Physiotherapy Department, King's College Hospital NHS Foundation Trust, London, UK.
Health Psychology Section, Psychology Department, King's College London, London, UK.
Musculoskeletal Care. 2022 Sep;20(3):686-696. doi: 10.1002/msc.1672. Epub 2022 Jul 15.
Fibromyalgia guidelines recommend multi-modal, non-pharmacological interventions but there is limited evidence on the optimal programme. The Fibromyalgia Active Management and Exercise programme (FAME) aimed to improve function and quality of life. It consisted of 12 sessions delivered by a multidisciplinary team and incorporated education, exercise, Cognitive Behavioural Therapy and mindfulness approaches. This qualitative service evaluation explored the experience and acceptability of FAME from the perspective of the patients' and healthcare practitioners' (HCP).
All patients and HCP involved in the first FAME programme were invited to attend either one audio-recorded focus group or an individual semi-structured interview. Topic guides were developed a priori. Data were transcribed verbatim and analysed thematically.
Thirteen participants (six HCP (three physiotherapists, two nurses, one psychologist)) and seven patients (mean age 46 (7.5) years, all female,) were enroled. FAME was acceptable to HCP participants but not to all patient participants. Where patient participants understood and anticipated the aims of FAME, the programme was found to be acceptable. Whereas, patient participants who did not fully understand the aims of the programme reported lower acceptability. Three themes were generated: expectations and preparation for FAME, the value of social support, and FAME as a learning opportunity. The themes could be explained by five constructs of the Theoretical Framework of Acceptability.
FAME was acceptable to HCPs but not to all patient participants. Patient and HCP participants valued social support and regarded this as central to their learning. Further adaptation of FAME is required to optimise acceptability.
纤维肌痛症指南建议采用多模式、非药物干预措施,但针对最佳方案的证据有限。纤维肌痛症主动管理和运动方案(FAME)旨在改善功能和生活质量。它由多学科团队提供的 12 个疗程组成,结合了教育、运动、认知行为疗法和正念方法。本定性服务评估从患者和医疗保健从业者(HCP)的角度探讨了 FAME 的体验和可接受性。
所有参与第一个 FAME 方案的患者和 HCP 均被邀请参加一次录音焦点小组或单独的半结构化访谈。事先制定了主题指南。数据逐字转录并进行主题分析。
共纳入 13 名参与者(6 名 HCP(3 名物理治疗师、2 名护士、1 名心理学家)和 7 名患者(平均年龄 46(7.5)岁,均为女性)。FAME 得到了 HCP 参与者的认可,但并非所有患者参与者都接受。在患者参与者理解并预期 FAME 的目标的情况下,该方案被认为是可接受的。而那些不完全理解该方案目标的患者参与者报告了较低的可接受性。生成了三个主题:对 FAME 的期望和准备、社会支持的价值以及 FAME 作为学习机会。这些主题可以用可接受性理论框架的五个结构来解释。
FAME 得到了 HCP 的认可,但并非所有患者参与者都接受。患者和 HCP 参与者都重视社会支持,并认为这是他们学习的核心。需要进一步调整 FAME 以优化可接受性。