"This is how we should work" - healthcare professionals' past uncertainty and present confidence in management of fibromyalgia

“这才是我们应该做事的方式”——医疗保健专业人员过去对纤维肌痛管理的迷茫与现在的信心

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Abstract

OBJECTIVE: Fibromyalgia is a chronic illness that is poorly understood by healthcare professionals (HCPs), and HCPs may express uncertainty due to limited available knowledge. Our objective was to explore what HCPs tell about their present confidence in delivering self-management programs to patients with fibromyalgia. METHODS: A narrative research approach was applied, and interviews were conducted with nine HCPs from various professional backgrounds. The HCPs were experienced in the management of fibromyalgia, and one year earlier, they had revised their self-management program to ascertain person-centredness. The interview data were subjected to a narrative analysis of what and how they storied their clinical experiences of delivering the programs. RESULTS: The new confidence of the HCPs was grounded in a cohesive, collective platform with an explicit purpose linked to a defined content and an explorative educational approach. This was articulated by a shared clinical mindline emphasizing stress, patients' experiences of life stress, and facilitating patients to find solutions to repair their disrupted daily lives. The cohesive, collective platform fostered mutual respect and shared responsibility for the wholeness of the program. Further the collective as well as discipline-specific clinical mindlines and skills were bolstered through the team's engagement and reflective learning on episodes in practice. CONCLUSIONS: The findings indicate that clinical confidence arises from a shared clinical mindline that articulates a theoretical rationale linked to the actions required and how to deliver the program, together with interdisciplinary collaboration and ongoing reflective practice.

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