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Upplevelser av kontakten med vården bland patienter med Ehlers-Danlos syndrom – En kvalitativ intervjustudie

Wallström, Johan and Stalfors, Love (2021) LÄKC54 20201
MD Programme
Abstract
Background: Ehlers-Danlos Syndrome (EDS) is a hereditary disease that affects the connective tissue of the body. Common symptoms include stretchy and frail skin, hypermobility, joint pain and chronic fatigue, although the disease is associated with many more symptoms. Because of this, the disease often remains un- or misdiagnosed. The interactions between patients with EDS and healthcare professionals has previously been described as inadequate and patients have reported being mistreated.

Aim: This study aimed to study experiences of individuals suffering from EDS in their interactions with healthcare professionals, as well as their expectations and desires, by examining the following research questions:
● What experiences do... (More)
Background: Ehlers-Danlos Syndrome (EDS) is a hereditary disease that affects the connective tissue of the body. Common symptoms include stretchy and frail skin, hypermobility, joint pain and chronic fatigue, although the disease is associated with many more symptoms. Because of this, the disease often remains un- or misdiagnosed. The interactions between patients with EDS and healthcare professionals has previously been described as inadequate and patients have reported being mistreated.

Aim: This study aimed to study experiences of individuals suffering from EDS in their interactions with healthcare professionals, as well as their expectations and desires, by examining the following research questions:
● What experiences do individuals suffering from EDS have of treatment and support from their interactions with healthcare?
● What do these individuals expect and desire from their healthcare?

Method: Twelve individuals suffering from EDS were interviewed using a study-specific interview guide. The interviews were transcribed and analysed using qualitative text analysis.

Results: Two themes were identified: Treatment from healthcare professionals and One’s own wishes, as well as five categories: Distrust, Knowledge, Support and treatment, Expectations and Continuity.

Conclusions: Participants feel that they rarely receive proper treatment and support. They often feel disrespected and distrusted in meetings with healthcare personnel. Knowledge of EDS among healthcare personnel is rare, according to the participants, forcing them to educate healthcare personnel about EDS themselves. Several participants would rather not seek healthcare, as their expectations of Swedish healthcare aren’t met and the stress and exertion of being mistreated is, according to some participants, worse than living with the symptoms. Poor knowledge of EDS among healthcare personnel can be outweighed if the personnel show insight regarding their own knowledge and respect the patient. According to the participants, many issues could be solved through specialist clinics for EDS, more continuity in healthcare, and better general knowledge of EDS. (Less)
Popular Abstract (Swedish)
Ehlers-Danlos syndrom (EDS) är en ovanlig ärftlig sjukdom som påverkar bindväven och leder till flera olika symptom med påverkan i hela kroppen. Framför allt ses överrörlighet och smärta i leder, trötthet och en generell benägenhet till smärta och ångest, men symptomen kan variera mycket från person till person. Eftersom symptomen även kan ses vid många andra sjukdomar blir det ofta svårt för läkare att sätta rätt diagnos. Vårdpersonalens bemötande gentemot EDS-patienter har tidigare beskrivits som undermåligt och patienter har uppgett att de blivit felbehandlade.

Syftet med denna studie var att undersöka EDS-patienters upplevelser och erfarenheter av bemötande vid kontakt med vården, samt deras önskemål och förväntningar, genom... (More)
Ehlers-Danlos syndrom (EDS) är en ovanlig ärftlig sjukdom som påverkar bindväven och leder till flera olika symptom med påverkan i hela kroppen. Framför allt ses överrörlighet och smärta i leder, trötthet och en generell benägenhet till smärta och ångest, men symptomen kan variera mycket från person till person. Eftersom symptomen även kan ses vid många andra sjukdomar blir det ofta svårt för läkare att sätta rätt diagnos. Vårdpersonalens bemötande gentemot EDS-patienter har tidigare beskrivits som undermåligt och patienter har uppgett att de blivit felbehandlade.

Syftet med denna studie var att undersöka EDS-patienters upplevelser och erfarenheter av bemötande vid kontakt med vården, samt deras önskemål och förväntningar, genom följande frågeställningar:
● Vilka upplevelser och erfarenheter har personer med EDS av kontakten med vården?
● Vad önskar och förväntar sig personer med EDS av sin vård?

I studien intervjuades tolv personer med EDS om sina upplevelser i kontakten med vården, utifrån en intervjuguide utvecklad för studien. Intervjuerna spelades in och analyserades genom kvalitativ textanalys där citat som kunde tänkas svara på frågeställningarna valdes ut.
Utifrån citaten formulerades två teman: Vårdpersonalens Bemötande och Egna önskningar, samt fem kategorier: Misstro, Kunskapsnivå, Stöd och behandling, Förväntningar och Kontinuitet.

Utifrån resultatet dras slutsatsen att de EDS-patienter vi intervjuat upplever att de inte får den vård och det bemötande och stöd som de borde få. Bemötandet från vårdpersonal upplevs alltför ofta undermåligt och har inslag av respektlöshet, misstro och kränkande beteende. Vårdpersonalens kunskap om EDS upplevs vara är för låg och patienterna känner att de behöver informera vårdpersonal om vad deras sjukdom innebär. Detta leder till en ovilja att söka vård hos vissa deltagare, då de är trötta på att inte få sina förväntningar på svensk sjukvård uppfyllda. Små förbättringar i vårdpersonalens bemötande verkar dock kunna göra stor skillnad. Att bemöta patienterna med respekt trots att den egna kunskapen om EDS är dålig kan betyda mycket för patienterna. Deltagarna anser att kontinuitet, specialistvård och större kunskap om EDS bland alla läkare skulle göra stor nytta för personer med EDS eftersom det skulle främja ett gott bemötande samt säkerställa en vård av högre kvalitet. (Less)
Please use this url to cite or link to this publication:
author
Wallström, Johan and Stalfors, Love
supervisor
organization
alternative title
Experiences of health care encounters among patients with Ehler-Danlos syndrome – A qualitative interview study
course
LÄKC54 20201
year
type
L3 - Miscellaneous, Projetcs etc.
subject
keywords
Patientupplevelser, vårdkvalitet, vårdkontakt
language
Swedish
id
9063763
date added to LUP
2021-08-25 15:42:51
date last changed
2021-08-30 16:58:52
@misc{9063763,
  abstract     = {{Background: Ehlers-Danlos Syndrome (EDS) is a hereditary disease that affects the connective tissue of the body. Common symptoms include stretchy and frail skin, hypermobility, joint pain and chronic fatigue, although the disease is associated with many more symptoms. Because of this, the disease often remains un- or misdiagnosed. The interactions between patients with EDS and healthcare professionals has previously been described as inadequate and patients have reported being mistreated. 

Aim: This study aimed to study experiences of individuals suffering from EDS in their interactions with healthcare professionals, as well as their expectations and desires, by examining the following research questions:
●	What experiences do individuals suffering from EDS have of treatment and support from their interactions with healthcare?
●	What do these individuals expect and desire from their healthcare?

Method: Twelve individuals suffering from EDS were interviewed using a study-specific interview guide. The interviews were transcribed and analysed using qualitative text analysis. 

Results: Two themes were identified: Treatment from healthcare professionals and One’s own wishes, as well as five categories: Distrust, Knowledge, Support and treatment, Expectations and Continuity. 

Conclusions: Participants feel that they rarely receive proper treatment and support. They often feel disrespected and distrusted in meetings with healthcare personnel. Knowledge of EDS among healthcare personnel is rare, according to the participants, forcing them to educate healthcare personnel about EDS themselves. Several participants would rather not seek healthcare, as their expectations of Swedish healthcare aren’t met and the stress and exertion of being mistreated is, according to some participants, worse than living with the symptoms. Poor knowledge of EDS among healthcare personnel can be outweighed if the personnel show insight regarding their own knowledge and respect the patient. According to the participants, many issues could be solved through specialist clinics for EDS, more continuity in healthcare, and better general knowledge of EDS.}},
  author       = {{Wallström, Johan and Stalfors, Love}},
  language     = {{swe}},
  note         = {{Student Paper}},
  title        = {{Upplevelser av kontakten med vården bland patienter med Ehlers-Danlos syndrom – En kvalitativ intervjustudie}},
  year         = {{2021}},
}