The Experience of Stigma in People Affected by Fibromyalgia: A Metasynthesis

纤维肌痛患者所经历的污名:一项荟萃分析

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Abstract

AIM: To review the qualitative literature regarding how people with fibromyalgia experience and are impacted by stigma. DESIGN: A systematic review and metasynthesis of qualitative studies was conducted following the Thomas and Harden method. METHODS: The electronic databases PubMed, CINAHL, PsycInfo, Embase and Scopus were queried (September 2023). No publication year limit was set. Twelve studies were included in the final analysis. The findings were reported according to the Enhancing Transparency in Reporting the Synthesis of Qualitative Research (ENTREQ) statement. FINDINGS: Three main themes with 11 sub-themes were identified: manifestations and roots of stigma, avoidance and coping strategies, and consequences of stigma. Stigma arises from disbelief due to the invisibility of symptoms, protracted time to diagnosis and gender stereotyping, especially against women. Various strategies to avoid or cope with prejudice may involve social isolation, hiding the disease, controlling information, getting closer to or further away from other patients, acknowledging and understanding the disease. Stigmatisation can diminish a person's integrity and dignity, undermine trust in health care professionals and worsen suffering. CONCLUSION: The metasynthesis findings align with previous research highlighting the pervasive stigma associated with chronic pain conditions. Greater awareness of the impact of disease-related stigma on individuals with fibromyalgia is crucial, not only among health care professionals but also within broader societal and institutional contexts. IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE: Understanding the stigma experienced by individuals with fibromyalgia can guide health care professionals in adopting more empathtic approaches, potentially improving the diagnostic process and the overall management of the condition. IMPACT: This study highlights the profound impact of stigma on individuals with fibromyalgia, emphasising the need for greater awareness and targeted interventions to address stigma in clinical practice and societal contexts. PATIENT OR PUBLIC CONTRIBUTION: No patient or public contribution.

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