Do Women With Severe Persistent Fatigue Present With Fatigue at the Primary Care Consultation?, 2020, olde Hartman et al

This type of research on ME/CFS patients in theory might be interesting, though I have no idea what this paper is like.

https://econtent.hogrefe.com/doi/full/10.1027/2151-2604/a000402

chronic fatigue syndrome, fatigue, primary care, retrospective studies, questionnaire

 

Perhaps researchers should step.into someone's shoes for a week and experience life .

If you are unemployed and of lower education then life is probably one that is incomprehensible to researchers. Women are often the glue that holds fragile, stressful situations together and can suffer for it. I have no problem comprehending that they would be knackered, and that persistent fatigue carries other health possibilities. The fact that they keep turning up perhaps should be seen as something is wrong, they don't necessarily know what, but expect some expertise to be applied

Fatigue is a woolly term . Presentation at primary care provider can be an asymmetrical power balance. Then of course there is the possibility, highlighted often here, that go records are dangerously inaccurate.

If GPs don't listen and don't record accurately is it any wonder things are missed .
From a twitter thread from a # pwme. A number of missed , treatable diagnoses , could be equally applicable for many others


https://twitter.com/user/status/1264189090142003201

 

If you take a sampling of patients from a GP practice, it's obviously going to skew results by not factoring in those who have simply given up trying to get a GP to do their job. This is bad inference. Especially as it's typically advised that unless there are specific reasons for it, healthy young people do not need to take regular appointments with a GP. In my country I think it's only around 50 that GPs are advised to make regular check-ups. When I got sick, I had not seen my GP in something like 6 years. This is pretty typical and it's expected that sick people would naturally have more contact with health care than healthy people advised not to do that unless necessary.

And this is the explanation. Patients who would be categorized in this "with severe fatigue" get the message that they are not welcome and give up. Which happens to literally be the point of doing that, the entire premise for this approach is to exclude those patients from medical practice because they are too expensive and annoying and we get the damn message that we are not welcome.

And then there's the fact that there is no such thing as being diagnosed with severe fatigue, or even fatigue. It's a symptom, not a diagnosis. So that's hardly surprising because unlike anxiety, which is equally untestable, does get "diagnosed" even though it consists of nothing more than "are you anxious?" "I guess" "OK then a diagnosis of anxiety it is".

Nevermind that, again, fatigue is rarely ever the only symptom and almost never the most significant one, it's the obsessive focus of zealots that created this artificial supercategory out of the most common symptom in all of medicine.

Other than being officially advised, you mean? That seems pretty clear. It's literally advised. I'm not sure what could possibly be hard to understand here. When you insult people over something they stop bringing it up. The insults are explicitly on purpose based on a belief system meant to discourage exactly this. The response is obviously not to bring it up, in part because it immediately becomes the obsessive focus from a psychological waste of efforts.

It seems like this could get somewhere but it's hard to tell without the full paper. So close to getting it, still struggling with basic cognitive dissonance, though.

 

Just out of interest I clicked on each name in the first quote box in post #1. The first three names only returned the paper shown in post #1. The fourth name returned 8545 results. I'm not sure what this is telling me!

 

The corresponding author Olde Hartman is a GP who has been involved in developing the Dutch MUS guidelines. He was also in the Dutch Health Council for ME. I'm not a fan...

https://www.radboudumc.nl/en/people/tim-olde-hartman/tim-olde-hartman