Configuring symptoms: experiences from an internet-based self-help programme for persistent physical symptoms in general practice 2026 Frumer et al

Andy

Andy

Senior Member (Voting rights)

Highlights​

  • Engagement with digital self-help shows the fluidity of persistent physical symptoms.
  • Patients and GPs negotiate symptoms, responsibilities, and care practices.
  • Digital self-help require ongoing interpretive and relational work.
  • Digital programmes may favour patients fluent in health systems and technology.
  • Digitalizing care reflects wider shifts toward data-driven, individualized welfare.

Abstract​

This article explores the introduction of the internet-based self-help programme “My Symptoms” into Danish general practice. The programme aims to assist patients and general practitioners (GPs) in managing persistent physical symptoms (PPS) such as pain, fatigue, gut trouble, and dizziness. These symptoms affect a significant part of the population, yet they are rarely explained by a pathophysiological diagnosis. The article is based on ethnographic fieldwork in four general practice clinics in the Central Denmark Region and 31 semi-structured interviews with GPs and patients engaged in the programme. Inspired by work emphasizing technologies-in-practice as multidirectional, that is, shaped through reciprocal interactions across actors and settings, we examine how this programme subtly co-constitutes symptoms, practices, and relationships between patients and GPs. Rather than taking either a patient or a clinician perspective, we analyse engagement across both groups and across of both home and clinic. Through this lens, we explore three interrelated themes in the making of PPS: primary care, everyday life, and the redistribution of responsibilities. By attending to the fluidity and adaptability of PPS and programme engagements, we show the sensemaking and reconfiguring practices required to transform digital health programmes into meaningful care practices. The analysis, therefore, complicates the dominant promises of a digital transformation of healthcare by showing how technologies define and constrain specific care practices as possible. This raises critical questions about shifting responsibilities and the distributed work of self-help technologies in contemporary healthcare.

Open access
 
I tried skim reading this article. What a lot of words.

The bottom line seemed to me to be the aim is to get people with persistent symptoms like fatigue pain and digestive issues out of the GP's office and make them responsible for their own medical care by working through an online program on their own. As expected, the program is just exercise and some form of CBT.

Unsurprisingly it doesn't seem to have been much use.
 
I've not read the paper.

These statements stood out:

"....we examine how this programme subtly co-constitutes symptoms,"

No clue what that means. Word salad.

".....and the redistribution of responsibilities."

Think this is key. I suspect this is about patients taking responsibility for their symptoms as their GPs don't have any answers or much to offer....
 
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