Coping with chronic fatigue syndrome: a review and synthesis of qualitative studies

Background: Interventions that potentially improve coping with chronic fatigue syndrome (CFS) are important for patients, clinicians, and researchers. Purpose: To identify factors experienced by patients to promote coping with CFS and to provide recommendations for adequate interventions in this patient group. Methods: A systematic review of qualitative studies was performed. Structured searches were conducted in major scientific databases. Two reviewers independently performed the study selection and assessment. Meta-ethnography was applied to review and synthesise the studies. The analysis provided key concepts that could be aggregated using second-order interpretations. Results: Fifteen studies were included. Findings suggested that coping strategies, including activity management and the use of cognitive and emotional strategies, and psychological processes, such as acceptance and the rebuilding of identities and lives, may promote coping with CFS. The use of adequate coping strategies appeared to be facilitated by progress in these psychological processes. Coping appeared to be facilitated mainly by self-management, occasionally complemented by treatments and social support. Conclusions: Interventions focusing on coping may include the use of adequate coping strategies and take into account progress in psychological processes, which may fluctuate over time. Interventions may be complemented by self-management, other types of treatments, and social support.