TY - JOUR
T1 - Experiences of patients identifying with chronic Lyme disease in the healthcare system
T2 - A qualitative study
AU - Ali, Ather
AU - Vitulano, Lawrence
AU - Lee, Robert
AU - Weiss, Theresa R.
AU - Colson, Eve R.
N1 - Funding Information:
We thank our participants for their insights. This work was supported by the Yale Pediatric Faculty Scholars Program, from grant number K23 AT006703 from the National Center for Complementary and Alternative Medicine; from CTSA Grant Number UL1 TR000142 from the from the National Center for Advancing Translational Science; components of the National Institutes of Health (NIH). Its contents are solely the responsibility of the authors and do not necessarily represent the official view the NIH. The sponsors had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; and preparation, review, or approval of the manuscript.
PY - 2014/5/1
Y1 - 2014/5/1
N2 - Background: Chronic Lyme disease is a term that describes a constellation of persistent symptoms in patients with or without evidence of previous Borrelia burgdorferi infection. Patients labeled as having chronic Lyme disease have a substantial clinical burden. Little is known about chronic Lyme disease patient experiences in the healthcare system and their relationships with healthcare providers. The purpose of this study was to gather insights about the experiences of patients who carry a diagnosis of chronic Lyme disease in the United States healthcare system. Methods. Qualitative, phenomenological study in 12 adult participants who identified themselves as having chronic Lyme disease. Semi-structured face-to-face in-depth interviews were conducted, 60-90 minutes in length, focusing on perceptions of disease burden and of their healthcare providers, using the dimensions of the Health Belief Model. Transcribed interviews were analyzed for emergent topics and themes in the categories of beliefs/understanding, personal history/narrative, consequences/limitations, management, and influences on care. Results: Enrollment continued until theoretical saturation was obtained. Four major themes emerged from participants' descriptions of their experiences and perceptions: 1) changes in health status and the social impact of chronic Lyme disease, 2) doubts about recovery and the future, 3) contrasting doctor-patient relationships, 4) and the use of unconventional therapies to treat chronic Lyme disease. Conclusions: Participants reported a significant decline in health status associated with chronic Lyme disease and were often unsatisfied with care in conventional settings. Negative experiences were associated with reports of dismissive, patronizing, and condescending attitudes. Positive experiences were associated with providers who were reported to be attentive, optimistic, and supportive. Consultations with CAM practitioners and use of CAM therapies were common. Actively engaged and sympathetic clinical encounters may foster greater satisfaction in healthcare settings.
AB - Background: Chronic Lyme disease is a term that describes a constellation of persistent symptoms in patients with or without evidence of previous Borrelia burgdorferi infection. Patients labeled as having chronic Lyme disease have a substantial clinical burden. Little is known about chronic Lyme disease patient experiences in the healthcare system and their relationships with healthcare providers. The purpose of this study was to gather insights about the experiences of patients who carry a diagnosis of chronic Lyme disease in the United States healthcare system. Methods. Qualitative, phenomenological study in 12 adult participants who identified themselves as having chronic Lyme disease. Semi-structured face-to-face in-depth interviews were conducted, 60-90 minutes in length, focusing on perceptions of disease burden and of their healthcare providers, using the dimensions of the Health Belief Model. Transcribed interviews were analyzed for emergent topics and themes in the categories of beliefs/understanding, personal history/narrative, consequences/limitations, management, and influences on care. Results: Enrollment continued until theoretical saturation was obtained. Four major themes emerged from participants' descriptions of their experiences and perceptions: 1) changes in health status and the social impact of chronic Lyme disease, 2) doubts about recovery and the future, 3) contrasting doctor-patient relationships, 4) and the use of unconventional therapies to treat chronic Lyme disease. Conclusions: Participants reported a significant decline in health status associated with chronic Lyme disease and were often unsatisfied with care in conventional settings. Negative experiences were associated with reports of dismissive, patronizing, and condescending attitudes. Positive experiences were associated with providers who were reported to be attentive, optimistic, and supportive. Consultations with CAM practitioners and use of CAM therapies were common. Actively engaged and sympathetic clinical encounters may foster greater satisfaction in healthcare settings.
KW - Burden
KW - Chronic Lyme
KW - Complementary medicine
KW - Health beliefs
KW - Lived experiences
KW - Qualitative
UR - http://www.scopus.com/inward/record.url?scp=84900459913&partnerID=8YFLogxK
U2 - 10.1186/1471-2296-15-79
DO - 10.1186/1471-2296-15-79
M3 - Article
C2 - 24885888
AN - SCOPUS:84900459913
SN - 1471-2296
VL - 15
JO - BMC Family Practice
JF - BMC Family Practice
IS - 1
M1 - 79
ER -