| The purpose of this study was to explore the lived experience of patients who report medically unexplained physical symptoms (MUPS) in primary care from a nursing perspective. Hermeneutic phenomenological methodology was used to attain an in-depth understanding of the lived experience of MUPS, guided by the theoretical framework of Martha Rogers's "Science of Unitary Beings" that emphasizes illness experience in the context of human-environment interactions.; Twenty qualitative interviews were conducted with patients identified by their providers as presenting with physical symptoms with either no identifiable organic cause or exaggerated intensity in proportion to an identified organic cause. Participants were recruited among patients seeking primary care services at a community health center or a general practitioner small practice, both in working class urban settings. Participants included 17 first generation Hispanic and Brazilian immigrants, and 3 US-born whites, and provided a good representation of the particular cultural diversity among patients attending these clinics.; Four major themes emerged: pain and suffering: expressions of loss and loneliness; being known as a person: seeking, relating, and connecting; the healthcare environment affects help-seeking; and discovering the strength to carry on.; Physical and emotional aspects of pain appeared to be inseparable, and closely linked with experiences of loss. The nature of the patient-provider relationship, and the healthcare environment seemed to exert significant influence on help-seeking behavior for MUPS sufferers. Experiences of MUPS were associated with an "endurance to carry on" that resulted in a relentless seeking. The notion of "dislocation" emerged as a particularly relevant aspect of the participants' experience, regardless of being foreign born or a migrant within the contiguous US. Findings suggest that MUPS needs to be understood in the context of human environment interactions, and revealed the value of using a Rogerian theoretical framework to guide qualitative inquiry of MUPS.; Implications for the development of more effective interventions that address the multidimensional aspects of MUPS were addressed and extended to nursing theory, research, practice, education and policy. |
