<abstract xmlns="http://www.w3.org/1999/xhtml"><sec id="j_sjph-2017-0012_s_006_w2aab2b8b3b1b7b1aab1c15b1Aa"><h3>Introduction</h3><p>Medically unexplained symptoms (MUS) are very common in family medicine, despite being a poorly-defined clinical entity. This study aimed to evaluate the effect of an educational intervention (EI) on self-rated quality of life, treatment satisfaction, and the family physician-patient relationship in patients with MUS.</p></sec><sec id="j_sjph-2017-0012_s_007_w2aab2b8b3b1b7b1aab1c15b2Aa"><h3>Methods</h3><p>In a multi-centre longitudinal intervention study, which was performed between 2012 and 2014, patients were asked to rate their quality of life, assess their depression, anxiety, stress and somatisation, complete the Hypochondriasis Index, the Medical Interview Satisfaction Scale and the Patient Enablement Instrument for assessing the physician-patient relationship, before and after the EI.</p></sec><sec id="j_sjph-2017-0012_s_008_w2aab2b8b3b1b7b1aab1c15b3Aa"><h3>Results</h3><p>The mean values before and after the intervention showed that after the EI, patients with MUS gave a lower (total) mean rating of their health issues and a higher rating of their quality of life, and they also had a more positive opinion of their relationship with the physician (p&lt;0.05). However, there were no differences in the (total) rating of treatment satisfaction before and after the EI (p=0.423). Significant differences in the symptoms in patients with MUS before and after the intervention were confirmed for stress, somatisation and hypochondriasis (p&lt;0.05).</p></sec><sec id="j_sjph-2017-0012_s_009_w2aab2b8b3b1b7b1aab1c15b4Aa"><h3>Conclusions</h3><p>It could be beneficial to equip family physicians with the knowledge, skills and tools to reduce hypochondriasis and somatisation in MUS patients, which would improve patients’ self-rated health status.</p></sec></abstract>

IntroductionMedically unexplained symptoms (MUS) are very common in family medicine, despite being a poorly-defined clinical entity. This study aimed to evaluate the effect of an educational intervention (EI) on self-rated quality of life, treatment satisfaction, and the family physician-patient relationship in patients with MUS.MethodsIn a multi-centre longitudinal intervention study, which was performed between 2012 and 2014, patients were asked to rate their quality of life, assess their depression, anxiety, stress and somatisation, complete the Hypochondriasis Index, the Medical Interview Satisfaction Scale and the Patient Enablement Instrument for assessing the physician-patient relationship, before and after the EI.ResultsThe mean values before and after the intervention showed that after the EI, patients with MUS gave a lower (total) mean rating of their health issues and a higher rating of their quality of life, and they also had a more positive opinion of their relationship with the physician (p<0.05). However, there were no differences in the (total) rating of treatment satisfaction before and after the EI (p=0.423). Significant differences in the symptoms in patients with MUS before and after the intervention were confirmed for stress, somatisation and hypochondriasis (p<0.05).ConclusionsIt could be beneficial to equip family physicians with the knowledge, skills and tools to reduce hypochondriasis and somatisation in MUS patients, which would improve patients’ self-rated health status.

The effect of an educational intervention in family phisicians on self-rated quality of life in patients with medically unexplained symptoms

University of Maribor, Faculty of Medicine, Department of Family Medicine, Taborska 8, 2000 Maribor,

SAVA MED, d.o.o., Cesta k Dravi 8, 2241 Spodnji Duplek,

University of Ljubljana, Faculty of Medicine, Department of Family Medicine, Poljanski nasip 58, 1000 Ljubljana,

Slovenian Journal of Public Health

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.

VPLIV EDUKATIVNE INTERVENCIJE ZDRAVNIKOV NA SAMOOCENO KAKOVOSTI ŽIVLJENJA, ZADOVOLJSTVA Z OBRAVNAVO IN PARTNERSKEGA ODNOSA Z ZDRAVNIKOM DRUŽINSKE MEDICINE PRI BOLNIKIH Z MEDICINSKO NEPOJASNJENIMI STANJI

IntroductionMedically unexplained symptoms (MUS) are very common in family medicine, despite being a poorly-defined clinical entity. This study aimed to...

		BEFORE INTERVENTION	AFTER INTERVENTION	P
		n=422	n=269
Depression		n = 260 (61.6%)	n = 170 (63.2%)
(Criterion: depression >2)
Mean ± standard dev'ation		3.92±3.270	3.85±3.100	0.051
95% confidence interval
	lower limit	3.61	3.48
	upper limit	4.24	4.22

Anxiety		n = 126 (29.9%)	n=77 (28.6%)
(Criterion: anxiety >8)
Mean ± standard dev'ation		6.53±5.325	6.36±5.145	0.558
95% confidence interval
	lower limit	6.02	5.74
	upper limit	7.04	6.97

Stress		n=367 (87.2%)	n = 237 (88.1%)
(Criterion: stress >10)
Mean ± standard deviation		19.57±7.216	18.64±6.701	0.000
95% confidence interval
	lower limit	18.88	17.83
	upper limit	20.26	19.44

Somatisation		n=393 (93.1%)	n=248 (92.2%)
(Criterion: somatisation >10)
Mean ± standard deviation		19.49±5.728	18.54±5.585	0.000
95% confidence interval
	lower limit	18.94	17.87
	upper limit	20.04	19.21

Whiteley Hypochondriasis Index		n=422 (100%)	n=269 (100%)
Mean ± standard dev’ation		45.31±9.732	44.16±8.785	0.000
95% confidence interval
	lower limit	44.38	43.11
	upper limit	46.24	45.22

		BEFORE INTERVENTION	AFTER INTERVENTION	P
		n=422	n=269
		(Total) rating of healtd issues

Mean ± standard deviation		8.51±1.40	8.16±1.45	0.000
95% confidence interval
	lower limit	8.38	7.98
	upper limit	8.65	8.33

		Quality of life (self-rated healtd)

Mean ± standard deviation		44.81±11.927	48.21±11.722	0.000
95% confidence interval
	lower limit	43.67	46.80
	upper limit	45.95	49.62

		(Total) rating of treatment satisfaction

Mean ± standard deviation		3.72±0.400	3.71±0.304	0.423
95% confidence interval
	lower limit	3.68	3.68
	upper limit	3.76	3.75

		Opinion on tde physician-patient relationship	1

Mean ± standard deviation		2.69±0.48	2.39±0.53	0.000
95% confidence interval
	lower limit	2.65	2.33
	upper limit	2.74	2.45

The effect of an educational intervention in family phisicians on self-rated quality of life in patients with medically unexplained symptoms

Article Category: Original scientific article

Published Online: Feb 26, 2017

Page range: 91 - 98

Received: May 09, 2016

Accepted: Sep 02, 2016

DOI: https://doi.org/10.1515/sjph-2017-0012

Keywords
medically unexplained symptoms, family medicine, educational intervention, quality of life, treatment satisfaction, family physician-patient relationship

© National Institute of Public Health, Slovenia

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.

Figure 1

Figure 2

The analysis of differences in the symptoms of MUS patients, and the hypochondriasis index before and after the intervention.

The analysis of differences in the (total) rating of health issues, quality of life, treatment satisfaction and the physicianpatient relationship in patients with MUS, before and after the intervention.

The effect of an educational intervention in family phisicians on self-rated quality of life in patients with medically unexplained symptoms

Article Category: Original scientific article

Published Online: Feb 26, 2017

Page range: 91 - 98

Received: May 09, 2016

Accepted: Sep 02, 2016

DOI: https://doi.org/10.1515/sjph-2017-0012

Keywordsmedically unexplained symptoms, family medicine, educational intervention, quality of life, treatment satisfaction, family physician-patient relationship

© National Institute of Public Health, Slovenia

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.

Figure 1

Figure 2

The analysis of differences in the symptoms of MUS patients, and the hypochondriasis index before and after the intervention.

The analysis of differences in the (total) rating of health issues, quality of life, treatment satisfaction and the physicianpatient relationship in patients with MUS, before and after the intervention.

Keywords
medically unexplained symptoms, family medicine, educational intervention, quality of life, treatment satisfaction, family physician-patient relationship