title: Exploring the potential role of the advanced nurse practitioner within a care path for patients with chronic fatigue syndrome.
abstract: OBJECTIVE
  To explore the experiences and expectations of patients with chronic fatigue syndrome and general practitioners to develop the potential role of an advanced nurse practitioner at the diagnostic care path of abnormal fatigue developed for regional transmural implementation in the Belgian provinces of East and West Flanders.
  
  
  BACKGROUND
  Patients with chronic fatigue syndrome experience an incapacitating chronic fatigue that is present for at least 6 months. Since many uncertainties exist about the causes and progression of the disease, patients have to cope with disbelief and scepticism. Access to health care may be hampered, which could lead to inappropriate treatments and guidance.
  
  
  METHODS
  Qualitative design.
  
  
  METHODS
  Individual semi-structured interviews were conducted with patients with chronic fatigue syndrome and general practitioners in Belgium. Data were collected over 9 months in 2014-2015. All interviews were audio recorded and transcribed for qualitative analysis using open explorative thematic coding.
  
  
  RESULTS
  Fifteen patients and 15 general practitioners were interviewed. Three themes were identified: mixed feelings with the diagnosis, lack of one central intermediator and insufficient coordination. Participants stressed the need for education, knowledge and an intermediator to provide relevant information at the right time and to build up a trust relationship.
  
  
  CONCLUSIONS
  This qualitative exploration underscores some clear deficiencies in the guidance of patients suffering from chronic fatigue syndrome and abnormal fatigue. An advanced nurse practitioner as a central intermediator in the transmural care of these patients could promote interdisciplinary/multidisciplinary collaboration and effective communication, provide education and ensure a structured and coordinated approach.
authors.affiliation: Department of General Internal Medicine, Ghent University Hospital, Belgium.|Department of Endocrinology and Diabetology, Onze-Lieve-Vrouw Ziekenhuis, Aalst, Belgium.
authors.forename: Hannah
authors.initials: H
authors.lastname: Ryckeghem
authors.affiliation: Department of General Internal Medicine, Ghent University Hospital, Belgium.|Centre for Neurophysiologic Monitoring, Ghent University Hospital, Belgium.
authors.forename: Liesbeth
authors.initials: L
authors.lastname: Delesie
authors.affiliation: Department of General Internal Medicine, Ghent University Hospital, Belgium.|Centre for Neurophysiologic Monitoring, Ghent University Hospital, Belgium.
authors.forename: Els
authors.initials: E
authors.lastname: Tobback
authors.affiliation: Department of General and Applied Psychology, Faculty of Psychology and Educational Sciences, Ghent University, Belgium.
authors.forename: Stefaan
authors.initials: S
authors.lastname: Lievens
authors.affiliation: Department of General Internal Medicine, Ghent University Hospital, Belgium.|Centre for Neurophysiologic Monitoring, Ghent University Hospital, Belgium.|Department of Internal Medicine, Faculty of Medicine and Health Sciences, University of Ghent, Belgium.
authors.forename: Dirk
authors.initials: D
authors.lastname: Vogelaers
authors.affiliation: Department of General Internal Medicine, Ghent University Hospital, Belgium.|Centre for Neurophysiologic Monitoring, Ghent University Hospital, Belgium.|Department of Internal Medicine, Faculty of Medicine and Health Sciences, University of Ghent, Belgium.
authors.forename: An
authors.initials: A
authors.lastname: Mariman
mesh_terms: D001530:Belgium; D015673:Fatigue Syndrome, Chronic / Q000451:nursing*; D006801:Humans; D009722:Nurse Practitioners; D024802:Nurse's Role
keywords: advanced nurse practitioner; chronic fatigue; chronic fatigue syndrome; myalgic encephalomyelitis; nurse; nurse practitioner; nurse specialist