“We need to be believed": A qualitative interview study on the Hertfordshire (UK) Long Covid and Physical Activity Study, 2025, Logue et al

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“We need to be believed": A qualitative interview study on the Hertfordshire (UK) Long Covid and Physical Activity Study

Logue¹, M; Lyus¹, ² R; Slemmings³, W; Keen³, S

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Background
The Covid-19 pandemic has led to the emergence of Long Covid, a complex multisystem condition characterised by persistent symptoms lasting for at least two months. This qualitative study evaluates the impact and experiences of a community-based physical activity study for individuals with Long Covid in Hertfordshire, UK.

Methods
A semi-structured qualitative interview study was conducted with a purposively selected sample of eleven participants, including eight service users and three health professionals involved in the study. The data corpus was collected from December 2023 to August 2024. Data were analysed thematically using Braun and Clarke’s six phase framework to explore the lived experiences of individuals with Long Covid and the perceived influence of physical activity on their symptoms and overall well-being.

Results
The analysis yielded three primary themes: (1) Leadership, Collaboration, and Community Engagement; (2) Tailored and Holistic Approaches; and (3) Barriers, Stigma, and Lack of Recognition. The study highlighted the critical importance of tailored physical activities, multidisciplinary collaboration, and community engagement.

Participants reported tangible improvements in their physical and mental health. However, these benefits were contextualised by significant challenges, including the management of post-viral fatigue, the navigation of systemic barriers, and a pervasive feeling of not being believed by health practitioners and society. Several participants commented on the disruption that Long Covid has had on their life journey.

Conclusion
The findings suggest that structured and highly personalised physical activity initiatives can offer benefits to individuals with Long Covid. However, the study strongly underscores the profound and detrimental impact of stigma and disbelief on the patient experience.

For such interventions to succeed, they must be situated within a broader ecosystem of care that actively acknowledges and addresses these systemic barriers and validates peoples’ experiences and addresses the biographical impact of Long Covid. Sustainable funding and continuous, validating support are essential for the long-term success of such initiatives.

Web | DOI | PDF | Research Square | Preprint
 
An advertisement for social prescribing. The government will love this.

From skim reading, it looks like the main outcome is the patients involved most valued being believed and meeting others with shared experiences. The authors are mostly from the county public health department.

The sample were self selected 9 pwLC and 3 professionals from a larger study. The study is based on half hour interviews.
 
An advertisement for social prescribing. The government will love this.

From skim reading, it looks like the main outcome is the patients involved most valued being believed and meeting others with shared experiences. The authors are mostly from the county public health department.

The sample were self selected 9 pwLC and 3 professionals from a larger study. The study is based on half hour interviews.
People gotta justify selling their wares/their place. We all have it in our jobs.

But you are right it is four people who maybe were the few who felt something was better than nothing due to their level of debility vs situation and their level of people-pleasing they felt they had to do.

That’s completely different to me/cfs being respected as not ‘fatigue’ and treated with ‘send em off to the woman who offers them choirs and allotments’ because they’ve been trained in the attitude that we deserve so little that even when we describe our symptoms we don’t deserve to have them heard right but corrected so people hear ‘not that bad’ in place of the truth and we are silenced. And made to seem mad because everyone is being whispered to and ordered to think we are just a bit tired feeling so goodness knows why we can’t even fill in a form of shower - that must be in our heads thinking because we feel a bit tired as people do at the end if a day we ‘over interpret it’

Which is not medical truth and sounds exactly like the misinformation that should be banned but is still being allowed as vicious rumour being pushed via islets from Moss-Morris and Chalder, who should be banned from being allowed to speak words about owns because their attitude is so wrong and harmful.

They are still just pushing that we have false beliefs that we can’t x,y,z ie have not updated a thing other than become more devious and manipulative in brainwashing those around us to believe that about us. It’s so silly dystopian that individuals would go that to others do they can’t even be seen or believed in any part of the world as their life’s aim I find it hard to comprehend . It’s not ‘stigma’ which is the first problem we allow people to get away with as a minimization but designed , systematized ostracisation.
 
People gotta justify selling their wares/their place. We all have it in our jobs.

But you are right it is four people who maybe were the few who felt something was better than nothing due to their level of debility vs situation and their level of people-pleasing they felt they had to do.

That’s completely different to me/cfs being respected as not ‘fatigue’ and treated with ‘send em off to the woman who offers them choirs and allotments’ because they’ve been trained in the attitude that we deserve so little that even when we describe our symptoms we don’t deserve to have them heard right but corrected so people hear ‘not that bad’ in place of the truth and we are silenced. And made to seem mad because everyone is being whispered to and ordered to think we are just a bit tired feeling so goodness knows why we can’t even fill in a form of shower - that must be in our heads thinking because we feel a bit tired as people do at the end if a day we ‘over interpret it’

Which is not medical truth and sounds exactly like the misinformation that should be banned but is still being allowed as vicious rumour being pushed via islets from Moss-Morris and Chalder, who should be banned from being allowed to speak words about owns because their attitude is so wrong and harmful.

They are still just pushing that we have false beliefs that we can’t x,y,z ie have not updated a thing other than become more devious and manipulative in brainwashing those around us to believe that about us. It’s so silly dystopian that individuals would go that to others do they can’t even be seen or believed in any part of the world as their life’s aim I find it hard to comprehend . It’s not ‘stigma’ which is the first problem we allow people to get away with as a minimization but designed , systematized ostracisation.


@bobbler Wrote:

"It’s not ‘stigma’ which is the first problem we allow people to get away with as a minimization but designed , systematized ostracisation."



This! Thank you @bobbler. It's now accepted for all to write that ME and the patient are subject to 'stigma', or that the illness is surrounded by 'stigma'. But the word 'stigma' is itself a convenient deceptive smokescreen diversion.

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The analysis yielded three primary themes: (1) Leadership, Collaboration, and Community Engagement; (2) Tailored and Holistic Approaches; and (3) Barriers, Stigma, and Lack of Recognition.
As usual, none for the patients actually asked for this. They reported that being ill is mentally draining and disrupted, and they want to be believed.

The «professionals» went on about deconditioning and psychosocial factors causing ill health.
 
As usual, none for the patients actually asked for this. They reported that being ill is mentally draining and disrupted, and they want to be believed.

The «professionals» went on about deconditioning and psychosocial factors causing ill health.
Indeed. BPS adds a disability on top. ANd it isn't 'a small extra' but I'd say I'm so many times more ill than I ever needed to be and lost most of my opportunities due to them and their misinformation vs if I'd just had ME/CFS and the world hadn't been influenced by them but just gave leeway based on how we describe pushing boundaries makes for deterioration long-term. That's a horrific, embarrassing record.

And of course they want to do what narcissists do in bad relationships in assuming their victim is mad and got it wrong so gaslighting them, but these people are saying - politely because they will already have learned how vicious the penalties are for talking normally with your voice on something they don't like (ie we are silenced) - is "please stop doing this... these are the consequences". And in return they are using it to say they need more of the harmful psychological techniques used not for 'mental health' but to get their way.

I've recently realised one of the issues that caused things to be so horrific for ME/CFS wasn't just that it was psychiatrists and/or bad psychologists that were allowed to obsessively control us, but that we got the dregs of those professions ie the quality of those that focused on us even within those areas. THe ones who believed in some very niche, actually often laughed at twenty years ago 'beliefs' in eg scientific psychology which was having to try and oversee what schools were nonsense and which had method and would ever look to get somewhere that was helpful rather than just prop up doing the same thing.

The above has just drawn in those who would have been normal, logical people doing actual helpful thigns for other segments by making sure they never get to see the full system/picture so they don't realise their 'little bit' isn't actually going to involve someone who will check they haven't been misdiagnosed and has any variety in what they are going to do, and those receiving them aren't told that eg GPs are just given a decision chart of 'could it be fatigue --> send to x to be dealt with' rather than have had all other things looked into by the time they end up there. And noone wants the accountability of opening their eyes to the real function they have and what their cog is actually doing.

Even in mental health you don't fix being bullied at work by only sending someone to a choir and anything good from said choir (when you don't have ME/CFS) is because you happened to meet a normal person who knows bps is bs and so finally gave the basic practical help to stop the bullying and validate the person. INdeed when psychology was proper and a science and not the IAPT ba****isation reversal then you were supposed to begin with the situation because 90% of those in a bad place are due to the situation... and no it isn't theirs alone to fix. Noone is responsible to stop their own bully or unjust situation - that is supposed to be society and bystanders stopping it happenning.

There's the first nonsense propaganda changing black to white eerie message coming from this lot - the idea that those being targeted are causing that themselves, rather than there are bad people and situations who if not given boundaries or disapproval will seek out those who have support removed.

ANd there's the second bps reversal, removing the support system by deliberately spreading misinformation to ostracise people from support networks. WHen real psychology research also noted that for almost all the deterioration is almost always an indicator of how bad or good their support system are acting rather than them and so that needs to be put in place - but these people are deliberately spreading deconstruction of that, in fact a lot of CBT guides are about encouraging others to go do yoga or mindfulness guides to whom they have no relationship over spending time with people who might have spent 20yrs helping them out and need that connection in return.

And of course gerrymandering the relationship/support from any basic service any pwme might ever need to encounter so they can't exist because someone else has got there first with rumour-mongering then telling said services 'if they say anything different assume they are deluded'. So everytime someone just needs to set an appointment for equipment they have some old-fashioned person still being deliberately mis-taught, even though they were pulled up on it in the new guideline so know better and know the foreseeability that 'you'll lose function if you stop using it' nonsense and don't want to hear a word of it as a pwme exhausts themselves trying to explain their world and needs.

I struggle to think of anything more cruel, callous and/or deluded. It's a world of people taught to hold their hand up saying 'talk to the hand not the face' and having not just been given permission for it but told they aren't allowed to do any basic human stuff instead because they will have to explain why they 'broke policy' to all those deluded people 'following the system'. And then they , anyone who has such basic morals they try to give us what basic respect other equivalents might get, get to experience the overwhelming impossibility and energy drain and exhaustion of being sandbagged at every angle and your reputation being trashed behind your back for saying out loud what the eyes can see and is obvious instead of some fake narrative of 'oh yeah now I can see it isn't what I see with my eyes but with my beliefs' kind of game.

These people really think, I think that if we just got their therapy to understand noone really wants to put up with us and our whinging and we just have to understand everyone else doesn't want to see us when we are exhausted so we need to hide it or shove off and 'all will be better' that they've cured our illness. It's their same delusion underneath it all that magically this 'thing' they can't be arsed to 'acknowledge' will eventually go away if they refuse to acknowledge it like a mother with a child saying they grazed their knee stops crying if they say there is no damage and acts unworried.

And they really quite obviously many of those behind this want to spread this worrying attitude-problem into society for any illness and go 'transdiagnostic'. Anything they want to term as 'fatigue' just disappeared by the power not of their words or sophism but how far they will go in coercion and inappropriately using hierarchies and loopholes in systems as long as they can sell it upwards. What we have doesn't really even 'look like' 'fatigue' as they train it into people so the whole thing really is a strange brainwashing a la 1960s nonsense when people do stuff, often way too much in order to please others or achieve something then end up literally passed out and declining severely over the space of 6months.

Not like them feeling sluggish because they got a bit too into the junk food aisle and need to start being more discplined on their box set marathons - and they'll feel much better at work if they spend SUndays doing a walk with the family and add in a few nights after work doing some virtuous hobby instead of whatever. And what assuming that's what 'fatigue' from chemotherapy is like? And 'fatigue' from MS or RA when the meds aren't catching it or have worn off is like? I mean it's nice for them to kid themselves that ill = their sluggishness-feeling or when they feel tired from having done all those lovely trips to zoos and parties with kids others are too unwell to have, but it is amoral and wrong that they are being given permission to pretend they can't learn and won't hear the two are different and need different thigns.


The issue with ME/CFS is that you don't just have a huge disability for example taking 50% of your capability and that being in such a way that it makes you unreliable vs society unless people are given the correct information because if we overdo it then we are out for x days and no colleagues or people around us will accept suddenly not being able to attend work or look after yourself for a week because they made you overdo it by an hour or two or the car broke down or that person thought they were being clever forcing you to walk an extra mile by secretly parking the car further away 'cos they thought it would make you fitter' (more likely they just wanted to kick the dog because they had a bad day but can't admit that part of their human nature to themselves).

The BPS then adds twice that level of disability on top. SO people who might have been able to have with support and the correct adaptations like a blue badge and shower aids and maybe a scooter have a limited social life and work part-time or complete studies with an understanding institution without getting worse are deliberately then being driven to severe where they can't even brush their teeth... just cos of the beliefs of some strange other people.

SO ME/CFS disability isn't just the illness but the BPS misinformation and incitement for people to undermine us and make life deliberately more inaccessible and for us to be targeted and certainly to be kept from any access to any healthcare for anything or support that others might get in any other services.

WHat people are talking about is that this wall of foot on neck that comes in from this system those interviewing are part of is genuinely to the extent people are shocked and probably spend the next ten years checking is really as real as it is because it is so unbelievable. Being deliberately prevaricated through systems that for other illness are made to have a pathway instead of deliberately waste energy in an opaque way so noone can call a decision out - and by doing so they spent ten times more resource than if they just gave the person the thing they needed is the worst bit.
 
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The combination of the title and the content is really incredible. Pure arrogance. It's directed at them, and they're completely oblivious to it. They could put it on a t-shirt they'd wear while gaslighting their patients and think they're doing great. They can pretend to run discussion groups where what the participants say is irrelevant because they just write whatever they want, and apply completely delusional conclusions that have nothing to do with reality, yet again promoting the failed nonsense that has been used in practice for decades. The themes they selected are completely self-centred, and obviously did not come from the patients' discussion but is what they put forward to begin with.

The idea of personalized medicine makes sense in the context of real medicine, but it can't work here, in fact it's the worst possible combination. It does not scale, is completely economically unfeasible. In addition to being a massive failure, which clearly does not bother any of the professionals involved. There is also zero evidence that any level of personalization changes a damn thing, and obviously they do no such thing. Anything they do is irrelevant because it has nothing to do with the problem.

This is just showing how a system built on self-grading cannot be trusted without significant oversight. They keep failing, but they grade their own homework so it doesn't matter, they get a passing grade by simply turning an empty test with their name on it. The whole system is failing, it's layers and layers of process that should be flagging this as invalid, but instead keep demanding more, because it's self-graded.

They want to shift from a model that works, to one that doesn't:
A key strategic goal underpinning this collaboration was the conscious shift from a purely medicalised model of care towards a more sustainable framework of community empowerment. Paula identified the need to:

"shift people from that medical model and management into a community self-care management".


This strategy was presented not only as beneficial for patient autonomy but also as a pragmatic response to a public health system under immense strain. As Sabine noted:

"The NHS is at bursting point. It doesn’t have capacity; it doesn’t have the funding."
But it would have the capacity to do highly-personalized individual 1:1 in-person rehabilitation for months? They don't even bother making sense.

As best as I can tell, all the themes they mention in the abstract came from the professionals. All of them. Of course. It's literally independent discussions that have nothing to do with one another, basically more of a negotiation where one side decides everything and the other has zero leverage. When it comes to what the patients say, they explicitly frame aspirations as basically describing the program. They sold all the eggs so they're all out of chickens but they'll keep selling the idea of having eggs.

Even when it comes to understanding, the participants note how it's nice to have people who get it. Who are the people who get it? The other patients, not the professionals. Good grief Dr Magoo, this is ridiculous.
A powerful therapeutic element was the peer support and shared understanding fostered within the study. Juliet described the profound relief of connecting with others who:

"get it": "I’ve realised how nice it is to talk to someone who understands... it’s just fantastic because they’re like, ‘Yeah, I know that, that’s how I feel’".
Like I mentioned, when the patients talk of legitimacy and discrimination, they mean the medical profession:
Sabine commented that in some medical quarters there were certain beliefs around conditions like Long Covid:

There’s always been people have a typical view of what the old CFS and fibromyalgia population is.
And nothing has changed. This is literally more of the same failure.

Just pure delusion and/or bullshit:
The findings reveal that while a tailored, community-based study can provide significant benefits, its success is contingent upon understanding and addressing the profound psychosocial and systemic challenges that people face.
This literally only comes from the professionals, and those are not 'findings', they're just the typical delusional ideology. None of the participants said anything remotely close to this, but it's the conclusion they began with. There is nothing supporting the conclusion about "structured and highly personalised physical activity initiatives", in fact it's explicitly pointed out how most of the patients can barely walk.

There is zero overlap between what the patients and the professionals say, they're mutually conflicting:
The imperative for a tailored and holistic approach emerged as a central finding, strongly reinforcing the existing evidence base [6, 7]. The negative experience reported by Dave after attempting a gym workout directly reflects the well-documented risk of PEM [5].
Perhaps the most significant contribution of this study is its illumination of the theme of Navigating Barriers, Stigma, and Disbelief. The plea, "We need to be believed," encapsulates a struggle for legitimacy that transcends the physical symptoms of the disease. This experience of delegitimisation is a common and painful feature of other contested illnesses, such as myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) and fibromyalgia [9]. This invalidation is a formidable barrier to care, eroding trust and hindering help-seeking.
They are literally describing what they are doing and are completely oblivious to it. This is a maddening level of incompetence and hubris.

Psychosomatic ideology is by far the most incompetent thing ever put together by a group of professionals. It needs to be rooted out and burned to vapor.
 
@bobbler Wrote:

"It’s not ‘stigma’ which is the first problem we allow people to get away with as a minimization but designed , systematized ostracisation."



This! Thank you @bobbler. It's now accepted for all to write that ME and the patient are subject to 'stigma', or that the illness is surrounded by 'stigma'. But the word 'stigma' is itself a convenient deceptive smokescreen diversion.

.
Yup it’s institutional exclusion of people disabled byME/CFS
 
Psychosomatic ideology is by far the most incompetent thing ever put together by a group of professionals. It needs to be rooted out and burned to vapor.
Psychosomatics is by far the greatest failure and disaster of modern medicine. How it has become so dominant and immune to legit criticism is a damning indictment of the profession's technical and ethical standards, and the rest of the governance system for allowing to get so far and become such a sacred cow.
 
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