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Oğuz M, Dede BT, Aytekin E, Bağcier F. Letter to the Editor: Obturatorius Internus is the Game Changer in Pelvic Pain: It Comes to Mind at the End, But It Is the Leading Role! Med Acupunct 2024; 36:118-119. [PMID: 38659721 PMCID: PMC11036151 DOI: 10.1089/acu.2023.0068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/26/2024] Open
Affiliation(s)
- Muhammed Oğuz
- Departmant of Physical Medicine and Rehabilitation, Istanbul Training and Research Hospital, Istanbul, Turkey
| | - Burak Tayyip Dede
- Departmant of Physical Medicine and Rehabilitation, Istanbul Training and Research Hospital, Istanbul, Turkey
| | - Ebru Aytekin
- Departmant of Physical Medicine and Rehabilitation, Istanbul Training and Research Hospital, Istanbul, Turkey
| | - Fatih Bağcier
- Departmant of Physical Medicine and Rehabilitation, Basaksehir Cam and Sakura City Hospital, Istanbul, Turkey
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Climent-Sanz C, Hamilton KR, Martínez-Navarro O, Briones-Vozmediano E, Gracia-Lasheras M, Fernández-Lago H, Valenzuela-Pascual F, Finan PH. Fibromyalgia pain management effectiveness from the patient perspective: a qualitative evidence synthesis. Disabil Rehabil 2023:1-16. [PMID: 37965900 PMCID: PMC11093884 DOI: 10.1080/09638288.2023.2280057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2023] [Accepted: 11/01/2023] [Indexed: 11/16/2023]
Abstract
PURPOSE This qualitative evidence synthesis aimed to identify and integrate findings where adults with fibromyalgia discussed how they managed their pain, and their perceptions of prescribed treatments from healthcare professionals. MATERIALS AND METHODS A comprehensive search strategy was implemented in PubMed, Scopus, ISI Web of Science, and Cinahl Plus databases. The GRADE-CERQual framework was used to evaluate the findings confidence. The findings were analyzed using an inductive thematic analysis approach. RESULTS A total of 35 studies (N = 728) were included. The confidence in the findings ranged from high to low confidence. Patients with fibromyalgia often do not benefit from seeking medical attention due to provider stigma, and have varying views on medication effectiveness commonly reporting feeling like "walking chemists." They find mixed effects from exercise, and consider psychological support essential, although the benefits of cognitive-behavioral therapy were controversial. Combining cognitive-behavioral therapy with physical exercise appears more effective, while natural and complementary therapies have short-term benefits and high costs. CONCLUSIONS Pain management is a source for frustration and an unmet need for patients with fibromyalgia. The current findings provide crucial insight for providers and researchers; and support the need for fibromyalgia phenotyping and precision medicine approaches to pain management.Implications for RehabilitationChronic widespread pain is the defining feature of fibromyalgia, yet pain reduction is often an unmet need for these individuals.The lack of effective treatments resulting in long-term relief proves frustrating for patients and healthcare providers.Rehabilitation professional should consider the unique insight into this complex, heterogeneous condition that this qualitative synthesis provides to better understand their patient's perspective on pain management.Given the differing perspectives on pain treatment approaches individuals with fibromyalgia report, providers should discuss with each patient their current strategies and take a patient-centered, individualized approach to form an effective treatment plan.
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Affiliation(s)
- Carolina Climent-Sanz
- Department of Nursing and Physiotherapy, University of Lleida, Lleida, Spain
- Health Care Research Group (GRECS), Lleida Institute for Biomedical Research Dr. Pifarré Foundation, IRBLleida, Lleida, 25198, Spain
- Grup d’Estudis Societat, Salut, Educació i Cultura (GESEC), Institute for Social and Territorial Development (INDEST), University of Lleida, Spain
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - Katrina R. Hamilton
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - Oriol Martínez-Navarro
- Department of Nursing and Physiotherapy, University of Lleida, Lleida, Spain
- Health Care Research Group (GRECS), Lleida Institute for Biomedical Research Dr. Pifarré Foundation, IRBLleida, Lleida, 25198, Spain
| | - Erica Briones-Vozmediano
- Department of Nursing and Physiotherapy, University of Lleida, Lleida, Spain
- Health Care Research Group (GRECS), Lleida Institute for Biomedical Research Dr. Pifarré Foundation, IRBLleida, Lleida, 25198, Spain
- Grup d’Estudis Societat, Salut, Educació i Cultura (GESEC), Institute for Social and Territorial Development (INDEST), University of Lleida, Spain
| | | | - Helena Fernández-Lago
- Department of Nursing and Physiotherapy, University of Lleida, Lleida, Spain
- Health Care Research Group (GRECS), Lleida Institute for Biomedical Research Dr. Pifarré Foundation, IRBLleida, Lleida, 25198, Spain
- Grup d’Estudis Societat, Salut, Educació i Cultura (GESEC), Institute for Social and Territorial Development (INDEST), University of Lleida, Spain
| | - Fran Valenzuela-Pascual
- Department of Nursing and Physiotherapy, University of Lleida, Lleida, Spain
- Health Care Research Group (GRECS), Lleida Institute for Biomedical Research Dr. Pifarré Foundation, IRBLleida, Lleida, 25198, Spain
- Grup d’Estudis Societat, Salut, Educació i Cultura (GESEC), Institute for Social and Territorial Development (INDEST), University of Lleida, Spain
| | - Patrick H. Finan
- Department of Anesthesiology, University of Virginia School of Medicine, Charlottesville, VA, USA
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Byrne A, Jones K, Backhouse M, Rose F, Moatt E, van der Feltz-Cornelis C. Patient and primary care practitioners' perspectives on consultations for fibromyalgia: a qualitative evidence synthesis. Prim Health Care Res Dev 2023; 24:e58. [PMID: 37750736 PMCID: PMC10540196 DOI: 10.1017/s1463423623000506] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Revised: 03/29/2023] [Accepted: 08/28/2023] [Indexed: 09/27/2023] Open
Abstract
BACKGROUND Fibromyalgia presents a challenge to both the patients experiencing symptoms and the staff aiming to treat them. This qualitative review aimed to synthesise how patients and practitioners experience primary care consultations, develop a rounded picture of how they perceive each other, the challenges to primary care consultation and how they might be tackled. METHODS CINAHL, Embase, CENTRAL and Medline were searched from inception to November 2021. Qualitative studies were included if they explored the perspectives and experiences of either fibromyalgia patients or primary care practitioners. Quantitative data, studies not published in English, not set in primary care or that did not distinguish the type of patient or clinician were excluded. Included studies were analysed using thematic synthesis and their quality assessed. RESULTS In total, 30 studies met the inclusion criteria. Thematic synthesis identified three overarching themes: (1) life turned upside down - exploring the chaos experienced by patients as they seek help; (2) negative cycle - highlighting how patient and practitioner factors can create a detrimental cycle; and (3) breaking the cycle - validating patient-doctor relationships underpinned by clear communication can help break the negative cycle. CONCLUSIONS Fibromyalgia patients experience uncertainty and chaos that can clash with the attitudes of GPs and the help they can feasibly provide. Difficult consultations in which neither the GP nor patient are satisfied can easily occur. Promoting supportive, reciprocal and open patient-doctor relationships is essential. Future research is required to further explore GP attitudes and to develop an intervention that could improve consultations, patient outcomes and GP satisfaction.
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Affiliation(s)
- Ailish Byrne
- York Trials Unit, Department of Health Sciences, University of York, Heslington, York, UK
| | - Katherine Jones
- Warwick Clinical Trials Unit, University of Warwick, Coventry, UK
| | | | - Fiona Rose
- York Trials Unit, Department of Health Sciences, University of York, Heslington, York, UK
| | - Emma Moatt
- York Trials Unit, Department of Health Sciences, University of York, Heslington, York, UK
| | - Christina van der Feltz-Cornelis
- Mental Health and Addictions Research Group, Department of Health Sciences, Hull York Medical School, University of York, Heslington, York, UK
- Institute of Health Informatics, University College London, London, UK
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Corline A, Cole F, Trewern L, Penlington C. 'Power to the People, to the people': Training for social prescribers improves support of persistent pain. Br J Pain 2023; 17:281-292. [PMID: 37342392 PMCID: PMC10278448 DOI: 10.1177/20494637231152979] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/20/2023] Open
Abstract
Introduction Supported self-management is an important aspect of managing pain, however widely held beliefs about the biomedical nature of pain and limited time availability can make it a tricky concept to introduce to patients. Social prescribers are in an ideal position to support self-management of pain if appropriate training is available to support them. This study aimed to evaluate training for social prescribers and to explore their opinions and experiences about providing self-management support. Methods This was a mixed methods study. Repeated measures t-tests were used to compare the reported confidence of attendees in supporting different facets of self-management before and after the training. Thematic analysis of interviews was used to develop a deeper understanding of how participants related the training to their work with patients. Results Average confidence improved in all aspects of supporting self-management, and particularly with regard to supporting understanding pain, acceptance, pacing, setting goals, sleep and managing setbacks. Challenges were identified around explaining pain in an accurate and accessible way in order to provide a meaningful rationale for self-management. Conclusion Training for social prescribers in self-management support is feasible and leads to improvements in self-reported confidence. Further research is needed to determine the impact on patients and over a longer period of time.
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Affiliation(s)
- Alex Corline
- Faculty of Medical Sciences, Newcastle University, Newcastle, UK
| | | | - Louise Trewern
- Lead Lived Experience Trainer, Live Well with Pain, NHS Pain Service Volunteer Torbay and South Devon
| | - Chris Penlington
- Faculty of Medical Sciences, Newcastle University, Newcastle, UK
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Patient-clinician brain concordance underlies causal dynamics in nonverbal communication and negative affective expressivity. Transl Psychiatry 2022; 12:44. [PMID: 35091536 PMCID: PMC8799700 DOI: 10.1038/s41398-022-01810-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2021] [Revised: 01/03/2022] [Accepted: 01/12/2022] [Indexed: 12/13/2022] Open
Abstract
Patient-clinician concordance in behavior and brain activity has been proposed as a potential key mediator of mutual empathy and clinical rapport in the therapeutic encounter. However, the specific elements of patient-clinician communication that may support brain-to-brain concordance and therapeutic alliance are unknown. Here, we investigated how pain-related, directional facial communication between patients and clinicians is associated with brain-to-brain concordance. Patient-clinician dyads interacted in a pain-treatment context, during synchronous assessment of brain activity (fMRI hyperscanning) and online video transfer, enabling face-to-face social interaction. In-scanner videos were used for automated individual facial action unit (AU) time-series extraction. First, an interpretable machine-learning classifier of patients' facial expressions, from an independent fMRI experiment, significantly distinguished moderately painful leg pressure from innocuous pressure stimuli. Next, we estimated neural-network causality of patient-to-clinician directional information flow of facial expressions during clinician-initiated treatment of patients' evoked pain. We identified a leader-follower relationship in which patients predominantly led the facial communication while clinicians responded to patients' expressions. Finally, analyses of dynamic brain-to-brain concordance showed that patients' mid/posterior insular concordance with the clinicians' anterior insula cortex, a region identified in previously published data from this study1, was associated with therapeutic alliance, and self-reported and objective (patient-to-clinician-directed causal influence) markers of negative-affect expressivity. These results suggest a role of patient-clinician concordance of the insula, a social-mirroring and salience-processing brain node, in mediating directional dynamics of pain-directed facial communication during therapeutic encounters.
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The Impact of a Peer Social Support Network from the Perspective of Women with Fibromyalgia: A Qualitative Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182312801. [PMID: 34886527 PMCID: PMC8657284 DOI: 10.3390/ijerph182312801] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Revised: 11/25/2021] [Accepted: 12/01/2021] [Indexed: 12/22/2022]
Abstract
Background: Fibromyalgia is a chronic and complex disease whose management by patients requires a high level of commitment. Patient empowerment therefore represents an important milestone in chronic disease treatment and control. We explored the impact of a peer social support network from the perspective of women with fibromyalgia. Methods: A generic qualitative design was proposed for the study, for which women who had been diagnosed with fibromyalgia were purposefully selected. Six semi-structured interviews were conducted, and the collected data were thematically analysed. Results: Three key themes emerged regarding the peer social support network: (1) empowerment (facilitating acceptance of the diagnosis and acting as a source of information); (2) effects on well-being and quality of life (attenuated the stigma, improved physical well-being, provided emotional support and was a socialization medium); and (3), valuable aspects (transmitted feelings of being understood and listened to and increased personal feelings of satisfaction). Conclusions: A peer social support network for women with fibromyalgia exerts positive effects on their physical, mental, and social well-being and empowers them to better manage their disease. Healthcare for women with fibromyalgia should include strategies that connect them through peer social support networks.
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Macedo CC, Figueiredo PHS, Gonçalves NRB, Afonso CA, Martins RM, Santos JM, Gaiad TP, Sañudo B, Oliveira VC, Mendonça VA, Lacerda ACR. Fibromyalgia in social media: content and quality of the information analysis of videos on the YouTube platform. Inform Health Soc Care 2021; 47:305-316. [PMID: 34748454 DOI: 10.1080/17538157.2021.1990934] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
To evaluate the fibromyalgia (FM) content in YouTube videos and verify if American College of Rheumatology (ACR) guidelines are being met. The videos were searched with the keyword "Fibromyalgia." Two independent researchers evaluated and coded specific characteristics of the videos. The popularity of the videos, the presentation properties, and content related to FM according to the ACR criteria were analyzed. Of the 200 videos included, the majority were presented by health professionals, 61.5%. Most videos covered more than one subject, 38.5%. The videos presented by health professionals were the most viewed. Following the ACR guidelines, 38% defined FM, 24% described the etiology, 19.5% described the diagnostic criteria and 52% presented recommended management strategies. The results indicate that users mainly watch videos published by health professionals. Most of the published videos do not follow the information recommended by the ACR guidelines. Therefore, videos should be interpreted with caution, not being the most appropriate resource for health education for patients with FM. Most of the videos published on YouTube about FM do not meet the ACR guidelines for FM.
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Affiliation(s)
- Caik C Macedo
- Department of Physiotherapy, Universidade Federal dos Vales do Jequitinhonha e Mucuri, Diamantina, Brazil
| | - Pedro H S Figueiredo
- Department of Physiotherapy, Universidade Federal dos Vales do Jequitinhonha e Mucuri, Diamantina, Brazil.,Postgraduate Program in Rehabilitation and Functional Performance, Universidade Federal dos Vales do Jequitinhonha e Mucuri, Diamantina, Brazil
| | - Nelcilaine R B Gonçalves
- Department of Physiotherapy, Universidade Federal dos Vales do Jequitinhonha e Mucuri, Diamantina, Brazil
| | - Clarita A Afonso
- Department of Physiotherapy, Universidade Federal dos Vales do Jequitinhonha e Mucuri, Diamantina, Brazil
| | - Rosana M Martins
- Department of Physiotherapy, Universidade Federal dos Vales do Jequitinhonha e Mucuri, Diamantina, Brazil
| | - Jousielle M Santos
- Department of Physiotherapy, Universidade Federal dos Vales do Jequitinhonha e Mucuri, Diamantina, Brazil.,Postgraduate Program in Rehabilitation and Functional Performance, Universidade Federal dos Vales do Jequitinhonha e Mucuri, Diamantina, Brazil.,Multicenter Postgraduate Program in Physiological Sciences, Universidade Federal dos Vales do Jequitinhonha e Mucuri, Diamantina, Brazil
| | - Thaís P Gaiad
- Department of Physiotherapy, Universidade Federal dos Vales do Jequitinhonha e Mucuri, Diamantina, Brazil.,Postgraduate Program in Rehabilitation and Functional Performance, Universidade Federal dos Vales do Jequitinhonha e Mucuri, Diamantina, Brazil
| | - Borja Sañudo
- Departamento de Educación Física y Deporte, Universidad de Sevilla, Seville, Spain
| | - Vinicius C Oliveira
- Department of Physiotherapy, Universidade Federal dos Vales do Jequitinhonha e Mucuri, Diamantina, Brazil.,Postgraduate Program in Rehabilitation and Functional Performance, Universidade Federal dos Vales do Jequitinhonha e Mucuri, Diamantina, Brazil.,Postgraduate Program in Health Sciences, Universidade Federal dos Vales do Jequitinhonha e Mucuri, Diamantina, Brazil
| | - Vanessa A Mendonça
- Department of Physiotherapy, Universidade Federal dos Vales do Jequitinhonha e Mucuri, Diamantina, Brazil.,Postgraduate Program in Rehabilitation and Functional Performance, Universidade Federal dos Vales do Jequitinhonha e Mucuri, Diamantina, Brazil.,Multicenter Postgraduate Program in Physiological Sciences, Universidade Federal dos Vales do Jequitinhonha e Mucuri, Diamantina, Brazil.,Postgraduate Program in Health Sciences, Universidade Federal dos Vales do Jequitinhonha e Mucuri, Diamantina, Brazil
| | - Ana Cristina R Lacerda
- Department of Physiotherapy, Universidade Federal dos Vales do Jequitinhonha e Mucuri, Diamantina, Brazil.,Postgraduate Program in Rehabilitation and Functional Performance, Universidade Federal dos Vales do Jequitinhonha e Mucuri, Diamantina, Brazil.,Multicenter Postgraduate Program in Physiological Sciences, Universidade Federal dos Vales do Jequitinhonha e Mucuri, Diamantina, Brazil.,Postgraduate Program in Health Sciences, Universidade Federal dos Vales do Jequitinhonha e Mucuri, Diamantina, Brazil
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Wang XJ, Ebbert JO, Gilman EA, Rosedahl JK, Ramar P, Philpot LM. Central Sensitization Symptom Severity and Patient-Provider Relationships in a Community Setting. J Prim Care Community Health 2021; 12:21501327211031767. [PMID: 34235997 PMCID: PMC8273518 DOI: 10.1177/21501327211031767] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Introduction Central sensitization syndromes (CSS) comprise an overlapping group of clinical conditions with the core feature of “pain arising as a direct consequence of a lesion or disease affecting the somatosensory system.” Patients with CSS are known to have challenging interactions with healthcare providers contributing to psychological distress and increased healthcare utilization. CSS symptom severity has been associated with psychologic comorbidities, but little is known about how symptom severity relates to provider interactions. Methods We performed a cross-sectional survey among patients with CSS in our primary care practices to examine the relationship between CSS symptom severity and experiences with doctors. Results A total of 775 respondents completed the survey (775/5000; 15.5%) with 72% reporting high CSS symptom severity. About 44% of respondents had a prior diagnosis of fibromyalgia, 72% had migraines, and 28% had IBS. Patients with high CSS symptom severity were more likely to report that doctor(s) had often/always told them that they don’t need treatment when they feel like they do (OR = 3.6, 95% CI 1.9-7.5), that doctor(s) often/always don’t understand them (OR = 3.1, 95% CI 1.9-5.4), and that doctor(s) often/always seem annoyed with them when compared with respondents with low-moderate CSS symptom severity (OR = 4.8, 95% CI 2.2-12.5). Patients with high CSS symptom severity were at greater than 5 times odds of reporting being told that their symptoms were “all in their head” when compared to patients with low-moderate symptom severity (OR = 5.4, 95% CI 3.3-9.0). Conclusion Patients with CSS spectrum disorders experience frequent pain and decreased quality of life. A high degree of CSS symptom severity is associated with negative experiences with healthcare providers, which deters the establishment of a positive provider-patient relationship. Further research is needed to help understand symptom severity in CSS and harness the power of the therapeutic alliance as a treatment modality.
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Schatman ME, Patterson E, Shapiro H. Patient Interviewing Strategies to Recognize Substance Use, Misuse, and Abuse in the Dental Setting. Dent Clin North Am 2020; 64:503-512. [PMID: 32448454 DOI: 10.1016/j.cden.2020.02.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Brief and effective clinical interviewing is critical for identifying patient risk factors, including those associated with substance use. Dental practitioners may perceive identifying patient substance misuse and abuse as a complex undertaking or may consider this clinical assessment beyond the scope of their training and practice. This article describes interviewing strategies that will help dental providers communicate effectively and empathically with their patients to collect relevant clinical information related to substance use, misuse, and abuse and provide better care for their patients.
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Affiliation(s)
- Michael E Schatman
- Department of Diagnostic Sciences, Tufts University School of Dental Medicine, 1 Kneeland Street, Boston, MA 02111, USA; Department of Public Health & Community Medicine, Tufts University School of Medicine, Boston, MA, USA.
| | - Ellen Patterson
- Department of Comprehensive Care, Tufts University School of Dental Medicine, 1 Kneeland Street, Boston, MA 02111, USA
| | - Hannah Shapiro
- Department of Biopsychology, Tufts University, Robinson Hall, 200 College Avenue, Medford, MA 02155, USA
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