School of Social and Health Sciences, Halmstad Universíty, Sweden.
Int J Qual Stud Health Well-being. 2011;6(2). doi: 10.3402/qhw.v6i2.7057. Epub 2011 Jun 10.
The aim of this study was to generate a substantive theory, based on interviews with women with fibromyalgia, explaining how they manage their main concerns in daily life. The study has an inductive approach in line with classic grounded theory (Glaser, 1992). Twenty-three women living in the southwest region of Sweden were interviewed in-depth about their daily living with fibromyalgia and problems related to this. Probing and follow-up questions were asked by the interviewers when relevant. The interviews were transcribed verbatim and consecutively analysed in line with guidelines for grounded theory. The results showed that the main concern for women with fibromyalgia was to reach a balance in daily life. This concern was resolved by them using different strategies aimed at minimizing the dysfunctional interplay between activity and recovery (core category). This imbalance includes that the women are forcing themselves to live a fast-paced life and thereby tax or exceed their physical and psychological abilities and limits. Generally, the fibromyalgia symptoms vary and are most often unpredictable to the women. Pain and fatigue are the most prominent symptoms. However, pain-free periods occur, often related to intense engagement in some activity, relaxation or joy, but mainly the "pain gaps" are unpredictable. To reach a balance in daily life and manage the dysfunctional interplay between activity and recovery the women use several strategies. They are avoiding unnecessary stress, utilizing good days, paying the price for allowing oneself too much activity, planning activities in advance, distracting oneself from the pain, engaging in alleviating physical activities, and ignoring pain sensations. Distracting from the pain seems to be an especially helpful strategy as it may lead to "pain gaps". This strategy, meaning to divert attention from the pain, is possible to learn, or improve, in health promoting courses based on principles of cognitive behavioural therapy (CBT). We suggest that such courses are offered in primary care for patients with fibromyalgia or other types of longstanding pain. The courses should be led by registered nurses or psychologists, who are experienced in CBT and have extensive knowledge about theories on longstanding pain, stress and coping. Such courses would increase well-being and quality of life in women suffering from fibromyalgia.
本研究旨在基于对患有纤维肌痛症女性的访谈，生成一个实质性理论，用以解释她们如何应对日常生活中的主要关注点。该研究采用与经典扎根理论（Glaser，1992）一致的归纳方法。23 名居住在瑞典西南部的女性接受了深入访谈，内容涉及她们的日常生活以及与纤维肌痛症相关的问题。访谈者会在相关时提出探究性和跟进问题。访谈内容逐字记录并按照扎根理论的指导进行连续分析。研究结果表明，患有纤维肌痛症的女性的主要关注点是在日常生活中达到平衡。她们通过使用不同的策略来解决这一问题，这些策略旨在最大限度地减少活动与恢复之间的功能失调相互作用（核心类别）。这种不平衡包括女性迫使自己过快的生活节奏，从而超过或超出其身体和心理能力和极限。一般来说，纤维肌痛症的症状变化不定，且通常难以预测。疼痛和疲劳是最突出的症状。然而，无痛期也会出现，通常与女性积极参与某项活动、放松或愉悦有关，但主要是“无痛间隙”是不可预测的。为了在日常生活中达到平衡并管理活动与恢复之间的功能失调相互作用，女性使用了几种策略。她们避免不必要的压力，利用好天气，为允许自己过度活动付出代价，提前计划活动，分散对疼痛的注意力，从事缓解身体活动的活动，并忽略疼痛感觉。分散注意力似乎是一种特别有帮助的策略，因为它可能导致“无痛间隙”。这种策略，即分散对疼痛的注意力，可以通过基于认知行为疗法（CBT）原则的健康促进课程来学习或提高。我们建议在初级保健中为患有纤维肌痛症或其他类型慢性疼痛的患者提供此类课程。这些课程应由注册护士或心理学家来教授，他们应具有 CBT 经验，并对慢性疼痛、压力和应对理论有广泛的了解。此类课程将提高患有纤维肌痛症的女性的幸福感和生活质量。
