Living with and caring for somatic symptom disorders: a qualitative interview-study with patients and GPs using a deductive-inductive content analytic approach

BACKGROUND: Persistent physical symptoms are common in general practice and often occur as part of a somatic symptom disorder. Patients suffering from somatic symptom disorders and their general practitioners (GPs) often experience barriers to mutual trust and effective care. Frequently, studies using a one-sided perspective bear mutual accusation about shortcomings of the respective other side. This study examines corresponding perspectives of patients with somatic symptom disorders and their treating GPs to capture their views on individual patient histories and thereby identify barriers to and potentially helpful aspects of communication, detection, care for and live with somatic symptom disorders. METHODS: Qualitative face-to-face interviews were conducted with dyads of patients with somatic symptom disorders and their treating GPs. The interviews focused on the patients' medical history as well as barriers and facilitators of management and care in general practice. Patients and their respective GPs were interviewed separately using a semi-structured interview guide. Interviews were digitally recorded and transcribed verbatim. Transcripts were analyzed using the qualitative content analysis approach described by Mayring. RESULTS: We interviewed 15 patient-GP dyads (i.e., 30 interviews). The interviews yielded three general aspects of living with and caring for somatic symptom disorders from the complementing perspectives of patients and their treating GPs: (1) The (undisclosed) patient side (partly invisible to the GP), (2) the shared part of the consultation in general practice, and (3) GPs' management and care. Patients and GPs alike talked about consultations focusing mainly on communicational and relational aspects. Patients painted a picture of living with somatic symptom disorders, giving details about the relevance of personal situation, relationships, and their work situation for their symptoms and illness management. GPs' focus lay on coordinating functions, and treatment and management strategies for patients with somatic symptom disorders. CONCLUSION: To establish a trusting relationship between patient and general practitioner, removal of time constraints for consultations and preoccupations for symptom management should allow for better insights of the general practitioners in patients' lives. If we allow for time to let the patient-doctor relationship grow, mutual trust may ensue. GERMAN CLINICAL TRIAL REGISTER: ID: DRKS00011380, registration date: 1st December 2016.