Coping with chronic fatigue syndrome: a review and synthesis of qualitative studies

Abstract

Background: Interventions that potentially improve coping with chronic fatigue syndrome (CFS) are important for patients, clinicians, and researchers. Purpose: To identify factors experienced by patients to promote coping with CFS and to provide recommendations for adequate interventions in this patient group. Methods: A systematic review of qualitative studies was performed. Structured searches were conducted in major scientific databases. Two reviewers independently performed the study selection and assessment. Meta-ethnography was applied to review and synthesise the studies. The analysis provided key concepts that could be aggregated using second-order interpretations. Results: Fifteen studies were included. Findings suggested that coping strategies, including activity management and the use of cognitive and emotional strategies, and psychological processes, such as acceptance and the rebuilding of identities and lives, may promote coping with CFS. The use of adequate coping strategies appeared to be facilitated by progress in these psychological processes. Coping appeared to be facilitated mainly by self-management, occasionally complemented by treatments and social support. Conclusions: Interventions focusing on coping may include the use of adequate coping strategies and take into account progress in psychological processes, which may fluctuate over time. Interventions may be complemented by self-management, other types of treatments, and social support.

Keywords:

• chronic fatigue syndrome
• coping
• qualitative research
• meta-analysis
• review

Acknowledgements

We would like to thank Marie Isachsen, librarian at Oslo University Hospital, for providing valuable support during literature search. We also would like to thank Lillebeth Larun, Ph.D., at the Norwegian Knowledge Centre for the Health Services, for useful advice regarding the initial preparations of this study.

Additional information

Funding

The study was supported by The Norwegian Foundation for Health and Rehabilitation (grant number: 2010/2/0201).

Notes on contributors

Irma Pinxsterhuis

Irma Pinxsterhuis, OT, MSc, is a Ph.D. Candidate at the University of Oslo, Department of Medicine, and works at the CFS/ME-centre at the Oslo University Hospital.

Elin B. Strand

Elin Bolle Strand, Ph.D., is a specialist in Clinical Community Psychology. She is leader of the research group at the CFS/ME-centre and advisor at the National Advisory Unit for CFS/ME at Oslo University Hospital.

Unni Sveen

Unni Sveen is a professor of occupational therapy at the Oslo and Akershus University College of Applied Sciences. She is also a senior researcher at the Oslo University Hospital, within the field of rehabilitation research.