Sexuality in male partners of women with fibromyalgia syndrome: A qualitative study

Partners' Experiences of Chronic Pain: A Qualitative Evidence Synthesis

This systematic review of qualitative studies synthesised evidence on the experience chronic pain from the perspective of romantic partners. Medline via Ovid, Embase via Ovid, CINAHL via EBSCO, APA PsycInfo via Ovid, Scopus, and Web of Science databases were searched. Studies exploring the impact of chronic pain from partners' perspectives using qualitative data collection methods were eligible for inclusion. Thematic synthesis was conducted, and confidence in the review findings was assessed using GRADE CERQual criteria. A total of 198 participants were represented from 15 primary studies. Four interconnected analytical themes were developed: 'life is different', 'internal conflict between two worlds', 'togetherness vs separateness', and 'coping in the longer term'. Out of 27 review findings, 9 were assessed as high confidence, 12 as moderate confidence, 4 as low confidence, and 2 as very low confidence. Socially isolated partners, those in strained relationships, and partners who continually sacrificed their own needs were more likely to experience distressing emotions. Greater recognition of partners' needs is needed within pain management services.

Gendered meanings and mechanisms of intimacy for people living with chronic pain

Cisheteronormative assumptions about women as able-bodied caregivers responsible for men's sexual pleasure compound the stigma associated with chronic pain because of an assumed inability to fulfil gender roles in intimate relationships. There is a need to move beyond this deficit model of gender, chronic pain and intimacy. People of all gender identities live with chronic pain, forming fulfilling intimate relationships regardless of their condition(s). Starting from a strengths-based assumption that individuals living with chronic pain develop their own understanding of and pathways to intimacy, I conducted written interviews with thirteen people living with a range of pain and pain-related conditions to theorise gendered differences in understandings and experiences of intimacy in the context of dating. Findings show that intimacy is associated with vulnerability and authenticity. These connotations vary between men, women and gender diverse participants, aligning with gendered socialisation about intimacy and relationships. Men tend to prioritise physical intimacy. Women and gender diverse participants emphasise their obligation to perform the labour necessary for forming and maintaining connections. However, regardless of gender, experiencing intimacy requires implementing flexible approaches to dating because doing so makes closeness accessible.

The protective roles of affectionate behaviors and communication on mental quality of life of couples living with fibromyalgia: movement toward a dyadic perspective

This study assessed the impact of affectionate behaviors and communication problems on the mental quality of life (mQoL) in couples with fibromyalgia. Dyadic multilevel modeling in 204 fibromyalgia couples found that people with fibromyalgia (PwFM) who engaged in high levels of affectionate behaviors with their partner had improved mQoL. There was no significant association between affectionate behaviors and mQoL for their partners. Similarly, when PwFM and their partners had more communication problems within the couple, they had poor mQoL. Both models found that higher levels of pain interference for PwFM were significantly associated with poorer mQoL for both members of the couple. Young partners were significantly more likely to report poorer mQoL. Findings highlight the importance of the interpersonal context of fibromyalgia and the protective roles that affectionate behaviors and positive communication can play. Clinicians should include the partner in the care plan and treat the couple as one unit to better optimize the health of both members.

Sexuality in Women with Fibromyalgia Syndrome: A Metasynthesis of Qualitative Studies

Fibromyalgia syndrome (FMS) is a nonarticular rheumatic syndrome which presents as chronic musculoskeletal pain, stiffness and body aches. FMS affects approximately 2.5% of the population, mostly women. FMS causes physical and psychological problems and reduces quality of life. The objective of this study is to identify qualitative evidence about experiences of women diagnosed with FMS about their sexuality.

METHODS

Metasynthesis of qualitative studies. The search included articles published between 2000 and June 2023 on the PubMed, WOS, CINAHL, SCOPUS, and SCIELO databases.

RESULTS

450 articles were found through the initial search, of which, only nine fulfilled the criteria and were included in the thematic synthesis. From this analysis, three main themes emerged: (1) "I want to, but I can't": FMS causes a shift in feminine sexuality. (2) Resetting sex life and intimacy. (3) Taking charge of a "new sexuality."

CONCLUSIONS

Women with FMS suffer from limitations of their sexuality that affect their partner. Pain, stiffness and a loss of desire make sexual encounters difficult. Becoming aware of this and striving not to lose their sexuality is key to coping with this problem. Women and their sexual partners can change roles and encourage communication, games, foreplay or touching. The use of lubricants, physical exercise and complementary therapies, along with social, professional and partner support, are key to coping with FMS.

Impact of Fibromyalgia Syndrome on Female Sexual Function: A Systematic Review With Meta-analysis

OBJECTIVE

The aim of this study was to examine sexual dysfuntion in women diagnosed with FMS compared with healthy controls.

METHODS

A systematic review with meta-analysis was performed. The literature search was conducted using PubMed Medline, Scopus, Web of Science, CINAHL, SciELO, and PsycINFO PROQUEST until February 2021. Observational studies with 2 groups (women with FMS and healthy controls) that assessed sexual function were included. Pooled effect was calculated using Cohen standardized mean difference (SMD) and its 95% confidence interval (CI) in a random-effects model.

RESULTS

Twelve studies were included comprising 1367 women (766 diagnosed with FMS and 601 healthy controls). The methodological quality of the included studies was moderate, according to the Newcastle-Ottawa Scale. Our findings showed a significant sexual dysfunction in women diagnosed with FMS (SMD = 1.72; 95% CI, 1.18-2.26; p < 0.001). In addition, the secondary outcomes more affected in women with FMS were sexual satisfaction (SMD = -2.09; 95% CI, -2.83 to -1.36; p < 0.001) and the pain during sexual relations (SMD = -1.97; 95% CI, -2.81 to -1.12; p < 0.001).

CONCLUSIONS

Women with FMS showed a significant sexual dysfunction and other related sexual difficulties, such as increase in sexual pain and a decreased sexual desire or sexual satisfaction, compared with healthy women.

Patients' appraisals about a multicomponent intervention for fibromyalgia syndrome in primary care: a focus group study

PURPOSE

To assess fibromyalgia patients' experiences and appraisals about a multidisciplinary intervention programme, in Catalonia's primary care, regarding its format and contents, benefits, and health impact in the short and long term.

METHOD

Qualitative interpretative research design through hermeneutic phenomenology perspective. Two focus groups discussions were conducted in February and July 2020. The purposive heterogeneous sample included 19 fibromyalgia patients who attended a multicomponent programme. In addition, thematic analysis on the verbatims was performed.

RESULTS

Findings were organized into five main domains with an explanatory theme each. Overall, the informants valued the programme as a positive experience due to its holistic approach, health benefits, suffering relief, group effect, and fibromyalgia legitimacy promotion. Detected improvable aspects focused on extending the timeframe, including family members as beneficiaries, deepening the thematic contents, and getting regular access to this healthcare service. Furthermore, the intervention was considered feasible to be incorporated into usual clinical care.

CONCLUSION

the programme fulfilled users' expectations about results and procedure and showed promise as a treatment strategy to reinforce the usual practice. Our findings suggest a broad perspective on fibromyalgia patients' suffering, which urges us to adjust the intervention programme to their real health needs.

Mishel's Model of Uncertainty Describing Categories and Subcategories in Fibromyalgia Patients, a Scoping Review

The aim of this review was to demonstrate the presence of categories and subcategories of Mishel's model in the experiences of patients with fibromyalgia by reviewing qualitative studies. Uncertainty is defined as the inability to determine the meaning of disease-related events. A scoping review of qualitative studies was carried out. Twenty articles were included, with sample sizes ranging from 3 to 58 patients. Articles from different countries and continents were included. Three categories of the model and eight subcategories could be shown to be present in the experiences of fibromyalgia patients through the scoping review. The first category, concerning antecedents of uncertainty in patients with fibromyalgia, is constituted by the difficulty in coping with symptoms, uncertainty about the diagnosis and uncertainty about the complexity of the treatment. The second concerns the cognitive process of anxiety, stress, emotional disorder and social stigma. The third category refers to coping with the disease, through the management of social and family support and the relationship with health care professionals.