{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,29]],"date-time":"2025-10-29T16:19:04Z","timestamp":1761754744559,"version":"build-2065373602"},"reference-count":31,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2019,3,8]],"date-time":"2019-03-08T00:00:00Z","timestamp":1552003200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000272","name":"National Institute for Health Research","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000272","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100009362","name":"South London and Maudsley NHS Foundation Trust","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100009362","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bpspsychub.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["British J Health Psychol"],"published-print":{"date-parts":[[2019,5]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>\n                      Fatigue is a common symptom in primary care. Chronic fatigue research highlights the value of preventing chronicity, but little research has investigated the early, subacute stage of the fatigue trajectory (&lt;3\u00a0months). We aimed to examine patient and general practitioner (\n                      <jats:styled-content style=\"fixed-case\">GP<\/jats:styled-content>\n                      ) perspectives of subacute fatigue in primary care: (1) to gain a better understanding of fatigue during this stage and (2) to explore how management could be improved.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>\n                      A qualitative study design was used. In\u2010depth, semi\u2010structured telephone interviews were conducted with 14 patients and 14\n                      <jats:styled-content style=\"fixed-case\">GP<\/jats:styled-content>\n                      s (non\u2010dyadic), recruited from 19 primary care practices.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Interview transcripts were thematically analysed. Initially, patient and\n                      <jats:styled-content style=\"fixed-case\">GP<\/jats:styled-content>\n                      accounts were analysed separately, before themes were merged to identify shared and independent perspectives.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Three main themes were identified. Within these, subthemes from patients\u2019,\n                      <jats:styled-content style=\"fixed-case\">GP<\/jats:styled-content>\n                      s\u2019, or shared patient\/\n                      <jats:styled-content style=\"fixed-case\">GP<\/jats:styled-content>\n                      perspectives emerged. The main themes encompassed the following: (1) Change from normal \u2013 the impact of fatigue; (2) The challenges of managing fatigue; and (3) The consultation\n                      <jats:styled-content style=\"fixed-case\">GP<\/jats:styled-content>\n                      s\u2019 knowledge was often not reflected in patients\u2019 accounts, even for those reporting positive experiences, suggesting knowledge was not effectively translated.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>\n                      Some findings, such as impact, mirror those described in chronic fatigue. New insights into early\u2010stage fatigue management also arose, including mismatches in patient and\n                      <jats:styled-content style=\"fixed-case\">GP<\/jats:styled-content>\n                      perceptions on negative tests and not re\u2010presenting. These highlight the need for better communication and shared understanding.\n                      <jats:styled-content style=\"fixed-case\">GP<\/jats:styled-content>\n                      s should pre\u2010emptively present a biopsychosocial model of fatigue and keep communication channels open, particularly in the light of negative physiological tests.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:label\/>\n                    <jats:p>\n                      <jats:boxed-text content-type=\"box\" position=\"anchor\">\n                        <jats:caption>\n                          <jats:title>Statement of contribution<\/jats:title>\n                        <\/jats:caption>\n                        <jats:p>\n                          <jats:italic>\n                            <jats:bold>What is already known on this subject?<\/jats:bold>\n                          <\/jats:italic>\n                        <\/jats:p>\n                        <jats:p>\n                          <jats:list list-type=\"bullet\">\n                            <jats:list-item>\n                              <jats:p>\n                                Patients with chronic fatigue retrospectively report lack of understanding from\n                                <jats:styled-content style=\"fixed-case\">GP<\/jats:styled-content>\n                                s in early stage of illness.\n                              <\/jats:p>\n                            <\/jats:list-item>\n                            <jats:list-item>\n                              <jats:p>Little research has investigated the early stages of the fatigue trajectory.<\/jats:p>\n                            <\/jats:list-item>\n                          <\/jats:list>\n                        <\/jats:p>\n                        <jats:p>\n                          <jats:italic>\n                            <jats:bold>What does this study add?<\/jats:bold>\n                          <\/jats:italic>\n                        <\/jats:p>\n                        <jats:p>\n                          <jats:list list-type=\"bullet\">\n                            <jats:list-item>\n                              <jats:p>\n                                Consequences of an episode of subacute fatigue are similar to those reported for\n                                <jats:styled-content style=\"fixed-case\">CFS<\/jats:styled-content>\n                                .\n                              <\/jats:p>\n                            <\/jats:list-item>\n                            <jats:list-item>\n                              <jats:p>\n                                There is discordance between\n                                <jats:styled-content style=\"fixed-case\">GP<\/jats:styled-content>\n                                s\u2019 positive view of negative tests and patients\u2019 need for explanation of symptoms.\n                              <\/jats:p>\n                            <\/jats:list-item>\n                            <jats:list-item>\n                              <jats:p>The length of appointments is a significant barrier for creating shared understanding.<\/jats:p>\n                            <\/jats:list-item>\n                          <\/jats:list>\n                        <\/jats:p>\n                      <\/jats:boxed-text>\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/bjhp.12361","type":"journal-article","created":{"date-parts":[[2019,3,8]],"date-time":"2019-03-08T05:50:42Z","timestamp":1552024242000},"page":"419-442","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Subacute fatigue in primary care \u2013 two sides of the story"],"prefix":"10.1111","volume":"24","author":[{"given":"Katrin","family":"Hulme","sequence":"first","affiliation":[{"name":"Health Psychology Section 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