{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T18:24:04Z","timestamp":1789583044660,"version":"build-2803163510"},"reference-count":41,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2023,10,16]],"date-time":"2023-10-16T00:00:00Z","timestamp":1697414400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["bpspsychub.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["British J Health Psychol"],"published-print":{"date-parts":[[2024,5]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>Postural orthostatic tachycardia syndrome (POTS) is a debilitating and under\u2010recognized condition of the autonomic nervous system. This study applied Leventhal's Common\u2010Sense Model of Illness Representations to explore the journey to a diagnosis of POTS and to understand its relevance to poorly understood conditions which have common comorbidities.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>An inductive qualitative approach was used to explore the processes by which patients formulate explanations and management of symptoms within the search for a diagnostic label and to investigate illness identity in the context of existing diagnoses or multimorbidity.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Participants (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200929) for this nested qualitative study were recruited from a larger longitudinal study of people who had been newly referred to a specialist POTS service. Semi\u2010structured interviews were conducted via video call. Three researchers coded and analysed data using Reflexive Thematic Analysis and elements of Grounded Theory.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The analysis resulted in three overarching themes:\n                      <jats:italic>\u2018Seeking physiological coherence and validation\u2019, \u2018Individual persistence\u2019,<\/jats:italic>\n                      and\n                      <jats:italic>\u2018Navigating the cumulative burden\u2019. \u2018Accessibility and disparities of health care\u2019<\/jats:italic>\n                      was noted as a contextual factor. Receiving a POTS diagnosis was regarded by participants as providing legitimacy and increased access to treatment. Overall, delays in the diagnostic journey and the lack of a clear diagnosis impacted negatively on patients through increased uncertainty and a lack of clear guidance on how to manage symptoms. Findings also suggested there were great complexities in assigning symptoms to labels in the context of multimorbidity.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Participants' stories highlighted the urgent need for better recognition of POTS so that the self\u2010regulatory process can be initiated from the early stages of symptom detection.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/bjhp.12700","type":"journal-article","created":{"date-parts":[[2023,10,17]],"date-time":"2023-10-17T00:40:17Z","timestamp":1697503217000},"page":"297-316","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Exploring the complexities of illness identity and symptom management in seeking a diagnostic label of postural orthostatic tachycardia syndrome (POTS): An inductive approach"],"prefix":"10.1111","volume":"29","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7610-1719","authenticated-orcid":false,"given":"Iris","family":"Knoop","sequence":"first","affiliation":[{"name":"Health Psychology Section, Institute of Psychiatry, Psychology and Neuroscience King's College London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephanie","family":"Gu","sequence":"additional","affiliation":[{"name":"Health Psychology Section, Institute of Psychiatry, Psychology and Neuroscience King's College London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shamim","family":"Fareghzadeh","sequence":"additional","affiliation":[{"name":"Neuroscience Section, Institute of Psychiatry, Psychology and Neuroscience King's College London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7868-2804","authenticated-orcid":false,"given":"Annie S. K.","family":"Jones","sequence":"additional","affiliation":[{"name":"Health Psychology Section, Institute of Psychiatry, Psychology and Neuroscience King's College London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1289-1421","authenticated-orcid":false,"given":"Nicholas","family":"Gall","sequence":"additional","affiliation":[{"name":"Cardiology Department King's College Hospital  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2927-3446","authenticated-orcid":false,"given":"Rona","family":"Moss\u2010Morris","sequence":"additional","affiliation":[{"name":"Health Psychology Section, Institute of Psychiatry, Psychology and Neuroscience King's College London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,10,16]]},"reference":[{"key":"e_1_2_13_2_1","doi-asserted-by":"publisher","DOI":"10.1080\/08870446.2015.1070851"},{"key":"e_1_2_13_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpsychores.2011.08.001"},{"key":"e_1_2_13_4_1","doi-asserted-by":"publisher","DOI":"10.1007\/978-3-030-39903-0_1171"},{"key":"e_1_2_13_5_1","first-page":"1","volume-title":"Thematic analysis: A practical guide","author":"Clarke V.","year":"2021"},{"key":"e_1_2_13_6_1","volume-title":"Basics of qualitative research: Techniques and procedures for developing grounded theory","author":"Corbin J.","year":"2014"},{"key":"e_1_2_13_7_1","doi-asserted-by":"publisher","DOI":"10.1348\/135910708X283760"},{"key":"e_1_2_13_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/joim.12852"},{"issue":"4","key":"e_1_2_13_9_1","first-page":"1","article-title":"Quality of life in postural orthostatic tachycardia syndrome (PoTS): Before and after treatment","volume":"25","author":"Flack T.","year":"2018","journal-title":"British Journal of Cardiology"},{"key":"e_1_2_13_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/ggi.12553"},{"key":"e_1_2_13_11_1","volume-title":"Long\u2010term conditions and multi\u2010morbidity","author":"Fund K.","year":"2015"},{"issue":"1","key":"e_1_2_13_12_1","first-page":"3","article-title":"Observational case series of postural tachycardia syndrome (PoTS) in post\u2010COVID\u201019 patients","volume":"29","author":"Gall N. 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