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Erschienen in: Quality of Life Research 3/2020

15.11.2019 | Care

Quality of life in primary care patients with moderate medically unexplained physical symptoms

verfasst von: P. E. van Westrienen, M. F. Pisters, S. A. J. Toonders, M. Gerrits, N. J. de Wit, C. Veenhof

Erschienen in: Quality of Life Research | Ausgabe 3/2020

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Abstract

Purpose

Medically Unexplained Physical Symptoms (MUPS) have a large impact on patient’s quality of life. Most studies have been limited to chronic MUPS and thus, little is known about moderate MUPS. Improved knowledge concerning determinants influencing quality of life in moderate MUPS patients can be helpful in managing MUPS. This study is aimed at describing the common characteristics seen in moderate MUPS patients and compare them with characteristics seen in chronic MUPS patients and general population. We also identified determinants of the physical and mental components of quality of life in moderate MUPS patients.

Methods

In a cross-sectional study, moderate MUPS patients (n = 160) were compared with chronic MUPS patients (n = 162) and general population (n = 1742) based on demographic characteristics and patient’s quality of life. Multivariable linear regression analyses were performed to identify determinants associated with a patient’s quality of life, assessed with the RAND-36.

Results

Moderate MUPS patients experienced a better quality of life than chronic MUPS patients, but a worse quality of life as compared to the general population. Determinants associated with the physical and mental components of quality of life explain 49.1% and 62.9% of the variance, respectively.

Conclusion

Quality of life of patients with MUPS varies with MUPS disease stage. Based on their quality of life scores, moderate MUPS patients would be adequately distinguished from chronic MUPS patients. Half of the variance in the physical component and almost two thirds of the mental component would be explained by a number of MUPS-related symptoms and perceptions.
Literatur
1.
Zurück zum Zitat Olde Hartman, T., Blankenstein, A., Molenaar, A., Bentz van den Berg, D., Van der Horst, H., Arnold, I., et al. (2013). NHG-standaard somatisch onvoldoende verklaarde Lichamelijk Klachten (SOLK). Huisarts Wet,56(5), 222–230. Olde Hartman, T., Blankenstein, A., Molenaar, A., Bentz van den Berg, D., Van der Horst, H., Arnold, I., et al. (2013). NHG-standaard somatisch onvoldoende verklaarde Lichamelijk Klachten (SOLK). Huisarts Wet,56(5), 222–230.
2.
Zurück zum Zitat Landelijke Stuurgroep Multidisciplinaire Richtlijnontwikkeling in de GGZ. (2010). Multidisciplinaire Richtlijn Somatisch Onvoldoende Verklaarde Lichamelijke Klachten En Somatoforme Stoornissen (Multidisciplinary Guideline of MUPS and Somatoform Disorders). Utrecht: Netherlands Institute of Mental Health Care and Addiction and Dutch Institute of Health Care Improvement 2010. Landelijke Stuurgroep Multidisciplinaire Richtlijnontwikkeling in de GGZ. (2010). Multidisciplinaire Richtlijn Somatisch Onvoldoende Verklaarde Lichamelijke Klachten En Somatoforme Stoornissen (Multidisciplinary Guideline of MUPS and Somatoform Disorders). Utrecht: Netherlands Institute of Mental Health Care and Addiction and Dutch Institute of Health Care Improvement 2010.
6.
Zurück zum Zitat American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (DSM-5) (5th ed.). Washington: American Psychiatric Press.CrossRef American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (DSM-5) (5th ed.). Washington: American Psychiatric Press.CrossRef
9.
Zurück zum Zitat Zonneveld, L. N., Sprangers, M. A., Kooiman, C. G., van ‘t Spijker, A., & Busschbach, J. J. (2013). Patients with unexplained physical symptoms have poorer quality of life and higher costs than other patient groups: A cross-sectional study on burden. BMC Health Services Research,17(13), 520. https://doi.org/10.1186/1472-6963-13-520.CrossRef Zonneveld, L. N., Sprangers, M. A., Kooiman, C. G., van ‘t Spijker, A., & Busschbach, J. J. (2013). Patients with unexplained physical symptoms have poorer quality of life and higher costs than other patient groups: A cross-sectional study on burden. BMC Health Services Research,17(13), 520. https://​doi.​org/​10.​1186/​1472-6963-13-520.CrossRef
14.
Zurück zum Zitat Olde Hartman, T. C., Hassink-Franke, L. J., Lucassen, P. L., van Spaendonck, K. P., & van Weel, C. (2009). Explanation and relations. How do general practitioners deal with patients with persistent medically unexplained symptoms: A focus group study. BMC Family Practice,24(10), 68. https://doi.org/10.1186/1471-2296-10-68.CrossRef Olde Hartman, T. C., Hassink-Franke, L. J., Lucassen, P. L., van Spaendonck, K. P., & van Weel, C. (2009). Explanation and relations. How do general practitioners deal with patients with persistent medically unexplained symptoms: A focus group study. BMC Family Practice,24(10), 68. https://​doi.​org/​10.​1186/​1471-2296-10-68.CrossRef
15.
Zurück zum Zitat Kroenke, K., & Jackson, J. (1998). Outcome in general medical patients presenting with common symptoms: A prospective study with a 2-week and a 3-month follow-up. Family Practice,15(5), 398–403.CrossRef Kroenke, K., & Jackson, J. (1998). Outcome in general medical patients presenting with common symptoms: A prospective study with a 2-week and a 3-month follow-up. Family Practice,15(5), 398–403.CrossRef
19.
Zurück zum Zitat Salaffi, F., Sarzi-Puttini, P., Girolimetti, R., Atzeni, F., Gasparini, S., & Grassi, W. (2009). Health-related quality of life in fibromyalgia patients: A comparison with rheumatoid arthritis patients and the general population using the SF-36 health survey. Clinical and Experimental Rheumatology,27(5 Suppl 56), S67–S74.PubMed Salaffi, F., Sarzi-Puttini, P., Girolimetti, R., Atzeni, F., Gasparini, S., & Grassi, W. (2009). Health-related quality of life in fibromyalgia patients: A comparison with rheumatoid arthritis patients and the general population using the SF-36 health survey. Clinical and Experimental Rheumatology,27(5 Suppl 56), S67–S74.PubMed
24.
Zurück zum Zitat Rusu, C., Gee, M. E., Lagacé, C., & Parlor, M. (2015). Chronic fatigue syndrome and fibromyalgia in Canada: Prevalence and associations with six health status indicators. Health Promotion and Chronic Disease Prevention in Canada,35(1), 3–11.CrossRef Rusu, C., Gee, M. E., Lagacé, C., & Parlor, M. (2015). Chronic fatigue syndrome and fibromyalgia in Canada: Prevalence and associations with six health status indicators. Health Promotion and Chronic Disease Prevention in Canada,35(1), 3–11.CrossRef
27.
Zurück zum Zitat Soriano-Maldonado, A., Amris, K., Ortega, F. B., Segura-Jiménez, V., Estévez-López, F., Álvarez-Gallardo, I. C., et al. (2015). Association of different levels of depressive symptoms with symptomatology, overall disease severity, and quality of life in women with fibromyalgia. Quality of Life Research,24(12), 2951–2957. https://doi.org/10.1007/s11136-015-1045-0.CrossRefPubMed Soriano-Maldonado, A., Amris, K., Ortega, F. B., Segura-Jiménez, V., Estévez-López, F., Álvarez-Gallardo, I. C., et al. (2015). Association of different levels of depressive symptoms with symptomatology, overall disease severity, and quality of life in women with fibromyalgia. Quality of Life Research,24(12), 2951–2957. https://​doi.​org/​10.​1007/​s11136-015-1045-0.CrossRefPubMed
29.
Zurück zum Zitat Bernardy, K., Klose, P., Welsch, P., & Häuser, W. (2018). Efficacy, acceptability and safety of cognitive behavioural therapies in fibromyalgia syndrome—A systematic review and meta-analysis of randomized controlled trials. European Journal of Pain,22(2), 242–260. https://doi.org/10.1002/ejp.1121.CrossRefPubMed Bernardy, K., Klose, P., Welsch, P., & Häuser, W. (2018). Efficacy, acceptability and safety of cognitive behavioural therapies in fibromyalgia syndrome—A systematic review and meta-analysis of randomized controlled trials. European Journal of Pain,22(2), 242–260. https://​doi.​org/​10.​1002/​ejp.​1121.CrossRefPubMed
33.
Zurück zum Zitat Henningsen, P. (2018). Management of somatic symptom disorder. Dialogues in Clinical Neuroscience,20(1), 23–31.PubMedPubMedCentral Henningsen, P. (2018). Management of somatic symptom disorder. Dialogues in Clinical Neuroscience,20(1), 23–31.PubMedPubMedCentral
35.
36.
Zurück zum Zitat Aaronson, N. K., Muller, M., Cohen, P. D., Essink-Bot, M. L., Fekkes, M., Sanderman, R., et al. (1998). Translation, validation, and norming of the Dutch language version of the SF-36 Health Survey in community and chronic disease populations. Journal of Clinical Epidemiology,51(11), 1055–1068.CrossRef Aaronson, N. K., Muller, M., Cohen, P. D., Essink-Bot, M. L., Fekkes, M., Sanderman, R., et al. (1998). Translation, validation, and norming of the Dutch language version of the SF-36 Health Survey in community and chronic disease populations. Journal of Clinical Epidemiology,51(11), 1055–1068.CrossRef
37.
Zurück zum Zitat Van der Zee, K. I., Sanderman, R. (1993). Het meten van de algemene gezondheidstoestandmet de RAND-36, een handleiding (Measurement of general healthwith the RAND-36, amanual). Groningen, the Netherlands: Noordelijk Centrum voor Gezondheidsvraagstukken; 1993. Van der Zee, K. I., Sanderman, R. (1993). Het meten van de algemene gezondheidstoestandmet de RAND-36, een handleiding (Measurement of general healthwith the RAND-36, amanual). Groningen, the Netherlands: Noordelijk Centrum voor Gezondheidsvraagstukken; 1993.
39.
Zurück zum Zitat Ware, J. E. J., & Gandek, B. (1998). Overview of the SF-36 health survey and the International Quality of Life Assessment (IQOLA) Project. Journal of Clinical Epidemiology,51(11), 903–912.CrossRef Ware, J. E. J., & Gandek, B. (1998). Overview of the SF-36 health survey and the International Quality of Life Assessment (IQOLA) Project. Journal of Clinical Epidemiology,51(11), 903–912.CrossRef
40.
Zurück zum Zitat Ware, J. E. J., Gandek, B., Kosinski, M., Aaronson, N. K., Apolone, G., Brazier, J., et al. (1998). The equivalence of SF-36 summary health scores estimated using standard and country-specific algorithms in 10 countries: Results from the IQOLA Project. International Quality of Life Assessment. Journal of Clinical Epidemiology,51(11), 1167–1170.CrossRef Ware, J. E. J., Gandek, B., Kosinski, M., Aaronson, N. K., Apolone, G., Brazier, J., et al. (1998). The equivalence of SF-36 summary health scores estimated using standard and country-specific algorithms in 10 countries: Results from the IQOLA Project. International Quality of Life Assessment. Journal of Clinical Epidemiology,51(11), 1167–1170.CrossRef
42.
Zurück zum Zitat Terluin, B., van Marwijk, H., Adèr, H., de Vet, H., Penninx, B., Hermens, M., et al. (2006). The Four-Dimensional Symptom Questionnaire (4DSQ): A validation study of a multidimensional self-report questionnaire to assess distress, depression, anxiety and somatization. BMC Psychiatry,22(6), 34. https://doi.org/10.1186/1471-244X-6-34.CrossRef Terluin, B., van Marwijk, H., Adèr, H., de Vet, H., Penninx, B., Hermens, M., et al. (2006). The Four-Dimensional Symptom Questionnaire (4DSQ): A validation study of a multidimensional self-report questionnaire to assess distress, depression, anxiety and somatization. BMC Psychiatry,22(6), 34. https://​doi.​org/​10.​1186/​1471-244X-6-34.CrossRef
43.
Zurück zum Zitat De, Terluin B. (1996). Vierdimensionale Klachtenlijst (4DKL): Een vragenlijst voor het meten van distress, depressie, angst en somatisatie. Huisarts Wet,39, 538–547. De, Terluin B. (1996). Vierdimensionale Klachtenlijst (4DKL): Een vragenlijst voor het meten van distress, depressie, angst en somatisatie. Huisarts Wet,39, 538–547.
44.
Zurück zum Zitat Terluin, B., Terluin, M., Prince, K., & van Marwijk, H. W. J. (2008). The Four-Dimensional Symptom Questionnaire (4DSQ) detects psychological problems. Huisarts Wet,51, 251–255.CrossRef Terluin, B., Terluin, M., Prince, K., & van Marwijk, H. W. J. (2008). The Four-Dimensional Symptom Questionnaire (4DSQ) detects psychological problems. Huisarts Wet,51, 251–255.CrossRef
45.
Zurück zum Zitat Terluin, B., Oosterbaan, D. B., Brouwers, E. P., van Straten, A., van de Ven, P. M., Langerak, W., et al. (2014). To what extent does the anxiety scale of the Four-Dimensional Symptom Questionnaire (4DSQ) detect specific types of anxiety disorder in primary care? A psychometric study. BMC Psychiatry,24(12), 121. https://doi.org/10.1186/1471-244X-14-121.CrossRef Terluin, B., Oosterbaan, D. B., Brouwers, E. P., van Straten, A., van de Ven, P. M., Langerak, W., et al. (2014). To what extent does the anxiety scale of the Four-Dimensional Symptom Questionnaire (4DSQ) detect specific types of anxiety disorder in primary care? A psychometric study. BMC Psychiatry,24(12), 121. https://​doi.​org/​10.​1186/​1471-244X-14-121.CrossRef
47.
Zurück zum Zitat Bussmann, H. (2013). Validation of the Active8 activity monitor: Detection of body postures and movements. Erasmus MC: Publisher. Bussmann, H. (2013). Validation of the Active8 activity monitor: Detection of body postures and movements. Erasmus MC: Publisher.
50.
Zurück zum Zitat Tremblay, M. S., Aubert, S., Barnes, J. D., Saunders, T. J., Carson, V., Latimer-Cheung, A. E., et al. (2017). Sedentary behavior research network (SBRN)—Terminology consensus project process and outcome. International Journal of Behavioral Nutrition and Physical Activity,14(1), 75. https://doi.org/10.1186/s12966-017-0525-8.CrossRefPubMed Tremblay, M. S., Aubert, S., Barnes, J. D., Saunders, T. J., Carson, V., Latimer-Cheung, A. E., et al. (2017). Sedentary behavior research network (SBRN)—Terminology consensus project process and outcome. International Journal of Behavioral Nutrition and Physical Activity,14(1), 75. https://​doi.​org/​10.​1186/​s12966-017-0525-8.CrossRefPubMed
51.
Zurück zum Zitat Health Council of the Netherlands. (2017). Physical activity guidelines 2017. The Hague: Health Council of the Netherlands, 2017;publication no. 2017/08e. Health Council of the Netherlands. (2017). Physical activity guidelines 2017. The Hague: Health Council of the Netherlands, 2017;publication no. 2017/08e.
52.
Zurück zum Zitat Divisie Sociale en ruimtelijke statistieken Sector Sociaal-economisch totaalbeeld. (2017). Standaard onderwijsindeling 2006—Editie 2016/’17. Centraal Bureau voor de Statistiek, Den Haag/Heerlen; 2017:10–14. Divisie Sociale en ruimtelijke statistieken Sector Sociaal-economisch totaalbeeld. (2017). Standaard onderwijsindeling 2006—Editie 2016/’17. Centraal Bureau voor de Statistiek, Den Haag/Heerlen; 2017:10–14.
54.
Zurück zum Zitat Miles, J., & Shevlin, M. (2001). Applying regression and correlation. A guide for students and researchers (2nd ed.). London: SAGE Publications Ltd. Miles, J., & Shevlin, M. (2001). Applying regression and correlation. A guide for students and researchers (2nd ed.). London: SAGE Publications Ltd.
55.
Zurück zum Zitat Ware, J. E., Snow, K. K., Kosinski, M., & Gandek, B. (1993). SF-36 health survey manual and interpretation guide. Boston, MA: New England Medical Center, The Health Institute. Ware, J. E., Snow, K. K., Kosinski, M., & Gandek, B. (1993). SF-36 health survey manual and interpretation guide. Boston, MA: New England Medical Center, The Health Institute.
Metadaten
Titel
Quality of life in primary care patients with moderate medically unexplained physical symptoms
verfasst von
P. E. van Westrienen
M. F. Pisters
S. A. J. Toonders
M. Gerrits
N. J. de Wit
C. Veenhof
Publikationsdatum
15.11.2019
Verlag
Springer International Publishing
Schlagwort
Care
Erschienen in
Quality of Life Research / Ausgabe 3/2020
Print ISSN: 0962-9343
Elektronische ISSN: 1573-2649
DOI
https://doi.org/10.1007/s11136-019-02358-8

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