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Practice Nurses’ views of their role in the management of Chronic Fatigue Syndrome/Myalgic Encephalitis: A qualitative study – Source: BMC Nursing, Jan 22, 2009

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Background: NICE [the UK’s National Institute for Clinical Excellence] guidelines suggest that patients with Chronic Fatigue Syndrome/Myalgic Encephalitis (CFS/ME) should be managed in Primary Care. Practice Nurses are increasingly being involved in the management of long-term conditions, so are likely to also have a growing role in managing CFS/ME.

However their attitudes to, and experiences of patients with CFS/ME and its management must be explored to understand what barriers may exist in developing their role for this group of patients. The aim of this study was to explore Practice Nurses’ understanding and beliefs about CFS/ME and its management.

Methods: Semi-structured interviews with 29 Practice Nurses. Interviews were transcribed verbatim and an iterative approach used to develop themes from the dataset.

Results: Practice nurses had limited understanding about CFS/ME which had been largely gained through contact with patients, friends, personal experiences and the media rather than formal training.

They had difficulty seeing CFS/ME as a long term condition.

They did identify a potential role they could have in management of CFS/ME but devalued their own skills in psychological intervention, and suggested counseling would be an appropriate therapeutic option.

They recognized a need for further training and ongoing supervision from both medical and psychological colleagues.

Some viewed the condition as contentious and held pejorative views about CFS/ME. Such skepticism and negative attitudes will be a significant barrier to the management of patients with CFS/ME in primary care.

Conclusions:

• The current role of Practice Nurses in the ongoing management of patients with CFS/ME is limited.

• Practice Nurses have little understanding of the evidence-base for treatment of CFS/ME, particularly psychological therapies, describing management options in terms of advice giving, self-help or counseling.

• Practice Nurses largely welcomed the potential development of their role in this area, but identified barriers and training needs which must be addressed to enable them to feel confident managing of patients with this condition.

• Training must begin by addressing negative attitudes to patients with CFS/ME.

Source: BMC Nursing (BioMedCentral), Jan 22, 2009: 8(2). DOI:10.1186/1472-6955-8-2, by Chew Graham C, Dixon R, Shaw JW, Smyth N, Lovell K, Peters S. Schools of Community-Based Medicine, Psychological Sciences, and Nursing, Midwifery & Social Work, University of Manchester, Manchester, UK. [E-mail: cchew@manchester.ac.uk]

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