How do health professionals experience working with people living with or affected by Medically Unexplained Symptoms (MUS) in South Wales Secondary Care Services? An exploration using reflexive thematic analysis

Davies, Stacey

Abstract

Background: Medically Unexplained Symptoms (MUS) present persistent challenges for people living with or affected by MUS, marked by uncertainty and stigmatisation. Equally, healthcare professionals face complex diagnostic and treatment dilemmas when working with these often un-diagnosable and untreatable conditions. Despite these challenges, research in this area has to date been limited in Wales, particularly within the Swansea Bay University Health Board (SBUHB) region. This lack of research and resources complicates efforts to understand how best to support healthcare professionals in their care for people living with or affected by MUS.
Aims: To explore the experiences of healthcare professionals in secondary care services at SBUHB, South Wales, when working with people living with or affected by MUS. The aim is to understand how these experiences affect them personally as individuals and in their professional roles, with the goal of enhancing support for both healthcare professionals and patients.
Methods: Ten participants were recruited from secondary care services in SBUHB. Semi-structured interviews focused on their experiences of working with people living with or affected by MUS and were analysed using a critical realist orientated Reflexive Thematic Analysis (RTA).
Results: The analysis produced three overarching themes, offering a complex and multifaceted nature of MUS: (1) ‘Lost in the Fog of Uncertainty’ (2) ‘Health Professionals Subjective Journeys’ and (3) ‘Beyond the Fog: Envisioning Future Care for MUS’.
Conclusions: This is the first known inquiry that asks health professionals in Wales about their experiences of working with people living with or affected by MUS, addressing critical gaps in the existing literature. It highlights the role of uncertainty, shared emotional burdens, vulnerability to Potential Morally Injurious Events (PMIE), and the fragility of the therapeutic relationship. Additionally, this inquiry illuminates the complex interplay between healthcare professionals' personal and professional identities, emphasising how these intersecting identities can shape perceptions of patients, influence patient responses, and ultimately affect the care provided in healthcare practice for people living with or affected by MUS.
Implications for Counselling Psychology: This inquiry advocates for a patient-centred paradigm shift, urging the recognition of addressing systemic challenges, advocating for reflexive practices, and a nuanced linguistic approach in MUS care. Counselling Psychology can lead these conversations and foster interest in the field of MUS in Wales, ensuring that the voices of healthcare professionals and people living with or affected by MUS are not only heard but also actively integrated into care practices. Moreover, findings highlight the importance of fostering reflexivity when working with people living with or affected by MUS. By championing self-awareness and reflective practices, Counselling Psychology can help equip healthcare professionals in navigating their ontological positions, deepening their understanding of their role in the therapeutic relationship, and shaping the trajectory of care.

• Thesis Type: Thesis
• Deposit Date: Dec 21, 2023
• Publicly Available Date: Mar 22, 2024
• Public URL: https://uwe-repository.worktribe.com/output/11533504
• Award Date: Mar 22, 2024