Pinxsterhuis2015 Coping with chronic fatigue syndrome: a review and synthesis of qualitative studies

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http://dx.doi.org/10.1080/21641846.2015.1035519

Coping with chronic fatigue syndrome: a review and synthesis of qualitative studies

Fatigue: Biomedicine, Health & Behavior, 2015
Vol. 3, No. 3, 173–188,


Irma Pinxsterhuisa,b*, Elin B. Stranda and Unni Sveenc,d a

Division of Medicine, Oslo University Hospital, P.O. Box 4959 Nydalen, 0424 Oslo, Norway; bFaculty of Medicine, University of Oslo, Oslo, Norway; cDepartment of Physical Medicine and Rehabilitation, Oslo University Hospital, P.O. Box 4956 Nydalen, 0424 Oslo, Norway; dDepartment of Occupational Therapy, Prosthetics and Orthotics, Oslo and Akershus University College of Applied Sciences, Oslo, Norway

(Received 8 December 2014; accepted 25 March 2015)

Background:

Interventions that potentially improve coping with chronic fatigue syndrome (CFS) are important for patients, clinicians, and researchers.

Purpose:

To identify factors experienced by patients to promote coping with CFS and to provide recommendations for adequate interventions in this patient group.

Methods:

A systematic review of qualitative studies was performed.

Structured searches were conducted in major scientific databases.

Two reviewers independently performed the study selection and assessment.

Meta-ethnography was applied to review and synthesise the studies.

The analysis provided key concepts that could be aggregated using second-order interpretations.

Results:

Fifteen studies were included.

Findings suggested that coping strategies, including activity management and the use of cognitive and emotional strategies, and psychological processes, such as acceptance and the rebuilding of identities and lives, may promote coping with CFS.

The use of adequate coping strategies appeared to be facilitated by progress in these psychological processes.

Coping appeared to be facilitated mainly by self-management, occasionally complemented by treatments and social support.

Conclusions:

Interventions focusing on coping may include the use of adequate coping strategies and take into account progress in psychological processes, which may fluctuate over time.

Interventions may be complemented by self-management, other types of treatments, and social support.

Keywords: chronic fatigue syndrome; coping; qualitative research; meta-analysis; review

 

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I found this to be a sympathetic article. Apart from a few small quibbles (which might be due to reviewers' comments), I think I would be happy enough for this to be shared with professionals.

 

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Points I'm not fully convinced about:

Identifying barriers to reaching specific goals were also considered helpful.[24]

Larun and Malterud’s study [19] highlighted the importance of setting small and specific goals for physical exercise, whereas Ward et al. [22] found that exercise regimes that caused participants to feel pushed to overdo it often were experienced to lead to setbacks.

Our synthesis indicated that the use of adequate coping strategies, such as activity management (problem-focused coping [8]) and cognitive and emotional strategies (emotion-focused coping [8]), may be facilitated by progress in psychological processes. Our findings were consistent with findings from other studies presenting theories on coping with different chronic illnesses.[28–30] However, listening to body signals and monitoring physical experiences and energy levels to enable individuals to live within their limits, preventing over-exertion and enabling faster restoration, appear to be more typical coping strategies for individuals with CFS. This finding is not surprising, as even minor over-exertions may lead to extensive setbacks. [13,16,31,32] The usefulness of pacing, however, is disputed among scientists, as quantitative studies have shown conflicting results regarding interventions including pacing. [33,34] Slightly divergent interpretations of pacing in these studies may explain the differences in outcomes,[35] as practising pacing by under-expending available energy may not be beneficial.[36].