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Title: Significant others and chronic fatigue syndrome
Author: Brocki, Joanna Mary
ISNI:       0000 0001 3481 0325
Awarding Body: University of Manchester
Current Institution: University of Manchester
Date of Award: 2008
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Chronic fatigue syndrome is a symptomatically defined condition primarily characterised by a minimum of 6 months severe and debilitating fatigue of new onset which cannot be explained by any other medical causes. CFS is considered a controversial condition as aetiology is unclear, prognosis poor and symptom patterns commonly fluctuate. Families may be particularly important in CFS as the loss of wider social networks may make CFS patients more reliant on close family members. What little work there is suggests that significant others and CFS patients hold largely similar beliefs about the illness and that significant others' responses may be associated with functional outcome in CFS (Heijmans, de Ridder, & Bensing, 1999; Schmaling, Smith, & Buchwald, 2000). The primary purpose of this study was to explore the illness cognitions, including spontaneously made causal explanations for CFS onset and symptoms (causal attributions), of significant others of patients with CFS in relation to a number of outcomes including significant others' burden, distress and their behavioural responses to the CFS patient. A secondary feature of this study is the use of a variety of different quantitative and qualitative research methods, combined to obtain a detailed understanding of significant others' beliefs. Participants were 30 CFS patients and their nominated 'significant other'. Participants were interviewed at home using a semistructured interview examining illness cognitions. They also completed a battery of questionnaires measuring distress and the illness perceptions of both patient and significant other. Patient functioning was assessed from the viewpoints of both patient and significant other. Significant others also completed a measure of behavioural responses to the patient, and a measure of burden. Additionally, eighty five undergraduate students completed questionnaire measures to assess their knowledge of and beliefs about CFS. CFS patients and students reported less coherent models of the condition than did significant others. Significant others' illness cognitions were found to be predictive of burden and distress experienced, and their behavioural responses were associated with a number of aspects of patient functioning. Significant other distress was associated with personal and global attributions. Rejecting-hostile responses towards the patient were associated with attributing CFS to causes personal to the patient. Where significant others made more controllability attributions, they were less likely to make responses encouraging the patient to rest. Additionally, there were significant associations between causal attributions and a number of illness cognition dimensions which are discussed. The use of qualitative analysis techniques (thematic analysis and interpretative phenomenological analysis) identified issues of identity as important in terms of illness beliefs and behavioural response. The present study demonstrates that illness cognitions, whether measured using standard questionnaires, from spontaneous attributions, or qualitatively, are related to important outcomes for both the significant other and the CFS patient. However, the use of different methods demonstrates that what appear to be similar or the same constructs derived from different methodologies may actually be subtly different. In terms of formulating models of illness, the present study highlights the importance of clarity when utilising terminology in terms of research in this area. Further research in this area might usefully focus on an examination of the way in which two partners thinking about and experiencing the impact of chronic illness together formulate a joint story with a particular focus on how such a joint story might develop.
Supervisor: Not available Sponsor: Not available
Qualification Name: Thesis (Ph.D.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available