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What do patients with medically unexplained physical symptoms (MUPS) think? A qualitative study
José Nunes1, Teresa Ventura1, Ricardo Encarnação2
1Department of Family Medicine, Faculty of Medical Sciences, New University of Lisbon, Lisbon, Portugal.
Mental Health in Family Medicine
|January 16, 2014
Summary
Patients experiencing medically unexplained physical symptoms (MUPS) often have psychosocial explanations for their complaints. Building a strong therapeutic relationship through listening and flexibility is key to effective care.
Area of Science:
- Family Medicine
- Psychosomatic Medicine
- Qualitative Research
Background:
- Medically unexplained physical symptoms (MUPS) are common in family medicine, causing patient distress and healthcare costs.
- Patients often feel misunderstood, while clinicians experience frustration and insecurity when managing MUPS.
- Traditional approaches may focus on finding answers rather than collaborating with patients.
Purpose of the Study:
- To explore patients' own explanations for their medically unexplained physical symptoms.
- To understand patients' fears, expectations, and desired therapeutic approaches for MUPS.
- To investigate changes in patients' causal beliefs and perceived useful treatments.
Main Methods:
- Qualitative analysis of interviews with 15 patients diagnosed with MUPS.
- Interviews conducted 6 months post-diagnosis in a family medicine setting.
- Exploration of patient-generated explanations, fears, expectations, and treatment preferences.
Main Results:
- Patient experiences significantly shape symptom meaning and illness behavior.
- Many patients identify underlying psychosocial factors contributing to their symptoms.
- Therapeutic listening, clinician flexibility, and a strong patient-doctor relationship are highly valued.
- Diagnostic tests, though used sparingly, can signal clinical interest and build rapport.
Conclusions:
- Patients with MUPS possess unique explanations and fears regarding their symptoms.
- The patient's perception of the symptom, not just the symptom itself, drives consultation.
- Effective management of MUPS requires a foundation of therapeutic relationship, listening, and flexibility.
- While patients may not always expect medication, it is frequently prescribed; diagnostic tests can serve a relational function.
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