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Introduction: People should have access to healthcare services that are effective, safe and secure, patient-centred, and coordinated and continuous. One group that has consistently reported negative experiences and feels dissatisfied with services are patients with Myalgic Encephalomyelitis (ME)/Chronic Fatigue Syndrome (CFS). The objective of this study was to develop a deeper understanding of the experiences of dissatisfaction among ME/CFS patients and explore the reasons for such dissatisfaction., Methods: We conducted in-depth interviews with 48 people from 24 households (comprising patients and family members), providing insight into the experiences of 37 ME/CFS sufferers in Norway. The participants were purposively sampled and included persons of different ages, genders, time since having the condition (3-30 years), and severity., Results: Four main themes were developed: (1) 'Nonexistent services' cover patients' experience that healthcare services had nothing to offer them after receiving their ME/CFS-diagnosis. (2) 'Nonpersonalised services' documents experiences where patients did receive services, which in theory was appropriate for relieving a specific health problem, but in practice were experienced as inappropriate because they were not adapted to the patient's need. (3) 'Slow services' address patients' experience of getting services too late (or too little) to be useful. (4) 'Wrong services' comprise patients' experiences of being offered and/or 'forced' to accept services that they felt were inappropriate for their health problems., Conclusions: Providers' lacking knowledge of the condition and lack of precise recommendations for follow up may partly explain unsatisfactory experiences. Providers' belief (or disbelief) in the condition could furthermore influence caregiving. Also, systemic issues in the healthcare sector, like high workloads and bureaucracy, can negatively affect care provision. Finally, users' unsatisfactory experiences may also be due to a lack of patient involvement in the design of such services. Further research should investigate how patients can be involved in service design, and also providers' perspectives on caregiving and the barriers they experience for providing high-quality care., Patient or Public Contribution: The ME-patient organisation suggested research topics to the call from which this study got funding. Patients and caregivers provided feedback during analysis and interpretation of data., (© 2023 The Authors. Health Expectations published by John Wiley & Sons Ltd.)

Background: Memory problems are a common cognitive complaint following stroke. Memory rehabilitation programmes either attempt to retrain lost or poor memory functions, or teach patients strategies to cope with them., Objectives: To determine the effectiveness of cognitive rehabilitation for memory problems following stroke., Search Strategy: We searched the Cochrane Stroke Group Trials Register (last searched September 2006). In addition, we searched the following electronic databases; the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library Issue 2, 2005), MEDLINE (1966 to June 2005), EMBASE (1980 to June 2005), CINAHL (1982 to June 2005), PsycINFO (1980 to July 2006), AMED (1985 to June 2005), British Nursing Index (1985 to June 2005), CAB Abstracts (1973 to May 2005) and the National Research Register (June 2006). We handsearched relevant journals and searched reference lists., Selection Criteria: We selected controlled trials of memory retraining in stroke. We excluded studies with mixed aetiology groups unless 75% or more of the participants had a stroke or separate data were available for the stroke patients., Data Collection and Analysis: Two review authors selected trials for inclusion, assessed quality, and extracted data., Main Results: Two trials, involving 18 participants, were included. One study compared the effectiveness of a mnemonic strategy treatment group with a 'drill and practice' control, while the other compared the effectiveness of an imagery mnemonics programme with a 'pragmatic' memory rehabilitation control programme. Formal meta-analyses could not be performed due to a paucity of studies and lack of commonly-employed outcome measures. The results do not show any significant effect of memory rehabilitation on performance of objective memory tests, and no significant effects of treatment on subjective and observer-rated measures of memory., Authors' Conclusions: There was no evidence to support or refute the effectiveness of memory rehabilitation on functional outcomes, and objective, subjective, and observer-rated memory measures. There is a need for more robust, well-designed and better-reported trials of memory rehabilitation using common standardised outcome measures.