چکیده (انگلیسی):

Background:Patients with medically unexplained physical symptoms (MUPS) form a heterogeneous group and
frequently attend their family physician (FP). Little is known about how FPs recognize MUPS in their patients.
We conducted a focus group study to explore how FPs recognize MUPS and whether they recognize specific
subgroups of patients with MUPS. Targeting such subgroups might improve treatment outcomes.
Methods:Six focus groups were conducted with in total 29 Dutch FPs. Two researchers independently analysed
the data applying the principles of constant comparative analysis in order to detect characteristics to recognize
MUPS and to synthesize subgroups.
Results:FPs take into account various characteristics when recognizing MUPS in their patients. More objective
characteristics were multiple MUPS, frequent and long consultations and many referrals. Subjective characteristics
were negative feelings towards patients and the feeling that the FP cannot make sense of the patient’sstory.Experience
of the FP, affinity with MUPS, consultation skills, knowledge of the patient’s context and the doctor-patient relationship
seemed to influence how and to what extent these characteristics play a role. Based on the perceptions of the FPs we
were able to distinguish five subgroups of patients according to FPs: 1) the anxious MUPS patient, 2) the unhappy MUPS
patient, 3) the passive MUPS patient, 4) the distressed MUPS patient, and 5) the puzzled MUPS patient. These
subgroups were not mutually exclusive, but were based on how explicit and predominant certain characteristics were
perceived by FPs.
Conclusions:FPs believe that they can properly identify MUPS in their patients during consultations and five distinct
subgroups of patients could be distinguished. If these subgroups can be confirmed in further research, personalized
treatment strategies can be developed and tested for their effectiveness.