title: Sickness absence, marginality, and medically unexplained physical symptoms: a focus-group study of patients' experiences.
abstract: OBJECTIVE
  Medically unexplained physical symptoms (MUPS) form a major cause of sickness absence. The purpose of this study was to explore factors which may influence further marginalization among patients with MUPS on long-term sickness absence.
  
  
  METHODS
  Two focus-group discussions were conducted with a purposive sample of 12 participants, six men and six women, aged 24-59 years. Their average duration of sickness absence was 10.5 months. Participants were invited to share stories about experiences from the process leading to the ongoing sickness absence, with a focus on the causes being medically unexplained. Systematic text condensation was applied for analysis. Inspired by theories of marginalization and coping, the authors searched for knowledge of how patients' positive resources can be mobilized to counteract processes of marginality.
  
  
  RESULTS
  Analysis revealed how invisible symptoms and lack of objective findings were perceived as an additional burden to the sickness absence itself. Factors that could counteract further marginalization were a supportive social network, positive coping strategies such as keeping to the daily schedule and physical activity, and positive attention and confidence from professionals.
  
  
  CONCLUSIONS
  Confidence from both personal and professional contacts is crucial. GPs have an important and appreciated role in this aspect.
authors: Research Unit for General Practice, Uni Health, Bergen, Norway. aase.aamland@gmail.com
authors: Aase
authors: A
authors: Aamland
authors: Erik L
authors: EL
authors: Werner
authors: Kirsti
authors: K
authors: Malterud
mesh_terms: D000041:Absenteeism; D000203:Activities of Daily Living / Q000523:psychology; D000223:Adaptation, Psychological; D000328:Adult; D005260:Female; D017144:Focus Groups; D006801:Humans; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D018582:Sick Leave; D062487:Social Marginalization / Q000523:psychology; D013001:Somatoform Disorders / Q000523:psychology*; D055815:Young Adult
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