The untapped potential for healthcare to support recovery for patients with stress-related exhaustion disorder - creating an experience of generalised safety.

Abstract

Background: Exhaustion disorder (ED) is one of the most rapidly increasing causes of sick leave in Sweden. The prolonged recovery time from ED creates a dilemma on both the societal and individual level. How patients experience the encounter with health care is critical for the recovery from ED. The aim of this study was to explore how patients with ED experience the encounter with health care.

Method: Data from 23 semi‑structured interviews with ED patients were analysed using content analysis.

Results: One of the main findings was that patients want to be listened to and taken seriously in the encounter with health care. However, patients experience that healthcare struggles to meet these expectations. Several informants reported not being listened to, worrying symptoms were overlooked, an individualised care plan was lacking, and patients experienced that they were prematurely dismissed. This created an experience of unsafety, and that could inadvertently maintain the stress response and negatively influence recovery for patients with stress‑related disorders.

Conclusion: It is paramount to convey an experience of predictability, despite the fact that patients undergo an unpredictable process related to their ED illness. By combining the traditional load‑recovery theory with the generalised unsafety theory of stress, we can tap into the potential to enhance recovery for patients with ED. We suggest that if the encounter with healthcare provides an experience of generalised safety, the conditions for patients with stress‑related disorders to recover would be distinctly enhanced.