Choline on the Brain? A Guide to Choline in Chronic Fatigue Syndrome
http://phoenixrising.me/research-2/the-brain-in-chronic-fatigue-syndrome-mecfs/choline-on-the-brain-a-guide-to-choline-in-chronic-fatigue-syndrome-by-cort-johnson-aug-2005
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New paper by Dr Geraghty:ME &BPS :a review of patient harm & distress in the medical encounter

Discussion in 'Latest ME/CFS Research' started by Countrygirl, Jun 22, 2018.

  1. Countrygirl

    Countrygirl Senior Member

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    https://www.tandfonline.com/doi/abs/10.1080/09638288.2018.1481149?journalCode=idre20

    Review Article

    Myalgic encephalomyelitis/chronic fatigue syndrome and the biopsychosocial model: a review of patient harm and distress in the medical encounter
    Keith J. Geraghty &Charlotte Blease
    Received 28 Mar 2017, Accepted 22 May 2018, Published online: 21 Jun 201
    Abstract
    Objective: Despite the growing evidence of physiological and cellular abnormalities in myalgic encephalomyelitis (ME)/chronic fatigue syndrome (CFS), there has been a strong impetus to tackle the illness utilizing a biopsychosocial model. However, many sufferers of this disabling condition report distress and dissatisfaction following medical encounters. This review seeks to account for this discord.

    Methods: A narrative review methodology is employed to synthesize the evidence for potential iatrogenesis.

    Results: We identify seven potential modalities of iatrogenesis or harm reported by patients:

    1. difficulties in reaching an acceptable diagnosis;

    2. misdiagnosis, including of other medical and psychological conditions;

    3. difficulties in accessing the sick role, medical care and social support;

    4. high levels of patient dissatisfaction with the quality of medical care;

    5. negative responses to controversial therapies (cognitive behavioral therapy and graded exercise therapy);

    6. challenges to the patient narrative and experience;

    7. psychological harm (individual and collective distress).


    Conclusion: The biopsychosocial framework currently applied to ME/CFS is too narrow in focus and fails to adequately incorporate the patient narrative. Misdiagnosis, conflict, and harm are observable outcomes where doctors’ and patients’ perspectives remain incongruent. Biopsychosocial practices should be scrutinized for potential harms. Clinicians should consider adopting alternative patient-centred approaches.

    • Implications for rehabilitation
    • Patients with ME/CFS may report or experience one or more of the modalities of harms and distress identified in this review.

    • It is important health and rehabilitation professionals seek to avoid and minimize harms when treating or assisting ME/CFS patients.

    • There are conflicting models of ME/CFS; we highlight two divergent models, a biopsychosocial model and a biomedical model that is preferred by patients.

    • The ‘biopsychosocial framework’ applied in clinical practice promotes treatments such as cognitive behavioral therapy and exercise therapy, however, the evidence for their success is contested and many patients reject the notion their illness is perpetuated by dysfunctional beliefs, personality traits, or behaviors.

    • Health professionals may avoid conflict and harm causation in ME/CFS by adopting more concordant ‘patient-centred’ approaches that give greater prominence to the patient narrative and experience of illness.


    Keywords: Chronic fatigue syndrome, biopsychosocial model, harm, iatrogenesis, treatment, doctor–patient relationship
     
  2. concepcion

    concepcion Senior Member

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    Does anyone have access to the full article?
     
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  3. alkt

    alkt Senior Member

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    the abstract looks like common sense but in effect tells doctors to lie to patients in order to gain trust and does not go into any detail about the fraudulent contested bps research .
     
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  4. CFS_for_19_years

    CFS_for_19_years Hoarder of biscuits

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    shannah, alkt and concepcion like this.
  5. concepcion

    concepcion Senior Member

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  6. Learner1

    Learner1 Forum Support Assistant

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    I hope "patient-centered approaches" means treating the medical issues found in patients with drugs, hormones, supplements, and other medical treatments.
     
  7. Mithriel

    Mithriel Senior Member

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    He means by listening to patients and believing them. Patients know what is helping them and what is doing them harm. He is a complete supporter of biomedical treatment and research for ME.
     
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  8. Mithriel

    Mithriel Senior Member

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    It really does not say that. Keith Geraghty is a staunch supporter of ME patients and a thorn in the side of the BPSers. He wants the patients to be believed and treated as experts in their own condition. The doctors are not encouraged to lie but to actually change how they look at and consider patients.

    It is important to have this sort of thing our there in a peer reviewed scientific paper so it has authority. The fraudulent BPS research is referenced elsewhere. This is not talking to us but to doctors so the language has to be measured to be acceptable to them to ultimately get us the changes we want in the system.
     
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  9. shannah

    shannah Senior Member

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  10. CFS_for_19_years

    CFS_for_19_years Hoarder of biscuits

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    I don't see why not.
     
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  11. CFS_for_19_years

    CFS_for_19_years Hoarder of biscuits

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  12. Tom Kindlon

    Tom Kindlon Senior Member

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    Tom Kindlon Senior Member

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    Tom Kindlon Senior Member

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  15. Tom Kindlon

    Tom Kindlon Senior Member

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    Tom Kindlon Senior Member

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    Tom Kindlon Senior Member

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    Tom Kindlon Senior Member

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  19. Tom Kindlon

    Tom Kindlon Senior Member

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  20. Tom Kindlon

    Tom Kindlon Senior Member

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