No description available.

Objective: To identify correlates of quality of life (QoL) measured with the Quality of Life Scale (QOLS) in participants of a multidisciplinary day hospital treatment program for fibromyalgia (FM). Methods: In this cross-sectional, observational study, “real world” data from 480 FM patients including socio-demographics, pain variables and questionnaires such as the SF-36, Beck Depression Inventory (BDI), Multiphasic Pain Inventory (MPI), SCL-90-R and others were categorized according to the components (body structure and function, activities and participation, personal factors, environmental factors) of the International Classification of Functioning (ICF). For every ICF component, a linear regression analysis with QOLS as the dependent variable was computed. A final comprehensive model was calculated on the basis of the results of the five independent analyses. Results: The following variables could be identified as main correlates for QoL in FM, explaining 56% of the variance of the QOLS (subscale/questionnaire and standardized beta in parenthesis): depression (− 0.22), pain-related interference with everyday life (− 0.19), general activity (0.13), general health perception (0.11), punishing response from others (− 0.11), work status (− 0.10), vitality (− 0.11) and cognitive difficulties (− 0.12). Pain intensity or frequency was not an independent correlate. Conclusions: More than 50% of QoL variance could be explained by distinct self-reported variables with neither pain intensity nor pain frequency playing a major role. Therefore, FM treatment should not primarily concentrate on pain but should address multiple factors within multidisciplinary therapy.

Introduction: Cognitive complaints are often reported by patients who also describe chronic pain. Reviews suggest chronic pain is likely to be associated with weaknesses, relative to control groups, in at least some cognitive functions including processing speed, attention, and possibly working memory, but differences between studies obscure the size of effects. Objective: This study provided a quantitative analysis of the magnitude of the association between chronic pain and neurocognitive test performances. Brief literature review is also done to focus on the functional brain changes associated with the chronic pain. Methods: Meta-analysis was performed using the Cochrane, PRISMA guidelines. The analysis included published experimental design and the tests were studied at least 3 times, by different researchers, and the outcomes were combined within the same cognitive test. Tests were excluded when heterogeneity of variance exceeded I2 = 0.60. Pain subgroups were combined. Results: 23 studies met criteria and involved heterogeneous pain populations, or subgroups including back pain, whiplash, and fibromyalgia. Seven tests had sufficient variance homogeneity. Effects sizes (- ve = chronic pain relative weakness) were: Tests measuring the attention such as PASAT and TEA, working memory (WAIS- digit span), executive functions such as Stroop test, TMT showed significant weaker performance on the tests performance, whereas performance on the test of visuospatial abilities such as ROCF and Corsi block test and WCST test, did not showed significant association. Conclusions: Chronic pain was associated with statistically significant performance reductions. The pattern suggests that chronic pain is associated with poorer performance in at least some tasks requiring processing speed, attention, working memory and learning. Differences between pain and control groups ranged from about 1/3 standard deviation to just under a full standard deviation. Too little research is available on non-verbal memory and executive functions in chronic pain. / Thesis / Master of Science (MSc)

Introduction: Patient education is an important part of the management of rheumatic and musculoskeletal diseases. Given that patients with diverse diseases do not have the same needs, it is crucial to assess the educational requirements of targeted groups to provide tailored educational interventions. The aim of our study was to assess educational needs of a large cohort of patients with different rheumatic and musculoskeletal diseases attending a health facility in Austria. Methods: We assessed educational needs, via an online survey of patients with fibromyalgia (FMS), rheumatoid arthritis (RA), and ankylosing spondylitis (AS) recruited from an Austrian health-care facility, using the Austrian version of the Educational Needs Assessment Tool (OENAT). Results: For our sample of 603 patients, AS (62%), RA (15%), and FMS (24%), there were no educational need differences for the domains of movements, disease process, and self-help measures. Patients with FMS had less need for pain management education and greater need for education about feelings, than other disease groups. Patients with RA had a greater need for education related to treatments than other groups, and patients with AS had a greater need for treatment education than patients with FMS. Patients with AS reported greater need for support system education than other patient groups. Conclusion: Educational needs vary by disease groups, suggesting that health-care professionals should assess disease-specific needs for education to provide optimal assistance in disease management for patients.

No description available.

Introduction Ehlers-Danlos syndrome (EDS), specifically the hypermobility type (hEDS), is associated with a variety of gastrointestinal (GI) conditions. This study aims to evaluate the prevalence of and factors associated with gut dysmotility in patients with hEDS. Methods This is a retrospective study of hEDS patients conducted at the Cleveland Clinic's Center for Personalized Genetic Healthcare between January 2007 and December 2017. Demographics, GI motility testing, endoscopic, and imaging data were extracted from the patients' charts. Results A total of 218 patients with hEDS were identified. Among them, 136 (62.3%) patients had at least one GI symptom at the time of EDS diagnosis. Motility testing was performed and reported in 42 (19.2%) patients. Out of them, five (11.9%) had esophageal dysmotility, 18 (42.8%) had gastroparesis, five (11.9%) had small bowel/colon altered transit time, and four (9.5%) had global dysmotility. In univariable analysis, patients with postural orthostatic tachycardia syndrome (POTS) [odds ratio (OR): 8.88, 95% CI: 3.69-24.9, p<0.0001], fibromyalgia (OR: 4.43, 95% CI: 2.04-10.1, p=0.0002), history of irritable bowel syndrome (OR: 5.01, 95% CI: 2.31-11.2, p<0.0001), and gastroesophageal reflux disease (OR: 3.33, 95% CI: 1.55-7.44, p=0.002) were more likely to be diagnosed with GI dysmotility. On multivariable analysis, only POTS (OR: 5.74, 95% CI: 2.25-16.7, p=0.0005) was significantly associated with an increased likelihood of GI dysmotility. Conclusions This study suggests that GI symptoms are relatively common among patients with hEDS. Of the patients tested for dysmotility, 76.2% were found to have some form of dysmotility. POTS was found to be an independent predictive factor for GI dysmotility.

Bakgrund: Sjukdomen fibromyalgi (FM) karaktäriseras främst av långvarig smärta och trötthet tillsammans med psykiska och kognitiva påfrestningar. Främst drabbas kvinnor. Den vanligaste åtgärden utgörs av farmakologisk behandling tillsammans med multimodal smärtrehabilitering. Det finns bristande kunskap om upplevelserna av att leva med fibromyalgi som kvinna.  Syfte: Att sammanställa vuxna kvinnors upplevelser kring att leva med fibromyalgi. Metod: Vald design utgjordes av en begränsad systematisk litteraturöversikt baserad på tolv artiklar med kvalitativ ansats från PubMed och CINAHL. Artiklar med intervju som metod och som inkluderade kvinnor över 18 år diagnostiserade med fibromyalgi inkluderades. Artiklar där kvinnorna självdiagnostiserats exkluderades. Artiklarna granskades genom SBU:s mall och analyserades genom integrerad analys. Resultat: Resultatet grundar sig i fem huvudteman: att leva med kroniska symtom; invalidering, misstro och stigmatisering; vikten av att klara av vardagen och arbetet; sociala relationer; sexualitet och partnerskap, och tio underteman.  Konklusion: Kvinnor med fibromyalgi upplever att sjukdomens fysiska och psykiska symtom har inverkan på vardagslivet, arbetet och sociala relationer. Många kvinnor kämpar dessutom med stigmatisering och invalidering kring sin sjukdom. Ytterligare forskning behövs för att öka kunskap om sjukdomen inom vården och samhället.

Hysteria has been researched from many different angles, but this thesis focuses on the persistence of gendered medical diagnoses following the demise of hysteria. In Chapter One, I provide an overview of hysteria’s long history, beginning with the first reference to the disorder in Ancient Egypt. I then conduct a study of nineteenth-century hysteria in Chapter Two, where I highlight the interactions between medicine and culture that characterized the hysteria epidemic in Victorian Britain and America. Chapter Three continues this discussion of nineteenth-century hysteria, detailing the rise of psychological explanations for hysteria in Europe. My most important research, however, comes in Chapters Four and Five where I chronicle the rise of specific diagnoses that replaced hysteria in the twentieth century. I focus on gendered wastebasket diagnoses—illnesses that predominantly affect women, are categorized based on shared symptoms rather than causes, and are defined in relation to femininity. In the Diagnostic and Statistical Manual of Mental Disorders (DSM), the descriptions of certain psychiatric conditions that are more frequently diagnosed in women contain stigmatizing language used to describe hysteria, especially in the nineteenth century. Outside of the psychiatric realm, chronic fatigue syndrome and fibromyalgia are also wastebasket diagnoses that are described by both doctors and academics using the dismissive language of earlier descriptions of hysteria. I argue that throughout all of this history, the mutual influence of medical theory and cultural assumptions—particularly about gender and femininity—has allowed women’s mysterious medical complaints to remain unexplained. The ambiguous nature of conditions descended from hysteria and their association with femininity causes doctors to return to long-standing stereotypes that diminish the suffering of these patients. Many patients with these conditions struggle to access effective treatments for their symptoms. Understanding these illnesses in the historical context of hysteria can help explain and address these experiences. / Thesis / Master of Arts (MA) / The medical field has long been influenced by its surrounding cultural context. Social factors, including gender, race, and class, all colour the ways in which illnesses are understood and patients are treated. This thesis examines these interactions between medicine and culture in the context of nineteenth-century hysteria and the related diagnoses that arose to replace it in the twentieth century. The disease entity hysteria disappeared in the early twentieth century, but patients continued to experience the symptoms associated with hysteria under a range of diagnostic titles. Situating these illnesses in the historical context of hysteria can help address patient complaints and deconstruct the stigmatizing stereotypes that affect these patients— particularly those stereotypes associated with femininity that were once attributed to hysteria patients

Fibromyalgi (FM) är en kronisk sjukdom som innebär långvarig smärta, fatigue och hjärntrötthet. Symtomen leder till kognitiva begränsningar som koncentrationssvårigheter och minnessvårigheter samt psykiska ohälsa som ångest och depression. Behandlingen är både farmakologisk och icke-farmakologisk. FM vårdas antigen via primärvården eller via smärtrehabiliterings team. Sjuksköterskor upplever svårigheter vid vården av denna grupp dels på grund av smärtproblematiken dels på grund av bristande kunskap. Syftet var att beskriva personers upplevelse av att leva med fibromyalgi. Litteraturstudien har en beskrivande design. Sökningen genomfördes på Medline via Pubmed och gav 22 vetenskapliga artiklar med kvalitativ ansats. Sedan har11 artiklar tagits fram genom relevans- och kvalitetsgranskning. I resultatet framkom fyra teman; utmaningar i arbetslivet, bristande bemötande från sjukvården, komplexa relationer och svårigheter i det sociala livet och begränsningar i vardagen. Dessa teman visade att FM har en stor inverkan på flera områden i människors liv och har en stor effekt på hur dessa personer upplever livet. Det framkom även att patientgruppen upplever undermåligt bemötande från omvårdnadspersonal däremot när vården är gynnsam upplever patientgruppen en bättre psykisk hälsa. Upplevelsen av att leva med fibromyalgi innebär stora utmaningar inom flera områden i livet. Personer med FM upplever bristande bemötande i sjukvården, däribland ifrågasättande attityder och undermålig kunskap från vårdpersonal. Däremot när vården fungerar fördelaktigt leder den till en bättre psykisk hälsa. Därför är det viktigt att förbättra sjuksköterskors kunskap och förståelse för upplevelsen av att leva med fibromyalgi. / Fibromyalgia (FM) is a chronic disease with chronic pain, fatigue, and brain fog. The symptoms often result in cognitive difficulties such as concentrations and memory difficulties as well as mental illness such as anxiety and depression. Intervention can be both pharmaceuticals as non-pharmaceutical. Healthcare is generally provided through primary care and pain rehabilitation teams for patients with FM. Nurses experience difficulties treating these individuals, partly because of the chronic pain difficulties and partly due to lack of knowledge. The aim was to describe the experience to live with fibromyalgia. This literature review had a descriptive design. The search was conducted on Pubmed and produced 22 qualitative articles. Thereafter the qualitative articles have been exanimated with relevance- and quality templets, 11 articles were selected for the literature review. The main findings are presented as four themes. These were challenges in the workplace, inadequate care from healthcare staff, complex relationships and difficulties in social life and limitations in everyday life. These themes indicate that FM have a great impact on several aspects in an individual’s life thus FM has a major impact on the experience of life. Another finding indicated substandard care from the healthcare staff regarding patients with FM, when the care is favourable these patients experience better mental health. The experience of living with FM consist of challenges in all areas of life. They experience substandard care such as condescending attitudes and a lack of understanding. Beneficial care leads to better mental health. Therefore it´s important to improve nurses’ knowledge and understanding regarding the experience of living with FM.

Bakgrund Fibromyalgi är en kronisk smärtsjukdom som främst påverkar muskler och leder. Diagnosen kräver tre månaders smärta och minst elva ömma punkter på kroppen. Utöver smärtan kännetecknas sjukdomen av trötthet och sömnsvårigheter. Globalt lider 2-6 procent av fibromyalgi, och av dessa är 80-90 procentkvinnor. Orsakerna till sjukdomen är inte helt klara. Det krävs flera vårdbesök för att diagnostisera sjukdomen, vilket leder till olika behandlingar och tester för att hantera symtomen. Syfte Syftet är att belysa personers upplevelse av att leva med fibromyalgi. Metod I översikten användes Fribergs metodologiska ramverk (2022) för en systematisk litteraturöversikt. Det innebär att sammanfatta och analysera befintlig forskning inom ett specifikt område med noggrann granskning och vetenskaplig ansats för att belysa ett aktuellt problemkomplex. Resultat Resultatet lyfte fram smärta och trötthet som centrala hinder för arbetslivet och vardagsuppgifter. Dessa utlöste ofta depression och påverkade starkt den mentala hälsan. Utöver detta påverkade tillståndet även familjeliv och identitet negativt. Särskilt tydligt var stressen på arbetsplatsen och den ekonomiska osäkerheten. Tre huvudteman framkom, Fångad av smärta och trötthet, Kampen mot nedstämdhet och identitetsförändringar och Familjens roll och sociala utmaningar. Slutsatsen Personer drabbade av fibromyalgi lider av smärta, trötthet och psykisk påverkan, vilket påverkar arbete, identitet och familj. Det innebär att de behöver samhällets och hälso- och sjukvårdens stöd. / Background Fibromyalgia is a chronic pain condition that primarily affects muscles and joints. The diagnosis requires three months of pain and at least eleven tender points on the body. Apart from pain, the condition is characterized by fatigue and sleep disturbances. Globally, 2-6 percent suffer from fibromyalgia, with 80-90 percent of them being women. The causes of the disease are not entirely clear. Diagnosing the condition necessitates multiple healthcare visits, resulting in various treatments and tests to manage the symptoms. Aim To illuminate individuals' experiences of living with fibromyalgia. Method The study utilized Friberg's methodological framework (2022) for a systematic literature review. This involved summarizing and analyzing existing research in a specific area with meticulous scrutiny and a scientific approach to shed light on a current complex problem Results The results highlighted pain and fatigue as central obstacles in both work and daily tasks. These often triggered depression and significantly impacted mental health. Additionally, this condition negatively affected family life and identity. Particularly evident were workplace stress and financial insecurity. Three main themes emerged: Trapped by Pain and Fatigue, Struggle against Depression and Identity Changes, and the Role of Family and Social Challenges. Conclusion: Fibromyalgia patients suffer from pain, fatigue, and psychological impact, affecting work, identity, and family. They require support from society and healthcare.