Background & Aims
Fibromyalgia (FM) is a chronic syndrome characterized by widespread pain without any identifiable causal disease. Patients use to present allodynia, hyperalgesia, muscle fatigue, sleep and cognitive disturbance, and requires a multimodalstrategy for the treatment, including physical therapy approaches. Surprisingly, the role of physiotherapists as well as theirs perceptions about the management of those patients is not comprehensively described, leaving an important gap in the available literature to describe relevant issues regarding physiotherapeutic management. The main objective of this study is to evaluate experiences, perceptions and beliefs of physiotherapists about their roles, practices and perceptions related to the physiotherapeutic approach to treat FM patients.
Methods
This is a qualitative study based on both Consolidated Criteria for Reporting Qualitative Studies (COREQ) and Standards for Reporting Qualitative Research (SRQR). The interviews were carried out by a single physiotherapist following a structured script with 42 items via web conference lasting 60 minutes, with the participation of the interviewer, the participant and the observer. To increase the reliability of the interview, we performed consultancy analysis, pilot testing and audit trail. Data analysis and coding were carried out using the MAXQDA® software version 2022, containing the data and investigator triangulation method.
Results
Twenty seven physiotherapists from different regions of Brazil were evaluated. Data analysis resulted
in n=28 subcategories. Difficulties were identified for assessing patients involving factors such as pain behavior, as well as concerns about diagnostic inaccuracy. Perceptions about the physiotherapeutic approach identified difficulties in the curricular basis, inadequate management of chronic pain and vision about patients’ knowledge, emphasizing analgesic resources as a therapeutic purpose as patients seek. Difficulties with previous experiences in other services and with treatment adherence were reported. Physiotherapists use evidence-based practice, international classification of functionality and biopsychosocial model as facilitating approaches, however, professional training is a limitation of use. The reception of patients with FM is seen as low and health care is perceived as having professional and structural barriers in the system.
Conclusions
The decision-making and performance of physiotherapists in the clinical management of fibromyalgia can be influenced by the professional’s training and qualification level, as well as their
experiences, perceptions and opinions about the disease. They report that factors related to the clinical condition, skills and competencies of the professional influence the adherence and evolution of physiotherapeutic treatment, as well as the relationship with the patient and health professionals. They report that factors related to the clinical condition, skills and competencies of the professional influence the adherence and evolution of physiotherapeutic treatment, as well as the relationship with the patient and health professionals.
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Presenting Author
Josimari DeSantana
Poster Authors
Josimari DeSantana
PT, PhD
Federal University of Sergipe
Lead Author
Monique Santos
Federal University of Sergipe
Lead Author
Francielly A. Silva
Federal University of Sergipe
Lead Author
Izabel Góis
Federal University of Sergipe
Lead Author
Milena J. Silva
Federal University of Sergipe
Lead Author
Topics
- Specific Pain Conditions/Pain in Specific Populations: Fibromyalgia