چکیده (انگلیسی):

Background:The NICE guideline for Chronic Fatigue Syndrome/Myalgic Encephalomyelitis (CFS/ME) emphasises
the need for an early diagnosis in primary care with management tailored to patient needs. However, GPs can be
reluctant to make a diagnosis and are unsure how to manage people with the condition.
Methods:A meta synthesis of published qualitative studies was conducted, producing a multi-perspective
description of barriers to the diagnosis and management of CFS/ME, and the ways that some health professionals
have been able to overcome them. Analysis provided second-order interpretation of the original findings and
developed third-order constructs to provide recommendations for the medical curriculum.
Results:Twenty one qualitative studies were identified. The literature shows that for over 20 years health
professionals have reported a limited understanding of CFS/ME. Working within the framework of the biomedical
model has also led some GPs to be sceptical about the existence of the condition. GPs who provide a diagnosis
tend to have a broader, multifactorial, model of the condition and more positive attitudes towards CFS/ME. These
GPs collaborate with patients to reach agreement on symptom management, and use their therapeutic skills to
promote self care.
Conclusions:In order to address barriers to the diagnosis and management of CFS/ME in primary care, the
limitations of the biomedical model needs to be recognised. A more flexible bio-psychosocial approach is
recommended where medical school training aims to equip practitioners with the skills needed to understand,
support and manage patients and provide a pathway to refer for specialist input.