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What are the barriers to the SHAI being completed within a ME/CFS service?

Published online by Cambridge University Press:  17 November 2020

Marianne Fanous ,
Kirsty Ryninks  and
Jo Daniels
Marianne Fanous
Affiliation:
Department of Psychology, University of Bath, Bath, UK
Kirsty Ryninks
Affiliation:
Department of Psychology, University of Bath, Bath, UK
Jo Daniels*
Affiliation:
Department of Psychology, University of Bath, Bath, UK
*
*Corresponding author. Email: [email protected]
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Abstract

Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) is a debilitating condition, characterised by unexplained and excessive fatigue, muscle pain and sleep disturbances. Health anxiety is common in ME/CFS and accurate measurement is essential in facilitating therapeutic gains. However, there are clinical concerns over the utility of the Short Health Anxiety Inventory (SHAI) in measuring health anxiety in this population. This study aims to use qualitative responses from two ex-service users and specialist health clinicians to explore the barriers to completing the SHAI within a specialist ME/CFS service. Qualitative responses from a focus group consisting of 15 specialist health professionals including occupational therapists, physiotherapists, dieticians, cognitive behavioural therapists, counsellors, clinical psychologists and assistant psychologists were transcribed and analysed for themes. Patient voices were represented by two former service users through individual semi-structured interviews on the telephone, which were recorded, transcribed and later analysed thematically. Clinicians and service user involvement agreed on core difficulties with the utility of the SHAI in the ME/CFS population. The timing of the SHAI being administered pre-diagnosis, the language of the SHAI and lack of context around the questionnaire were identified as barriers that were likely to contribute to the SHAI not being completed by service users. Sensitive and accurate measurement is required in order to retain patient engagement, which could further facilitate appropriate assessment and treatment of health anxiety and ME/CFS. Findings suggest that adaption of the SHAI is vital for use with ME/CFS.

Key learning aims

  1. (1) To understand the different barriers to completing the SHAI in a ME/CFS service.

  2. (2) To understand the implications of administering the SHAI to ME/CFS service users.

  3. (3) To learn from multi-disciplinary ME/CFS health professionals about perceived difficulties in administering the SHAI.

Keywords

CBTchronic fatiguefatigue syndromehealth anxietyME/c
Type
Reviews of Assessment Tools and Delivery
Information
the Cognitive Behaviour Therapist , Volume 13 , 2020 , e52
Copyright
© British Association for Behavioural and Cognitive Psychotherapies 2020

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References

Further reading

Daniels, J., & Loades, M. E. (2017). A novel approach to treating CFS and co-morbid health anxiety: a case study. Clinical Psychology & Psychotherapy, 24, 727–736.CrossRefGoogle ScholarPubMed
Daniels, J., Brigden, A., & Kacorova, A. (2017). Anxiety and depression in chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME): examining the incidence of health anxiety in CFS/ME. Psychology and Psychotherapy: Theory, Research and Practice, 90, 502–509.CrossRefGoogle ScholarPubMed
Daniels, J., Parker, H., & Salkovskis, P. M. (2020). Prevalence and treatment of chronic fatigue syndrome/myalgic encephalomyelitis and co-morbid severe health anxiety. International Journal of Clinical and Health Psychology, 20, 10–19.CrossRefGoogle ScholarPubMed
Tyrer, P., Salkovskis, P., Tyrer, H., Wang, D., Crawford, M. J., Dupont, S., … & Bhogal, S. (2017). Cognitive-behaviour therapy for health anxiety in medical patients (CHAMP): a randomised controlled trial with outcomes to 5 years. Health Technology Assessment, 21, 1–58.CrossRefGoogle ScholarPubMed

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