Physicians' experiences of assessing and supporting fatigued patients in primary care: a focus group study

Fatigue is a common symptom in primary healthcare, affecting 10-30% of patients, and is associated with increased healthcare consumption and functional disability. There is a lack of standardised guidelines to assess and treat patients with fatigue, and little is known about how patients are currently managed in primary healthcare. This study aimed to explore physicians' experiences of managing patients with fatigue in Swedish primary care to inform development of evidence-based care procedures.

Six semi-structured focus group interviews were conducted, including a total of 39 primary care physicians from three primary care centres in Stockholm. Data was analysed using thematic analysis.

The analysis generated the overarching theme "Frustration in the role as physician," consisting of two main themes: (1) "Time pressure and an empty toolbox", highlighting the perceived lack of standardised assessment procedures, effective interventions, and sufficient time for care; and (2) "Challenges in the patient-physician relationship", highlighting role ambivalence, ambivalence regarding sick leave, and the importance of reaching mutual understanding with the patient.

Physicians often feel frustrated, ill-equipped, and time-pressured when managing patients with fatigue. There is a pressing need to develop evidence-based assessment procedures and treatments in the primary care context.