Comforting factors that influence the severity of fatigue and other somatic symptoms from the perspective of individuals with chronic fatigue syndrome: A concept mapping study
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Objective: To broaden the clinical focus beyond suffering in individuals with chronic fatigue syndrome (CFS), it is important to focus on personal sources of strength and resilience in these individuals. The main aim of this study was to identify and examine the underlying hierarchical structure of soothing influences on somatic symptoms from the perspective of individuals with CFS. Methods: Online interviews yielded a comprehensive overview of 40 soothing influences that were sorted in a card sorting task according to meaning and importance by 73 individuals with chronic somatic symptoms, including seven individuals with CFS. Moreover, the participants completed the PHQ-15 to assess somatic symptom severity. A hierarchical cluster analysis (squared Euclidean distances, Ward‘s method) was used to obtain the underlying hierarchical structure of soothing influences. The relative importance of each soothing cluster was assessed by a repeated measure analysis of variance, whereas a linear regression analysis was computed to assess associations between soothing clusters and somatic symptom severity. Results: Hierarchical cluster analysis revealed four overarching categories of soothing influences: ‗Social support‘, ‗Medical Support’, ‘Adjustment’, and ‘Self-management’. These domains comprised 10 clusters. There were no significant differences in the perceived importance of soothing clusters according to seven individuals with CFS, although there was a wide range of individual differences. Adjustment was related to somatic symptom severity, whereas there was no association between social support, medical support, or self-management, and somatic symptom severity. Conclusions: This study revealed an encompassing hierarchical structure of soothing influences based on individuals with chronic somatic symptoms, including patients with CFS. This structure will guide the development of personalized treatment of individuals with CFS.