title: Factors influencing engagement of patients in a novel intervention for CFS/ME: a qualitative study.
abstract: OBJECTIVE
  To establish what factors are important for patients to engage in a new intervention for chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME) and make recommendations to general practitioners (GPs) on preparing a patient for referral to such a service.
  
  
  BACKGROUND
  NICE guidelines recommend a prominent role for primary care in the management of patients with CFS/ME, with prompt diagnosis and appropriate referral for evidence-based treatments.
  
  
  METHODS
  A qualitative study nested within a multi-centre randomised controlled trial of two new nurse therapist delivered interventions. Semi-structured interviews carried out with 19 patients who had received pragmatic rehabilitation (PR) in the trial. Interviews were transcribed verbatim and an iterative approach used to develop themes from the data set.
  
  
  RESULTS
  Factors that influence whether or not a patient engages with PR for CFS/ME are ensuring that the patient feels accepted and believed, that they accept the diagnosis, and that the model implicated by the treatment offered to the patient matches the model of illness held by the patient. If patients hold a clearly incompatible model of their illness, it is unlikely that they will engage with, and successfully complete, therapy. It is vital that the GP elicits and explores such illness beliefs either before making a referral to maximise patient engagement in therapy, or that an initial session with the therapist explores attitudes to the treatment model offered and then works with the patient's model.
authors: School of Community-Based Medicine, University of Manchester, Manchester, UK. cchew@manchester.ac.uk
authors: Carolyn
authors: C
authors: Chew-Graham
authors: Joanna
authors: J
authors: Brooks
authors: Alison
authors: A
authors: Wearden
authors: Christopher
authors: C
authors: Dowrick
authors: Sarah
authors: S
authors: Peters
mesh_terms: D000328:Adult; D026683:Advisory Committees; D001294:Attitude to Health; D015673:Fatigue Syndrome, Chronic / Q000534:rehabilitation*; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D015337:Multicenter Studies as Topic; D010349:Patient Compliance; D010358:Patient Participation; D010361:Patients / Q000523:psychology*; D016032:Randomized Controlled Trials as Topic; D012017:Referral and Consultation; D055815:Young Adult