Academic journal article The Qualitative Report

Life History of Women with Fibromyalgia: Beyond the Illness

Academic journal article The Qualitative Report

Life History of Women with Fibromyalgia: Beyond the Illness

Article excerpt

The syndrome of fibromyalgia is a chronic pain condition characterized by widespread muscle pain and also associated with fatigue, sleep and cognitive difficulties, anxiety and depressed mood (Smith et al., 2009). Fibromyalgia presents intense subjective complaints but no objective clinical findings, and although disruption of pain processing has been demonstrated at various levels in the nervous system, the lack of an objective test in the clinical setting to confirm a diagnosis makes this an uncertain condition (Fitzcharles & Yunus, 2012). It is much more common in women; the overall prevalence in the adult United States population was estimated at 2% and a survey in five European countries (France, Germany, Italy, Portugal, and Spain) found 2.9 % of fibromyalgia cases (Branco et al., 2010).

The lack of a clear explanation and comprehension about the causal mechanisms of this syndrome and the fact that psychological disorders are more prevalent in this population compared with normal population (Rose et al., 2009) enhances the interest about the links between physical and psychological aspects of this syndrome. Within a biopsychosocial perspective, several authors have claimed attention to the importance of psychosocial aspects, which could play a role as predisposing, triggering, and/or perpetuating factors for fibromyalgia (Eich, Hartmann, Muller, & Fischer, 2000; Van Houdenhove & Egle, 2004). Some of these aspects have been assessed mainly in quantitative studies, which have focused on childhood traumatic events and adversities as possible risk factors for fibromyalgia (Low, & Schweinhardt, 2012; Olivieri, Solitar, & Dubois, 2013; Smith et al., 2009). Although there have been several qualitative studies about the experience of patients with fibromyalgia, most of them focus on the time period after the onset of the syndrome and issues as the impact of fibromyalgia and confrontation with diagnosis, living with the symptoms, the treatments and perceived quality of care (Cunningham & Jillings, 2006; Lempp, Hatch, Carville, & Choy 2009), and the biographical disruptions brought by the syndrome (Asbring, 2001; Rodham, Rance & Blake, 2010). Few qualitative studies include the whole life history, and, of these, the great majority is still very focused on the experience of the syndrome, with interview questions especially addressing fibromyalgia (Hallberg & Carlsson, 1998; Hughes, 1999; Tevens, 2003; Wentz et al., 2004). Concerning data analysis, most of them use grounded theory or narrative analysis and the most common emergent theme is about adverse childhood experiences.

For this reason, we wanted to analyze the life history of women with fibromyalgia, because we consider that the lack of knowledge about the syndrome enhances the interest of a complete qualitative approach, comprising the whole existence of these patients and not specifically concerned with the experience of the syndrome. We used a Life History Interview that has no specific question about fibromyalgia, or even about health and illness, and our purpose was to identify common themes that may help elucidate the characteristics and functioning of women with fibromyalgia. This may be important to help clarify some predisposing and perpetuating factors and, mainly, to improve the psychological comprehension and management of women with fibromyalgia, in a multidisciplinary approach. As a research group of psychologists and rheumatologist, fibromyalgia is a study topic that embodies the convergence between these two fields, being a syndrome that includes physical and psychological features and should be approached in a multidisciplinary level, either in the assessment and comprehension as in the intervention.

Method

Participants

The participants were 10 women with a diagnosis of fibromyalgia, as part of a larger sample from a previous quantitative study (Gonzalez, Baptista, Branco, & Ferreira, 2013). …

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