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Arfuch VM, Caballol Angelats R, Aguilar Martín C, Gonçalves AQ, Carrasco-Querol N, González Serra G, Sancho Sol MC, Fusté Anguera I, Friberg E, Berenguera A. Patients' Lived Experience in a Multicomponent Intervention for Fibromyalgia Syndrome in Primary Care: A Qualitative Interview Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:13322. [PMID: 36293900 PMCID: PMC9603341 DOI: 10.3390/ijerph192013322] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Revised: 10/09/2022] [Accepted: 10/13/2022] [Indexed: 06/16/2023]
Abstract
Fibromyalgia syndrome (FMS) disrupts patients' biopsychosocial spheres. A multicomponent intervention (MCI) program, which combined health education, cognitive behavioral therapy, and physical activity, was conducted in South Catalonia's primary care centers with the aim of improving symptom self-management and quality of life. A qualitative interview study was carried out to understand patients' lived experiences during the intervention program. Sampled purposively, 10 patients were interviewed via phone calls and face-to-face. The encounters were audio-recorded, verbatim transcribed, and analyzed through thematic analysis. As a result, four themes emerged: legitimizing fibromyalgia through the MCI, the MCI as a socializing experience, learning how to live with FMS through the MCI, and room for improving the MCI. Participants agreed on the program being an insightful experience that promoted illness knowledge and acceptance and that improved their coping skills and symptom self-management. The inclusion of additional psychological guidance, expressive psychological group therapy, and providing relatives with information were proposed for enhancing the program. Our findings have contributed to gaining insight into the subjective impact of the MCI and identifying new therapeutic targets to tailor the program to patients' needs, which will hopefully increase its effectiveness and improve their quality of life.
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Affiliation(s)
- Victoria Mailen Arfuch
- Unitat de Suport a la Recerca Terres de l’Ebre, Fundació Institut Universitari per a la Recerca a l’Atenció Primària de Salut Jordi Gol I Gurina (IDIAPJGol), 20 Cristòfol Colom Avenue, 43500 Tortosa, Spain
- Department of Pediatrics, Obstetrics and Gynecology and Preventive Medicine and Public Health Universitat Autònoma de Barcelona, 08193 Bellaterra, Spain
- Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, 3 Berzelius väg Street, 6 Floor, 171 77 Stockholm, Sweden
| | - Rosa Caballol Angelats
- Centre d’Atenció Primària (CAP) El Temple, Gerència Territorial de Terres de l’Ebre, Institut Català de la Salut (ICS), Plaça Carrilet sn., 43500 Tortosa, Spain
- Unitat d’Expertesa en Sindromes de Sensibilització Central Terres de l’Ebre, Gerència Territorial de Terres de l’Ebre, Institut Català de la Salut (ICS), 20 Cristòfol Colom Avenue, 43500 Tortosa, Spain
| | - Carina Aguilar Martín
- Unitat de Suport a la Recerca Terres de l’Ebre, Fundació Institut Universitari per a la Recerca a l’Atenció Primària de Salut Jordi Gol I Gurina (IDIAPJGol), 20 Cristòfol Colom Avenue, 43500 Tortosa, Spain
- Unitat d’Avaluació, Direcció d’Atenció Primària Terres de l’Ebre, Gerència Territorial de Terres de l’Ebre, Institut Català de la Salut (ICS), 20 Cristòfol Colom Avenue, 43500 Tortosa, Spain
| | - Alessandra Queiroga Gonçalves
- Unitat de Suport a la Recerca Terres de l’Ebre, Fundació Institut Universitari per a la Recerca a l’Atenció Primària de Salut Jordi Gol I Gurina (IDIAPJGol), 20 Cristòfol Colom Avenue, 43500 Tortosa, Spain
- Unitat Docent de Medicina de Família i Comunitària Tortosa-Terres de L‘Ebre, Institut Català de la Salut (ICS), 44-58 Esplanetes Street, 43500 Tortosa, Spain
| | - Noèlia Carrasco-Querol
- Unitat de Suport a la Recerca Terres de l’Ebre, Fundació Institut Universitari per a la Recerca a l’Atenció Primària de Salut Jordi Gol I Gurina (IDIAPJGol), 20 Cristòfol Colom Avenue, 43500 Tortosa, Spain
| | - Gemma González Serra
- Servei de Rehabilitació i Medicina Física, Hospital de Tortosa Verge de la Cinta, Gerència Territorial de Terres de l’Ebre, Institut Català de la Salut (ICS), 44-58 Esplanetes Street, 43500 Tortosa, Spain
| | - Maria Cinta Sancho Sol
- Unitat d’Expertesa en Sindromes de Sensibilització Central Terres de l’Ebre, Gerència Territorial de Terres de l’Ebre, Institut Català de la Salut (ICS), 20 Cristòfol Colom Avenue, 43500 Tortosa, Spain
- Centre de Salut Mental d’Adults (CSMA) de Fundació Pere Mata Terres de l’Ebre, 50 Rambla de Pompeu Fabra, 43500 Tortosa, Spain
| | - Immaculada Fusté Anguera
- Centre d’Atenció Primària (CAP) El Temple, Gerència Territorial de Terres de l’Ebre, Institut Català de la Salut (ICS), Plaça Carrilet sn., 43500 Tortosa, Spain
- Unitat d’Expertesa en Sindromes de Sensibilització Central Terres de l’Ebre, Gerència Territorial de Terres de l’Ebre, Institut Català de la Salut (ICS), 20 Cristòfol Colom Avenue, 43500 Tortosa, Spain
| | - Emilie Friberg
- Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, 3 Berzelius väg Street, 6 Floor, 171 77 Stockholm, Sweden
| | - Anna Berenguera
- Department of Pediatrics, Obstetrics and Gynecology and Preventive Medicine and Public Health Universitat Autònoma de Barcelona, 08193 Bellaterra, Spain
- Central Research Unit, Fundació Institut Universitari per a la Recerca a l’Atenció Primària de Salut Jordi Gol I Gurina (IDIAPJGol), 08007 Barcelona, Spain
- Department of Nursing, Universitat de Girona, Plaça de Sant Domènec, 3, 17004 Girona, Spain
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Amigos de Fibro (Fibro Friends): Validation of an Educational Program to Promote Health in Fibromyalgia. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19095297. [PMID: 35564691 PMCID: PMC9102409 DOI: 10.3390/ijerph19095297] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Revised: 04/19/2022] [Accepted: 04/24/2022] [Indexed: 02/04/2023]
Abstract
Health education is one of the main items to enable the promotion of health for individuals with fibromyalgia (FM) in Primary Health Care (PHC) in Brazil. The purpose of this study was to validate a multidisciplinary educational health promotion program called Amigos de Fibro (Fibro Friends) for individuals with FM. Methodological research involving 23 health professionals (expert judges) and 45 individuals with FM (target audience) used an instrument to assess the objectives, proposed themes and initiatives, relevance, writing style, and structure of the program through the Delphi technique. The content validity index (CVI) ≥ 0.78 and coefficient kappa ≥ 0.61 were used for data analysis. All 25 items evaluated in both groups presented considerable minimum CVI by CVI and the kappa coefficient. In the global evaluation of Amigos de Fibro, the CVI of the specialist judges was 0.90, while the values of the target audience judges were 0.95. The kappa coefficient of the expert judges was 0.90 and that of the target audience judges was 0.85. Amigos de Fibro, a light technology in health, was considered with adequate content validity and internal consistency and is, therefore, valid in the use by health professionals with the target audience in PHC, making it possible for them to act as health-promoting agents.
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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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Arfuch VM, Queiroga Gonçalves A, Caballol Angelats R, Aguilar Martín C, Carrasco-Querol N, Sancho Sol MC, González Serra G, Fusté Anguera I, Berenguera A. Patients' appraisals about a multicomponent intervention for fibromyalgia syndrome in primary care: a focus group study. Int J Qual Stud Health Well-being 2021; 16:2005760. [PMID: 34839810 PMCID: PMC8843386 DOI: 10.1080/17482631.2021.2005760] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/29/2022] Open
Abstract
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.
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Affiliation(s)
- Victoria Mailen Arfuch
- Unitat de Suport a La Recerca Terres de l'Ebre, Institut Universitari d'Investigació En Atenció Primària Jordi Gol (Idiap Jordi Gol), Tortosa, Spain.,Department of Pediatrics, Obstetrics and Gynecology, and Preventive Medicine, Universitat Autònoma de Barcelona, Spain.,Insurance Medicine Division, Department of Neuroscience, Karolinska Institutet, Sweden
| | - Alessandra Queiroga Gonçalves
- Unitat de Suport a La Recerca Terres de l'Ebre, Institut Universitari d'Investigació En Atenció Primària Jordi Gol (Idiap Jordi Gol), Tortosa, Spain.,Unitat Docent de Medicina de Família I Comunitària Tortosa-Terres de L'Ebre, Institut Català de La Salut (Ics), Spain
| | - Rosa Caballol Angelats
- Centre d'Atenció Primària Baix Ebre Tortosa Est, Gerència Territorial de Terres de l'Ebre, Institut Català de La Salut (Ics), Tortosa, Spain.,Unitat d'Expertesa En Sindromes de Sensibilització Central Terres de l'Ebre, Gerència Territorial de Terres de l'Ebre, Institut Català de La Salut (Ics), Tortosa, Spain
| | - Carina Aguilar Martín
- Unitat de Suport a La Recerca Terres de l'Ebre, Institut Universitari d'Investigació En Atenció Primària Jordi Gol (Idiap Jordi Gol), Tortosa, Spain.,Unitat d'Avaluació, Direcció d'Atenció Primària Terres de l'Ebre, Gerència Territorial de Terres de l'Ebre, Institut Català de La Salut (Ics), Tortosa, Spain
| | - Noèlia Carrasco-Querol
- Unitat de Suport a La Recerca Terres de l'Ebre, Institut Universitari d'Investigació En Atenció Primària Jordi Gol (Idiap Jordi Gol), Tortosa, Spain
| | - Maria Cinta Sancho Sol
- Unitat d'Expertesa En Sindromes de Sensibilització Central Terres de l'Ebre, Gerència Territorial de Terres de l'Ebre, Institut Català de La Salut (Ics), Tortosa, Spain.,Centro de Salut Mental Adultos (Csma) de Fundació Pere Mata Terres de l'Ebre, Tortosa, Spain
| | - Gemma González Serra
- Unitat d'Expertesa En Sindromes de Sensibilització Central Terres de l'Ebre, Gerència Territorial de Terres de l'Ebre, Institut Català de La Salut (Ics), Tortosa, Spain.,Servei de Rehabilitació I Medicina Física, Hospital Verge de La Cinta, Gerència Territorial de Terres de l'Ebre, Institut Català de La Salut (Ics), Tortosa, Spain
| | - Immaculada Fusté Anguera
- Centre d'Atenció Primària Baix Ebre Tortosa Est, Gerència Territorial de Terres de l'Ebre, Institut Català de La Salut (Ics), Tortosa, Spain.,Unitat d'Expertesa En Sindromes de Sensibilització Central Terres de l'Ebre, Gerència Territorial de Terres de l'Ebre, Institut Català de La Salut (Ics), Tortosa, Spain
| | - Anna Berenguera
- Department of Pediatrics, Obstetrics and Gynecology, and Preventive Medicine, Universitat Autònoma de Barcelona, Spain.,Central Research Unit, Institut Universitari per a La Recerca a l'Atenció Primària de Salut Jordi Gol I Gurina (Idiapjgol), Barcelona, Spain.,Departament d'Infermeria, Universitat de Girona, Girona, Spain
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Arfuch VM, Caballol Angelats R, Aguilar Martín C, Carrasco-Querol N, Sancho Sol MC, González Serra G, Fusté Anguera I, Gonçalves AQ, Berenguera A. Assessing the benefits on quality of life of a multicomponent intervention for fibromyalgia syndrome in primary care: patients' and health professionals' appraisals: a qualitative study protocol. BMJ Open 2020; 10:e039873. [PMID: 33177139 PMCID: PMC7661363 DOI: 10.1136/bmjopen-2020-039873] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Revised: 10/07/2020] [Accepted: 10/23/2020] [Indexed: 11/04/2022] Open
Abstract
INTRODUCTION Fibromyalgia syndrome (FMS) is a complex condition still scarcely understood and with ambiguity when prescribing treatment. Both patients and healthcare providers can supply valuable information for the development of new treatment strategies. The qualitative narrative analysis of participant's accounts is potentially helpful to reveal new insights about their opinions, needs, and experiences and, consequently, to model healthcare interventions accurately. International treatment guidelines suggest a promising future for multicomponent intervention (MI) approaches for FMS. This study aims to assess the benefits of a MI for patients with FMS in the context of primary care (PC) in Terres de L'Ebre, Catalonia (Spain). Furthermore, it is intended to detect the overall perception of effectiveness and to understand patients' lived experience and its impact on the quality of life. METHOD AND ANALYSIS Qualitative research from a socioconstructivism paradigm perspective and a Hermeneutic Phenomenological method. For data collection, four focus group discussions (FGDs) of 8-12 people (2 FGDs of patients and 2 of professionals) and 10-12 key informant interviews with the participants in the MI group will be carried out. All the information will be recorded and verbatim transcribed to perform an interpretive thematic analysis. ETHICS AND DISSEMINATION This study protocol has been approved by the Clinical Research Ethics Committee from the IDIAPJGol Institute, on 25 April 2018 (code P18/068), according to the Declaration of Helsinki/Tokyo. All participants will receive oral/written information about the study, and they will be required to sign an informed consent sheet. Data anonymity will be guaranteed. Dissemination will be carried out through publications in scientific journals, presentations in academic meetings, workshops and through the local and national media. TRIAL REGISTRATION NUMBER ClinicalTrials.gov: NCT04049006; Pre-results.
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Affiliation(s)
- Victoria Mailen Arfuch
- Unitat de Suport a la Recerca Terres de l'Ebre, IDIAP Jordi Gol, Barcelona, Catalunya, Spain
- Department of Pediatrics, Obstetrics and Gynecology, and Preventive Medicine, Universitat Autonoma de Barcelona, Barcelona, Catalunya, Spain
| | - Rosa Caballol Angelats
- Equip d'Atenció Primària Tortosa Est, Institut Català de la Salut, Tortosa, Catalunya, Spain
- Unitat d'Expertesa en Sindromes de Sensibilització Central Terres de l'Ebre, Institut Català de la Salut, Tortosa, Catalunya, Spain
| | - Carina Aguilar Martín
- Unitat de Suport a la Recerca Terres de l'Ebre, IDIAP Jordi Gol, Barcelona, Catalunya, Spain
- Unitat d'Avaluació, Direcció d'Atenció Primària Terres de l'Ebre, Institut Català de la Salut, Tortosa, Catalunya, Spain
| | - Noèlia Carrasco-Querol
- Unitat de Suport a la Recerca Terres de l'Ebre, IDIAP Jordi Gol, Barcelona, Catalunya, Spain
| | - Maria Cinta Sancho Sol
- Unitat de Suport a la Recerca Terres de l'Ebre, IDIAP Jordi Gol, Barcelona, Catalunya, Spain
- Unitat d'Expertesa en Sindromes de Sensibilització Central Terres de l'Ebre, Institut Català de la Salut, Tortosa, Catalunya, Spain
| | - Gemma González Serra
- Unitat de Suport a la Recerca Terres de l'Ebre, IDIAP Jordi Gol, Barcelona, Catalunya, Spain
- Unitat d'Expertesa en Sindromes de Sensibilització Central Terres de l'Ebre, Institut Català de la Salut, Tortosa, Catalunya, Spain
| | - Immaculada Fusté Anguera
- Equip d'Atenció Primària Tortosa Est, Institut Català de la Salut, Tortosa, Catalunya, Spain
- Unitat d'Expertesa en Sindromes de Sensibilització Central Terres de l'Ebre, Institut Català de la Salut, Tortosa, Catalunya, Spain
| | - Alessandra Queiroga Gonçalves
- Unitat de Suport a la Recerca Terres de l'Ebre, IDIAP Jordi Gol, Barcelona, Catalunya, Spain
- Unitat Docent de Medicina de Família i Comunitària Tortosa-Terres de L'Ebre, Institut Català de la Salut, Tortosa, Catalunya, Spain
| | - Anna Berenguera
- Department of Pediatrics, Obstetrics and Gynecology, and Preventive Medicine, Universitat Autonoma de Barcelona, Barcelona, Catalunya, Spain
- Central Research Unit, IDIAP Jordi Gol, Barcelona, Catalunya, Spain
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Fernandez-Araque A, Gomez-Castro J, Giaquinta-Aranda A, Verde Z, Torres-Ortega C. Mishel's Model of Uncertainty Describing Categories and Subcategories in Fibromyalgia Patients, a Scoping Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E3756. [PMID: 32466421 PMCID: PMC7312620 DOI: 10.3390/ijerph17113756] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Revised: 05/17/2020] [Accepted: 05/19/2020] [Indexed: 12/14/2022]
Abstract
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.
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Affiliation(s)
- Ana Fernandez-Araque
- Department of Nursing, Faculty of Health Sciences, University of Valladolid, 42004 Soria, Spain; (J.G.-C.); (A.G.-A.); (C.T.-O.)
| | - Julia Gomez-Castro
- Department of Nursing, Faculty of Health Sciences, University of Valladolid, 42004 Soria, Spain; (J.G.-C.); (A.G.-A.); (C.T.-O.)
| | - Andrea Giaquinta-Aranda
- Department of Nursing, Faculty of Health Sciences, University of Valladolid, 42004 Soria, Spain; (J.G.-C.); (A.G.-A.); (C.T.-O.)
- Haemodialysis Service, Santa Bárbara Hospital, 42005 Soria; Spain
| | - Zoraida Verde
- Department of Biochemistry, Molecular Biology and Physiology, University of Valladolid, 42004 Soria, Spain;
| | - Clara Torres-Ortega
- Department of Nursing, Faculty of Health Sciences, University of Valladolid, 42004 Soria, Spain; (J.G.-C.); (A.G.-A.); (C.T.-O.)
- Emergency Service of the Hospital Santa Bárbara, 42005 Soria, Spain
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