Clinical self-efficacy and illness beliefs in ambiguous chronic pain conditions: General Practitioners’ management of Fibromyalgia.

Abstract

Aims: In ambiguous chronic pain conditions, professional be- haviour may be affected not only by scientific knowledge but also by be- liefs about illness. In Spain, Fibromyalgia is the most frequent cause of chronic pain at Primary Care level. Our aims are to identify General Prac- titioners' beliefs about Fibromyalgia, in terms of mental representation and clinical self-efficacy, and to study their relationships with patient man- agement. Methods: 208 General Practitioners recruited on a voluntarily basis while attending educational workshops on Fibromyalgia, completed an adapted version of the Brief Illness Perception Questionnaire and ad hoc scales of clinical self-efficacy, clinical behaviour and satisfaction. Pearson correlation, multiple regression, t test and ANOVA were per- formed. Results: Doctors see Fibromyalgia as a severe condition and they perceived low control and moderate clinical self-efficacy. The main caus- es of Fibromyalgia were seen to be psychological. Regression analysis showed that mental representation components predicted clinical man- agement with low explained variance (from 3% to 11%) while clinical self- efficacy predicted satisfaction with clinical management (from 46% to 61%). Conclusions: GPs self-efficacy and control perception of Fibrom- yalgia need to be enhanced. While FM continues to be an ambiguous con- dition, variations in clinicianscognitions will be important for the care