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Exploring the role of culture on the experience and perception of healthcare and daily life in patients with persistent physical symptoms

Watts, K. (2017). Exploring the role of culture on the experience and perception of healthcare and daily life in patients with persistent physical symptoms. (Unpublished Doctoral thesis, City, University of London)


Objectives: PPS are common and incur large healthcare costs. BME populations experience relatively poor health, including higher rates of PPS, but are often difficult to reach. This research aims to understand BME experiences of living with PPS, of accessing and receiving healthcare, and the role and influence of cultural factors. The findings may be used to indicate whether current clinical guidelines and training may be in need of further review.

Design: Using thematic analysis, qualitative data was collected using semi-structured interviews.

Methods: 30 patients, 15 white British and 15 BME, were recruited through the PRINCE Secondary trial. Interviews were audio-recorded, transcribed and analysed inductively using thematic analysis. An adapted version of the framework analysis method was employed to identify key differences between white British and BME participant responses.

Results: Five themes emerged, entitled ‘Beliefs surrounding the symptoms’, ‘Putting on a strong face’, ‘A need for social support’, ‘Quality of life has been stripped away’, and ‘Inconsistency within the NHS’. These were also split into 15 sub-themes. BME participants had more complex symptoms; were more likely to retire from work; were less likely to report emotions as out of control; were less accepting of symptoms; were more religious; reported more frequent family conflicts; reported poorer experiences of healthcare, and had a greater preference for holistic therapies.

Conclusion: Future training and guidelines for healthcare professionals may need further revision, in order to accommodate differences between white British and BME patients, and deliver a culturally sensitive service. Psychoeducation can improve patients’ psychological wellbeing. CBT should be recommended for patients keen and able to return to work. ACT may also be of benefit to patients with PPS, particularly those demonstrating low self-efficacy and mental agility, but further robust evidence is required.

Publication Type: Thesis (Doctoral)
Subjects: B Philosophy. Psychology. Religion > BF Psychology
Departments: School of Health & Psychological Sciences
Text - Accepted Version
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