Education on medically unexplained symptoms: a systematic review with a focus on cultural diversity and migrants 2023, Vermeir et al

Sly Saint

Senior Member (Voting Rights)
Abstract
Background

Health care providers often struggle with the management of patients with medically unexplained symptoms (MUS), especially in case of a different ethnicity and/or cultural background. These challenges are insufficiently addressed in their training.

Objectives
A systematic review on education in the field of MUS in a diverse context to improve MUS healthcare provider–patient interaction focused on intercultural communication.

Methods
Screening of PubMed, Web of Science, Cinahl and Cochrane Library on the keywords ‘Medical unexplained (physical) symptoms (MUS)’, ‘Somatoform disorder’, ‘Functional syndrome’, ‘Diversity’, ‘Migrants’, ‘Ethnicity’, ‘Care models’, ‘Medical education’, ‘Communication skills’, ‘Health literacy’.

Results
MUS patients, especially with a different ethnic background, often feel not understood or neglected. Health care providers experience feelings of helplessness, which may provoke medical shopping and resource consumption. Attitudes and perceptions from undergraduate trainees to senior physicians tend to be negative, impacting on the quality of the patient/health care provider relationship and subsequently on health outcomes, patient satisfaction and therapeutic adherence. Current undergraduate, graduate and postgraduate education and training does not prepare health care providers for diagnosing and managing MUS patients in a diverse context. A continuum of training is necessary to achieve a long term and lasting change in attitudes towards these patients and trainers play a key role in this process. Hence, education should pay attention to MUS, requiring a specific competency profile and training, taken into account the variety in patients’ cultural backgrounds.

Conclusions
This systematic review identified significant gaps and shortcomings in education on MUS in a diverse context. These need to be addressed to improve outcomes.

https://eurjmedres.biomedcentral.com/articles/10.1186/s40001-023-01105-7
 
Poor widdle doctor-poos. It must be so stressful having to sell snake-oil to your patients day after day, and being confronted with the inevitable lack of results and pissed off patients.

Let's give them all medals for being so brave in the face of hard reality.
 
MUS patients, especially with a different ethnic background, often feel not understood or neglected.

-> "MUS patients, especially with a different ethnic background, are often not understood and neglected."

Health care providers experience feelings of helplessness, which may provoke medical shopping and resource consumption.

I'm seeing the doctors trotting off en masse down to the Audi show room...

"CFS/ME". Ah OK, I'm about to stop reading... although I do agree with —

Educational interventions are needed to provide students with an acceptable and coherent model of CFS/ME and to give them the skills and confidence for diagnosis and management in their future medical practice.

Dualistic health care systems with separation between somatic and mental health disciplines produce delayed diagnoses (with a mean estimated duration between onset of somatoform disorder and first psychotherapeutic and psychiatric treatment of 25 years) and increase stigma for mental disorders.

The dualistic healthcare system might be better defined as the scientific good one and the pseudoscientific harmful one (whether that's oncology, orthopaedics or psychiatry). Although full credit to these patients for avoiding useless treatments for 25 years!
 
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