Approach to nursing diagnoses of people with myalgic encephalomyelitis / chronic fatigue syndrome: a qualitative meta-synthesis

Abstract

Objective To identify human responses (diagnostic foci) that shape the experience of living with myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) and how they manifest throughout the course of the illness.

Methods A qualitative meta-synthesis was conducted. Original studies exploring the experience of living with ME/CFS in adults with a confirmed diagnosis, published in English or Spanish between 1994 and June 2024, were included. The literature search was carried out in Medline/Medline In-Process, Embase, CINAHL, PsycINFO, SCI-EXPANDED, SSCI, SciELO, Lilacs, and Cuiden. Data analysis was based on the human responses (diagnostic foci) from the NANDA-I Nursing Diagnoses Classification, 2021–2023, with findings structured according to Fennell’s Four-Phase Model.

Results A total of 42 articles were selected. Twenty human responses (diagnostic foci) and three classes of the NANDA-I Nursing Diagnoses Classification were identified, interwoven across the different phases of the model. Some responses were present throughout all phases, while others, such as Energy Balance and Health Self-Management, became particularly relevant from Phase 2 onwards. Phases 3 and 4 were characterised by losses and processes of subjective reconstruction, with diagnostic foci such as Sorrow, Spiritual Distress, and Personal Identity being predominant.

Conclusions The identified human responses (diagnostic foci) highlight how the contested and chronic nature of ME/CFS profoundly shapes the lived experience of those affected. The model derived from this review provides a structured framework for targeted nursing interventions, aligned with the phase each individual is experiencing.