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Social inequalities in aggravating factors of somatic symptom persistence (SOMA.SOC): study protocol... 2023 von dem Knesebeck et al

Discussion in 'Psychosomatic research - ME/CFS and Long Covid' started by Andy, Apr 27, 2023.

  1. Andy

    Andy Committee Member

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    Full title: Social inequalities in aggravating factors of somatic symptom persistence (SOMA.SOC): study protocol for a mixed-method observational study focusing on irritable bowel syndrome and fatigue

    Introduction
    Some studies indicate that persistent somatic symptoms (PSS) are more prevalent among individuals with a low socioeconomic status (SES) and a migration background. However, factors explaining social inequalities in PSS are largely unknown. It is expected that aggravating factors of PSS like illness perception, illness beliefs (health literacy, stigma), illness behaviour and health anxiety may play an important role for this explanation. The SOMA.SOC study will examine social inequalities (according to SES and migration) in factors contributing to symptom persistence in irritable bowel syndrome (IBS) and fatigue.

    Methods and analysis
    The project will collect both quantitative and qualitative data. Quantitative data will be gathered via a representative telephone survey in Germany (N=2400). A vignette design will be used depicting patients varying in sex, condition (IBS/fatigue), occupational status (low/high) and migration (yes/no). In the survey, we will assess public knowledge and beliefs (eg, health literacy), attitudes (stigma) and personal experiences with the condition (eg, somatic symptom burden). Complementary, longitudinal qualitative interviews will be conducted with patients (n=32 at three time points, resulting in N=96 interviews) who will also vary according to sex, condition, occupational status and migration. Patients will be recruited from primary care practices in Hamburg. The interviews will cover origin and development of the condition, coping and help-seeking as well as social interactions and perception of the disease by others (eg, perceived stigma). SOMA.SOC is part of the interdisciplinary SOMACROSS (Persistent SOMAtic Symptoms ACROSS Diseases) research unit.

    Ethics and dissemination
    The study protocol was approved by the Ethics Committee of the Hamburg Medical Association on 25 January 2021 (reference number: 2020–10194- BO-ff). Informed consent will be obtained from all participants. The main findings will be submitted for publication in peer-reviewed journals within 12 months of study completion.

    Open access, https://bmjopen.bmj.com/content/13/4/e070635
     
    Andy, Apr 27, 2023
    #1
    Peter Trewhitt, MSEsperanza, Hutan and 1 other person like this.
  2. Andy

    Andy Committee Member

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    While they tend to talk only about 'fatigue', this shows that they see no difference between fatigue and ME/CFS.

    "Considering specific PSS with high prevalence such as fatigue (about 30% in Germany15 16) or irritable bowel syndrome (IBS, about 10–20% in Germany17), research on inequalities is scarce, particularly in Germany. Jason et al18 found highest levels of fatigue among minority groups and persons with lower levels of education and occupational status in the USA."

    Ref 18 is to "A community-based study of chronic fatigue syndrome".
     
    Andy, Apr 27, 2023
    #2
    Peter Trewhitt, alktipping, MSEsperanza and 2 others like this.
  3. Trish

    Trish Moderator Staff Member

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    Surely if something is registering as affecting 30% of the population, it's not identifying anything clinically useful. Presumably it includes people who are tired because of the demands of life or insufficient sleep, as well as those with a wide range of medical conditions.
     
    Trish, Apr 27, 2023
    #3
    Peter Trewhitt, alktipping, Joan Crawford and 3 others like this.
  4. Hutan

    Hutan Moderator Staff Member

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    Are they seriously going to cold call people, targeting migrants who may or may not have good German language skills, with the aim of getting 2400 people to tell them about their bowel function? And quiz them about their health literacy, their personal experiences with their IBS, including the stigma they feel? Probably with the underlying hypothesis that the person's illness behaviour and health anxiety is contributing to their symptoms. What could possibly go wrong?....It doesn't sound very ethical and it certainly doesn't sound like a good way to get reliable information.

    This bit would actually be useful if the team weren't bringing their patient-blaming hypotheses with them. Those biases can be expected to influence who they choose to interview and the spin they put on the information provided by the participants.

    I suppose it's too late, given the ethics approval in 2021; it's all probably been done.
    But, wouldn't it have been great if good ME/CFS and IBS support groups had been active in the migrant communities, reaching out to inform people, and inoculate them against having anything to do with SOMA.SOC.
     
    Hutan, Apr 27, 2023
    #4
    Peter Trewhitt, alktipping, RedFox and 1 other person like this.
  5. MSEsperanza

    MSEsperanza Senior Member (Voting Rights)

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    On SOMACROSS see this post.
     
    MSEsperanza, Apr 27, 2023
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    Peter Trewhitt and Hutan like this.

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