Introduction
MUS, chronic pain, fibromyalgia
CHRONIC PAIN, FIBROMYALGIA, SYNDROMES, CHRONIC FATIGUE SYNDROME
Medically unexplained syndromes (MUS), also termed persistent physical symptoms, are illnesses that manifest as clusters of physical symptoms without a known biological cause, such as fibromyalgia and chronic fatigue syndrome. These conditions are not only prevalent (affecting up to 34% of patients within primary care settings), but also chronic and disabling [While clinical practice guidelines recommend non-pharmaceutical, behavioral approaches to GWI management [This lack of concordance between providers and MUS patients about approaches to MUS care may not only contribute to excessive medical treatments, but also poorer treatment outcomes. Illness concordance is defined as a shared understanding between patients and providers about the nature, cause, and best treatment for persistent physical symptoms. Research shows that illness concordance is a strong predictor of treatment outcomes, such as treatment adherence [Developing better patient-provider concordance when treating GWI is inherently difficult because the cause of GWI is unknown and limited medical treatment options render a disease-driven approach ineffective. A person-centered approach to care may be vital in improving concordance and implementing effective treatment. Person-centered health care is defined as care in which “individuals’ values and preferences are elicited and, once expressed, guide all aspects of their health care, supporting their realistic health and life goals [Unfortunately, there is a lack of research on patient-generated goals among veterans with GWI. Studies examining patient goals for those with other persistent physical symptom conditions such as chronic pain and fibromyalgia have found that patients’ goals tend to focus on reducing pain/symptom intensity [A better understanding of patient-generated goals among veterans with GWI could facilitate a person-centered approach to care. Goals reveal the patient’s targets for change, and can guide practitioners in selecting, tailoring, and implementing treatment options [The current study therefore aims to assess both treatment goals and life goals among veterans with GWI. We did so by asking veterans with GWI about treatment goals and life goals at the start of a randomized clinical treatment trial comparing two behavioral treatments for GWI. Our objective was to identify the most commonly endorsed goals among this population and organize these goals into a typology that can be used to both guide future research and better inform more tailored and efficacious behavioral treatments.