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Self-management interventions for chronic widespread pain including fibromyalgia: a systematic review and qualitative evidence synthesis

Self-management interventions for chronic widespread pain including fibromyalgia: a systematic review and qualitative evidence synthesis
Self-management interventions for chronic widespread pain including fibromyalgia: a systematic review and qualitative evidence synthesis

Supporting behavioural self-management is increasingly important in the care for chronic widespread pain (CWP), including fibromyalgia. Understanding peoples' experiences of these interventions may elucidate processes and mechanisms that lead to or hinder their intended impact. We conducted a systematic review and thematic synthesis of qualitative studies exploring peoples' experiences of self-management interventions for CWP, including fibromyalgia. MEDLINE, Embase, PsycINFO, CINAHL, and Web of Science were searched. Primary qualitative or mixed-methods studies were included if they explored people's self-management intervention experiences for their CWP, including fibromyalgia. Screening, data extraction, and critical appraisal were conducted by 2 reviewers. Data analysis was conducted through thematic synthesis. Twenty-three studies were included, mostly were rated as high or moderate quality. We developed 4 analytic themes: A multifaceted experience of the intervention, potential for transformative experience of group cohesion, a new outlook, and striving for change after the loss of support. Broadly, personalisation was perceived as beneficial and people experienced a range of emotional experiences. These appeared to support positive behavioural and cognitive changes. For most, group activities promoted acceptance and support, fostering new perspectives and improved self-management, although some found aspects of group contexts challenging. Lack of on-going support after interventions led to challenges in applying behavioural strategies, and some struggled without social support from the group. The experiences of self-management interventions for CWP reflect a complex, multifaceted process. Although many reported positive experiences, addressing issues with integration of physical activity, group dynamics and postintervention support may improve effectiveness for a broader range of people.

Chronic widespread pain, Fibromyalgia, Qualitative, Self-care, Self-management, Systematic review
0304-3959
Hu, Xiao-Yang
Young, Ben
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Santer, Miriam
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Everitt, Hazel
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Pearson, Jen
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Bowers, Hannah
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Moore, Michael
1be81dad-7120-45f0-bbed-f3b0cc0cfe99
Little, Paul
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Pincus, Tamar
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Price, Cathy
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Robson, Tom
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de Barros, Clara
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Loewy, Jane
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Magee, Jenny
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Geraghty, Adam W A
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Hu, Xiao-Yang
Young, Ben
91b6f927-8ed1-468c-b84c-6e70d519e365
Santer, Miriam
3ce7e832-31eb-4d27-9876-3a1cd7f381dc
Everitt, Hazel
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Pearson, Jen
bd5af7cb-2d3d-4a87-96c0-f1026e28e914
Bowers, Hannah
c81d418d-3cd7-4da5-bd09-0eee862bd49f
Moore, Michael
1be81dad-7120-45f0-bbed-f3b0cc0cfe99
Little, Paul
1bf2d1f7-200c-47a5-ab16-fe5a8756a777
Pincus, Tamar
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Price, Cathy
1d81942c-46cc-4c70-8446-d4f62389cad1
Robson, Tom
bf2a9407-814f-43ff-8bba-0744f034c1bf
de Barros, Clara
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Loewy, Jane
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Magee, Jenny
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Geraghty, Adam W A
2c6549fe-9868-4806-b65a-21881c1930af

Hu, Xiao-Yang, Young, Ben, Santer, Miriam, Everitt, Hazel, Pearson, Jen, Bowers, Hannah, Moore, Michael, Little, Paul, Pincus, Tamar, Price, Cathy, Robson, Tom, de Barros, Clara, Loewy, Jane, Magee, Jenny and Geraghty, Adam W A (2024) Self-management interventions for chronic widespread pain including fibromyalgia: a systematic review and qualitative evidence synthesis. Pain. (doi:10.1097/j.pain.0000000000003379).

Record type: Article

Abstract

Supporting behavioural self-management is increasingly important in the care for chronic widespread pain (CWP), including fibromyalgia. Understanding peoples' experiences of these interventions may elucidate processes and mechanisms that lead to or hinder their intended impact. We conducted a systematic review and thematic synthesis of qualitative studies exploring peoples' experiences of self-management interventions for CWP, including fibromyalgia. MEDLINE, Embase, PsycINFO, CINAHL, and Web of Science were searched. Primary qualitative or mixed-methods studies were included if they explored people's self-management intervention experiences for their CWP, including fibromyalgia. Screening, data extraction, and critical appraisal were conducted by 2 reviewers. Data analysis was conducted through thematic synthesis. Twenty-three studies were included, mostly were rated as high or moderate quality. We developed 4 analytic themes: A multifaceted experience of the intervention, potential for transformative experience of group cohesion, a new outlook, and striving for change after the loss of support. Broadly, personalisation was perceived as beneficial and people experienced a range of emotional experiences. These appeared to support positive behavioural and cognitive changes. For most, group activities promoted acceptance and support, fostering new perspectives and improved self-management, although some found aspects of group contexts challenging. Lack of on-going support after interventions led to challenges in applying behavioural strategies, and some struggled without social support from the group. The experiences of self-management interventions for CWP reflect a complex, multifaceted process. Although many reported positive experiences, addressing issues with integration of physical activity, group dynamics and postintervention support may improve effectiveness for a broader range of people.

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Accepted/In Press date: 2024
e-pub ahead of print date: 12 September 2024
Additional Information: Publisher Copyright: Copyright © 2024 The Author(s).
Keywords: Chronic widespread pain, Fibromyalgia, Qualitative, Self-care, Self-management, Systematic review

Identifiers

Local EPrints ID: 494879
URI: http://eprints.soton.ac.uk/id/eprint/494879
ISSN: 0304-3959
PURE UUID: 4d16efcc-95d7-4e2c-83d5-ef4c74a9a124
ORCID for Miriam Santer: ORCID iD orcid.org/0000-0001-7264-5260
ORCID for Hazel Everitt: ORCID iD orcid.org/0000-0001-7362-8403
ORCID for Hannah Bowers: ORCID iD orcid.org/0000-0002-1996-6652
ORCID for Michael Moore: ORCID iD orcid.org/0000-0002-5127-4509
ORCID for Paul Little: ORCID iD orcid.org/0000-0003-3664-1873
ORCID for Tamar Pincus: ORCID iD orcid.org/0000-0002-3172-5624
ORCID for Cathy Price: ORCID iD orcid.org/0000-0003-0111-9364
ORCID for Adam W A Geraghty: ORCID iD orcid.org/0000-0001-7984-8351

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Date deposited: 22 Oct 2024 16:31
Last modified: 23 Oct 2024 02:08

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Contributors

Author: Xiao-Yang Hu
Author: Ben Young
Author: Miriam Santer ORCID iD
Author: Hazel Everitt ORCID iD
Author: Jen Pearson
Author: Hannah Bowers ORCID iD
Author: Michael Moore ORCID iD
Author: Paul Little ORCID iD
Author: Tamar Pincus ORCID iD
Author: Cathy Price ORCID iD
Author: Tom Robson
Author: Clara de Barros
Author: Jane Loewy
Author: Jenny Magee

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