The Role of empathy and burnout on the attitudes of medical and paramedical students to people with medically unexplained symptoms

Abstract

The first chapter of this thesis is a systematic review of the literature on the efficacy of psychological therapies for people with medically unexplained symptoms (MUS). Many of the reviews to date focus on specific symptoms of MUS and specific treatment approaches. In the current review, a total of nine papers met inclusion criteria. A narrative synthesis was used to explore the outcomes of psychological interventions on symptomology of MUS. The review suggests that psychological interventions for broader MUS may be efficacious in reducing physical and psychological symptoms. However, the review highlights possible methodological concerns, such as selection bias in studies, which may impact on the generalisability of findings. A need for further high-quality research trials in order to analyse the efficacy of a broader range of psychological therapies for people with MUS is identified.

The second part of this thesis is an empirical paper investigating the role of empathy and burnout on attitudes of medical and paramedical students to people with MUS. A total of 104 students from medical and paramedical professions participated in an online questionnaire based study. The findings suggest that particular forms of empathy, such as perspective taking and empathic concern, were associated with lower client focused burnout, whilst other forms of empathy, such as personal distress and fantasy, were associated with higher client and work focused burnout, respectively. High stress was associated with higher burnout across all three domains of burnout (work, personal and client focused), and increased confidence working with people with MUS was associated with lower work and client focused burnout. High client focused burnout, low confidence working with people with MUS, low perspective taking, and low empathic concern were associated with increased negative attitudes to MUS. Clinical implications for staff, patients and policy are discussed, in addition to suggestions for further research.

Keywords: medically unexplained symptoms, somatic, somatoform, psychological treatment, psychological therapy, talking therapies, intervention

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ORCID for Sarah Kirby: orcid.org/0000-0003-1759-1356

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