that the context in which interventions for functional somatic symptoms are delivered substantially influences their effectiveness. Although this hypothesis is in line with explanatory models of functional somatic symptoms, to our knowledge, studies primarily focusing on the influence of contextual aspects on treatment outcome are scarce. Contextual research in the field of somatic symptoms has (irrespective whether these symptoms can be medically explained or not), however, just begun and already yielded some valuable results. These findings can be organized according to Duranti's and Goodwin's theoretical approach to context in order to substantiate our hypothesis. Based on this approach, we categorized empirical findings in three contextual aspects, i.e. 1) the setting, 2) the behavioural environment, and 3) the language environment. Collectively, some support is found for the fact that early identification of patients with functional somatic symptoms, starting treatment as soon as possible, having a neat appearance and an organized office interior, a warm and friendly nonverbal approach and a language use without defensiveness are contextual parameters which enhance the assessment by the patient of the physician's competence to help. Nonetheless, in vivo studies addressing the most aspects, i.e. nonverbal behaviour and language, are needed for better understanding of these contextual aspect. Moreover, future research should address to what extent optimizing contextual aspects improve care for functional somatic symptoms.

U2 - 10.1016/j.mehy.2020.109731

DO - 10.1016/j.mehy.2020.109731

M3 - Article

C2 - 32335457

VL - 142

JO - Medical Hypotheses

JF - Medical Hypotheses

SN - 0306-9877

M1 - 109731

ER -

ID: 123697347