Mishel's Model of Uncertainty Describing Categories and Subcategories in Fibromyalgia Patients, a Scoping Review.

Ana Fernandez-Araque,Andrea Giaquinta-Aranda,Julia Gomez-Castro,Clara Torres-Ortega,Zoraida Verde

doi:10.3390/ijerph17113756

Abstract

The aim of this review was to demonstrate the presence of categories and subcategories of Mishel’s model in the experiences of patients with fibromyalgia by reviewing qualitative studies. Uncertainty is defined as the inability to determine the meaning of disease-related events. A scoping review of qualitative studies was carried out. Twenty articles were included, with sample sizes ranging from 3 to 58 patients. Articles from different countries and continents were included. Three categories of the model and eight subcategories could be shown to be present in the experiences of fibromyalgia patients through the scoping review. The first category, concerning antecedents of uncertainty in patients with fibromyalgia, is constituted by the difficulty in coping with symptoms, uncertainty about the diagnosis and uncertainty about the complexity of the treatment. The second concerns the cognitive process of anxiety, stress, emotional disorder and social stigma. The third category refers to coping with the disease, through the management of social and family support and the relationship with health care professionals.

Highlights

Uncertainty characterizes the nature of fibromyalgia syndrome (FMS)
The inclusion criteria for the selection of studies were qualitative designs on adult patients diagnosed with fibromyalgia syndrome, with individual or group intervention methods and verbal accounts of experiences, regardless of the use of the Mishel model as a theoretical framework
We proceeded with two steps to extract and show the presence in the verbal accounts and experiences of patients with FMS of the categories and possible subcategories in each study: (1) we identified statements, responses, individual or group aspects related to uncertainty, cognitive processes and coping with the disease in each study and their coincidence or not with the rest of the studies reviewed; (2) after having identified the categories, we carried out a second in-depth reading that allowed us to obtain subcategories and classify them according to the Mishel model [19]

Summary

Introduction

Uncertainty characterizes the nature of fibromyalgia syndrome (FMS). FMS is associated with psychiatric comorbidity and coping problems [1,2]. FMS is a chronic pain condition, which has a global mean prevalence of 2.7 % [3,4]. FMS is a chronic musculoskeletal disease which affects physical, mental and sexual health [5]. FMS affects 2.4% of the Spanish population [4].

Objectives

Methods

Discussion

Conclusion