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Mamo N, van de Klundert M, Tak L, Hartman TO, Hanssen D, Rosmalen J. Characteristics of collaborative care networks in functional disorders: A systematic review. J Psychosom Res 2023; 172:111357. [PMID: 37392482 DOI: 10.1016/j.jpsychores.2023.111357] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Revised: 04/28/2023] [Accepted: 05/04/2023] [Indexed: 07/03/2023]
Abstract
OBJECTIVE Functional disorders (FD) are complex conditions, for which multidisciplinary involvement is often recommended. Collaborative care networks (CCN) may unlock the potential of the multidisciplinary team (MDT) in FD care. To understand what characteristics should be part of CCNs in FD, we studied the composition and characteristics of existing CCNs in FD. METHODS We performed a systematic review following PRISMA guidelines. A search of PubMed, WebofScience, PsycInfo, SocINDEX, AMED and CINAHL was undertaken to select studies describing CCNs in FD. Two reviewers extracted characteristics of the different CCNs. Characteristics were classified as relating to structure and processes of networks. RESULTS A total of 62 studies were identified representing 39 CCNs across 11 countries. Regarding structural characteristics, we found that most networks are outpatient, secondary-care based, with teams of between two and 19 members. Medical specialists were most commonly involved and the typical team leads as well as main patient contacts were general practitioners (GPs) or nurses. Regarding processes, collaboration was demonstrated mostly during assessment, management and patient education, less often during rehabilitation and follow-up, mostly using MDT meetings. CCNs provided a wide range of treatment modalities, reflecting a biopsychosocial approach, including psychological therapies, physiotherapy and social and occupational therapy. CONCLUSION CCNs for FD are heterogeneous, showing a wide variety of structures as well as processes. The heterogeneity of results provides a broad framework, demonstrating considerable variation in how this framework is applied in different contexts. Better development of network evaluation, as well as professional collaboration and education processes is needed.
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Affiliation(s)
- Nick Mamo
- University of Groningen, University Medical Center Groningen, Department of Psychiatry, Groningen, Netherlands; Dimence Institute for Specialized Mental Health Care, Alkura Specialist Center Persistent Somatic Symptoms, Deventer, Netherlands.
| | - Manouk van de Klundert
- Department of Public Health, Faculty of Health and Medical Sciences, University of Copenhagen, Denmark
| | - Lineke Tak
- Dimence Institute for Specialized Mental Health Care, Alkura Specialist Center Persistent Somatic Symptoms, Deventer, Netherlands
| | - Tim Olde Hartman
- Department of Primary and Community Care, Radboud Institute of Health Sciences, Radboud University Medical Center, Nijmegen, Netherlands
| | - Denise Hanssen
- University of Groningen, University Medical Center Groningen, Department of Psychiatry, Groningen, Netherlands
| | - Judith Rosmalen
- University of Groningen, University Medical Center Groningen, Department of Psychiatry, Groningen, Netherlands; Dimence Institute for Specialized Mental Health Care, Alkura Specialist Center Persistent Somatic Symptoms, Deventer, Netherlands; University of Groningen, University Medical Center Groningen, Department of Internal Medicine, Groningen, Netherlands
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Millet GY, Bertrand MF, Lapole T, Féasson L, Rozand V, Hupin D. Measuring objective fatigability and autonomic dysfunction in clinical populations: How and why? Front Sports Act Living 2023; 5:1140833. [PMID: 37065809 PMCID: PMC10101442 DOI: 10.3389/fspor.2023.1140833] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Accepted: 03/13/2023] [Indexed: 04/18/2023] Open
Abstract
Fatigue is a major symptom in many diseases, often among the most common and severe ones and may last for an extremely long period. Chronic fatigue impacts quality of life, reduces the capacity to perform activities of daily living, and has socioeconomical consequences such as impairing return to work. Despite the high prevalence and deleterious consequences of fatigue, little is known about its etiology. Numerous causes have been proposed to explain chronic fatigue. They encompass psychosocial and behavioral aspects (e.g., sleep disorders) and biological (e.g., inflammation), hematological (e.g., anemia) as well as physiological origins. Among the potential causes of chronic fatigue is the role of altered acute fatigue resistance, i.e. an increased fatigability for a given exercise, that is related to physical deconditioning. For instance, we and others have recently evidenced that relationships between chronic fatigue and increased objective fatigability, defined as an abnormal deterioration of functional capacity (maximal force or power), provided objective fatigability is appropriately measured. Indeed, in most studies in the field of chronic diseases, objective fatigability is measured during single-joint, isometric exercises. While those studies are valuable from a fundamental science point of view, they do not allow to test the patients in ecological situations when the purpose is to search for a link with chronic fatigue. As a complementary measure to the evaluation of neuromuscular function (i.e., fatigability), studying the dysfunction of the autonomic nervous system (ANS) is also of great interest in the context of fatigue. The challenge of evaluating objective fatigability and ANS dysfunction appropriately (i.e.,. how?) will be discussed in the first part of the present article. New tools recently developed to measure objective fatigability and muscle function will be presented. In the second part of the paper, we will discuss the interest of measuring objective fatigability and ANS (i.e. why?). Despite the beneficial effects of physical activity in attenuating chronic fatigue have been demonstrated, a better evaluation of fatigue etiology will allow to personalize the training intervention. We believe this is key in order to account for the complex, multifactorial nature of chronic fatigue.
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Affiliation(s)
- Guillaume Y. Millet
- Université Jean Monnet Saint-Etienne, Université Savoie Mont-Blanc, Inter-university Laboratory of Human Movement Biology, F-42023, Saint-Etienne, Lyon, France
- Institut Universitaire de France (IUF), Paris, France
- Correspondence: Guillaume Y. Millet
| | - Mathilde F. Bertrand
- Université Jean Monnet Saint-Etienne, Université Savoie Mont-Blanc, Inter-university Laboratory of Human Movement Biology, F-42023, Saint-Etienne, Lyon, France
| | - Thomas Lapole
- Université Jean Monnet Saint-Etienne, Université Savoie Mont-Blanc, Inter-university Laboratory of Human Movement Biology, F-42023, Saint-Etienne, Lyon, France
| | - Léonard Féasson
- Université Jean Monnet Saint-Etienne, Université Savoie Mont-Blanc, Inter-university Laboratory of Human Movement Biology, F-42023, Saint-Etienne, Lyon, France
- Service de physiologie clinique et de l'exercice, CHU de Saint-Étienne, Saint-Étienne, France
- Centre Référent Maladies Neuromusculaires rares - Euro-NmD, CHU de Saint-Étienne, Saint-Étienne, France
| | - Vianney Rozand
- Université Jean Monnet Saint-Etienne, Université Savoie Mont-Blanc, Inter-university Laboratory of Human Movement Biology, F-42023, Saint-Etienne, Lyon, France
| | - David Hupin
- Service de physiologie clinique et de l'exercice, CHU de Saint-Étienne, Saint-Étienne, France
- Jean Monnet University Saint-Etienne, Mines Saint-Etienne, University hospital of Saint-Etienne, INSERM, SAINBIOSE, U1059, DVH team, Saint-Etienne, France
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Colas C, Jumel A, Vericel MP, Barth N, Manzanares J, Goutte J, Fontana L, Féasson L, Hupin D, Guyot J. Understanding Experiences of Fibromyalgia Patients Involved in the Fimouv Study During COVID-19 Lockdown. Front Psychol 2021; 12:645092. [PMID: 34354626 PMCID: PMC8329548 DOI: 10.3389/fpsyg.2021.645092] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Accepted: 06/17/2021] [Indexed: 11/24/2022] Open
Abstract
Introduction: The COVID-19 pandemic implied a period of lockdown for the general population, increasing the risk to develop some physical or mental disorders. In fibromyalgia patients, these disorders are part of the large clinical picture of the syndrome. Fibromyalgia management is especially based on a regular practice of physical activity. Lockdown imposed a break in rhythms, requiring a restructuring of scheduling. Thus, the present study aimed to investigate the experiences of fibromyalgia patients during COVID-19 lockdown using a qualitative analysis. Method: 19 patients (52 ± 9 years old) who completed a 3-month therapeutic education and/or supervised physical activity program were invited to participate (Fimouv study, Trial registration: ClinicalTrials.gov NCT04107948). A sociologist collected data by means of semi-structured interviews and analyzed them using thematic content analysis. Results: Lockdown exacerbated the main symptoms of fibromyalgia, but adjusting the rhythms of life to fluctuations of these symptoms allowed a better quality of life. Patients felt the lack of physical activity and 68% found alternatives to remain physically active. The reduction of social constraints allowed them to better contend with their pathology. Fibromyalgia stopped being a main priority. Conclusion: Lockdown was positively experienced by fibromyalgia patients. They linked the absence of physical activity with increased pain and fatigue. Nevertheless, reducing social constraints could be a key for fibromyalgia management, where symptoms seemed to take less space in everyday life. Clinical Trial Registration:www.ClinicalTrials.gov, identifier: NCT04107948.
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Affiliation(s)
- Claire Colas
- Univ. Lyon, UJM-Saint-Etienne Autonomic Nervous System Research Laboratory, SAINBIOSE INSERM, U1059, Saint-Etienne, France.,Department of Clinical and Exercise Physiology, University Hospital Center, Saint-Etienne, France.,Univ. Lyon, UJM-Saint-Etienne Chaire Santé des Ainés - Ingénierie de la Prévention, Saint-Etienne, France.,Univ. Lyon, UJM-Saint-Etienne Chaire ActiFS, Saint-Etienne, France
| | - Audrey Jumel
- Univ. Lyon, UJM-Saint-Etienne Chaire Santé des Ainés - Ingénierie de la Prévention, Saint-Etienne, France
| | - Marie-Pierre Vericel
- Department of Clinical and Exercise Physiology, University Hospital Center, Saint-Etienne, France
| | - Nathalie Barth
- Univ. Lyon, UJM-Saint-Etienne Autonomic Nervous System Research Laboratory, SAINBIOSE INSERM, U1059, Saint-Etienne, France.,Univ. Lyon, UJM-Saint-Etienne Chaire Santé des Ainés - Ingénierie de la Prévention, Saint-Etienne, France.,Gerontopole AURA, Saint-Etienne, France
| | | | - Julie Goutte
- Department of Internal Medicine, University Hospital Center, Saint-Etienne, France
| | - Luc Fontana
- Department of Occupational and Environmental Medicine, University Hospital Center, Saint-Etienne, France.,Univ. Lyon, Univ. Lyon 1, Univ. St Etienne, Univ. Gustave Eiffel, IFSTTAR, UMRESTTE, UMR_T9405, Saint-Etienne, France
| | - Léonard Féasson
- Department of Clinical and Exercise Physiology, University Hospital Center, Saint-Etienne, France.,Univ. Lyon, UJM-Saint-Etienne Chaire ActiFS, Saint-Etienne, France.,Univ. Lyon, UJM-Saint-Etienne Interuniversity Laboratory of Human Movement Biology, EA 7424, Saint-Etienne, France
| | - David Hupin
- Univ. Lyon, UJM-Saint-Etienne Autonomic Nervous System Research Laboratory, SAINBIOSE INSERM, U1059, Saint-Etienne, France.,Department of Clinical and Exercise Physiology, University Hospital Center, Saint-Etienne, France.,Univ. Lyon, UJM-Saint-Etienne Chaire Santé des Ainés - Ingénierie de la Prévention, Saint-Etienne, France.,Univ. Lyon, UJM-Saint-Etienne Chaire ActiFS, Saint-Etienne, France.,Department of Medicine, K2, Solna, Karolinska Institutet, Stockholm, Sweden
| | - Jessica Guyot
- Univ. Lyon, UJM-Saint-Etienne Autonomic Nervous System Research Laboratory, SAINBIOSE INSERM, U1059, Saint-Etienne, France.,Univ. Lyon, UJM-Saint-Etienne Chaire Santé des Ainés - Ingénierie de la Prévention, Saint-Etienne, France
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