Linguistic & interactional aspects that characterize consultations about medically unexplained symptoms: A systematic review, 2020, Stortenbeker et al

[Andy]

Highlights
• Systematic review of 18 papers of patient-provider interactions about MUS.
• Patients' need for recognition of symptoms is manifested during the interaction.
• Consultations carry trouble potential due to differing views and knowledge domains.
• Involving patients in symptom explanations helps to prevent or overcome trouble.

Abstract
Objective
The apparent absence of any specific underlying diseases challenges patient-provider communication about medically unexplained symptoms (MUS). Previous research focused on general communication patterns in these interactions; however, an overview of more detailed interactional and linguistic aspects is lacking. This review aims to gain a detailed understanding of communicative challenges in MUS consultations by synthesizing evidence from conversation and discourse analytic research.

Methods
A systematic review of publications using eight databases (PubMed, Embase, CINAHL, PsychINFO, Web of Science, MLA International Bibliography, LLBA and Communication Abstracts). Search terms included ‘MUS’, ‘linguistics’ and ‘communication’. Additional studies were identified by contacting experts and searching bibliographies. We included linguistic and/or interactional analyses of natural patient-provider interactions about MUS. Two authors independently extracted the data, and quality appraisal was based on internal and external validity.

Results
We identified 18 publications that met the inclusion criteria. The linguistic and interactional features of MUS consultations pertained to three dimensions: 1) symptom recognition, 2) double trouble potential (i.e. patients and providers may have differing views on symptoms and differing knowledge domains), and 3) negotiation and persuasion (in terms of acceptable explanations and subsequent psychological treatment). We describe the recurrent linguistic and interactional features of these interactions.

Conclusions
Despite the presence of a double trouble potential in MUS consultations, validation of symptoms and subtle persuasive conduct may facilitate agreement on illness models and subsequent (psychological) treatment.

Open access, https://www.sciencedirect.com/science/article/pii/S0022399919308165

 

[Trish]

There is so much awful about the conclusion of this I don't know where to start. I haven't read the full paper, and don't intend to, but the conclusion on its own is a huge red flag:

Conclusions
Despite the presence of a double trouble potential in MUS consultations, validation of symptoms and subtle persuasive conduct may facilitate agreement on illness models and subsequent (psychological) treatment.

So that's all right then. If you don't know what's wrong with your patient, use brainwashing techniques to persuade them there's nothing physically wrong, and move on to CBT/IAPT/ACT or some other pick and mix mumbo jumbo. Job done.

Something when horribly wrong when the whole field of 'health psychology' and similar were invented.

 

[James Morris-Lent]

Something when horribly wrong when the whole field of 'health psychology' and similar were invented.

I certainly can't see an argument against this.

This paper makes it quite clear that the Project is to study what things (and how) can be made agreeable for the benefit of a predetermined dogma and those who have an interest in upholding it. There is conspicuously no consideration for what is scientifically true or what is medically effective for the individual.

Politics + Marketing = 100 % propaganda.

 

[Sean]

GIGO

Again.