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, Geraghty Adam W A
Primary Care Research Centre, School of Primary Care, Population Sciences & Medical Education, Faculty of Medicine, University of Southampton, Southampton, United Kingdom.
School of Health and Wellbeing, University of Glasgow, Glasgow, United Kingdom.
Pain. 2025 Mar 1;166(3):e36-e50. doi: 10.1097/j.pain.0000000000003379. Epub 2024 Sep 17.
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.
在慢性广泛性疼痛（CWP）（包括纤维肌痛）的护理中，支持行为自我管理变得越来越重要。了解人们对这些干预措施的体验可能会阐明导致或阻碍其预期效果的过程和机制。我们对定性研究进行了系统综述和主题综合分析，以探索人们对CWP（包括纤维肌痛）自我管理干预措施的体验。检索了MEDLINE、Embase、PsycINFO、CINAHL和Web of Science数据库。如果初级定性或混合方法研究探讨了人们对其CWP（包括纤维肌痛）的自我管理干预体验，则将其纳入。由两名评审员进行筛选、数据提取和批判性评价。通过主题综合进行数据分析。纳入了23项研究，大多数被评为高质量或中等质量。我们形成了4个分析主题：干预的多方面体验、群体凝聚力带来转变性体验的潜力、新的观点以及在失去支持后努力改变。总体而言，个性化被认为是有益的，人们经历了一系列情感体验。这些似乎支持积极的行为和认知改变。对大多数人来说，团体活动促进了接纳和支持，培养了新的观点并改善了自我管理，尽管有些人发现团体环境的某些方面具有挑战性。干预后缺乏持续支持导致在应用行为策略方面面临挑战，一些人在没有团体社会支持的情况下苦苦挣扎。CWP自我管理干预的体验反映了一个复杂、多方面的过程。尽管许多人报告了积极的体验，但解决体育活动整合、团体动态和干预后支持方面的问题可能会提高对更广泛人群的有效性。
