Self-Perceived Health-Related Factors in the patient-journey of patients with fibromyalgia

ABSTRACT Aim Medically unexplained physical symptoms (MUPS) have a spectrum from mild to moderate and chronic MUPS. Fibromyalgia is considered to be the most common diagnosis in chronic MUPS. In their patient-journey, patients with fibromyalgia search actively for diagnosis, making them consult the general practitioner more often. It is already known that various health related factors (HRF) such as personality and life events influence the perceived severity of symptoms in patients with FM after diagnosis. To this moment, it is unclear which HRF influence the severity of symptoms in patients with fibromyalgia before diagnosis. It is suggested that HRF may affect prognosis in patients with fibromyalgia. Therefore, the aim of this study was to explore the patients’ perspective on HRF that influence the severity of symptoms before diagnosis. Methods This study employed an explorative qualitative design using semi-structured retrospective interviews including patients with fibromyalgia. Participants were diagnosed by a general practitioner or rheumatologist up to 16 months before the interview with fibromyalgia. Thematic analysis and constant comparison has been used in this study. Results A total of 10 participants were interviewed with fibromyalgia (nine women). The mean age was 42.1 years. The average time since diagnosis was 8.65 months. The HRF described are divided into predisposing, dislocating, sustaining and reducing HRF that affect the severity of symptoms, causing overload and distress. This was due to various life events, upbringing, personality, coping style and the perceived pressure from the social environment. While relaxing or ignoring the symptoms reduced the complaints, it was difficult to implement this in an adequate manner. Conclusion The HRF that influenced the severity of symptoms in patients with fibromyalgia before diagnosis from the patients’ perspective are diverse. Participants mentioned they lacked knowledge on coping strategies with the symptoms before diagnosis. Clinical Relevance Future research could focus on the long term influence of the identified HRF and predictors in order to provide a quantitative insight into a possible association between HRF and the severity of symptoms