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O contributo de sessões educativas, integradas num programa de fisioterapia, para a autogestão da fibromialgia
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Abstract(s)
Introdução: A fibromialgia é uma doença crónica caracterizada por dor músculo-esquelética generalizada. A
intervenção não-farmacológica constitui o tratamento de primeira linha recomendado para a fibromialgia,
devendo incluir a realização de exercício físico, bem como a educação para autogestão da condição clínica. A
necessidade de compreender as estratégias educativas utilizadas para a promoção da autogestão e o seu
impacto foi identificada como uma das prioridades de investigação, no contexto da fibromialgia. Conhecer e
compreender as perspetivas dos indivíduos acerca do tratamento permite o refinamento e desenvolvimento de
intervenções em fisioterapia centradas nas suas necessidades e expectativas, bem como a obtenção de
melhores resultados no futuro.
Objetivo: O objetivo deste estudo foi explorar, com base nas perspetivas de indivíduos com fibromialgia, o
contributo das sessões educativas, integradas num programa de fisioterapia, para a capacidade de autogestão
da condição clínica. Secundariamente, pretendeu-se ainda identificar e analisar as características da
intervenção/ sessões educativas consideradas mais relevantes para a promoção da capacidade de autogestão.
Método: Foi realizado um estudo qualitativo com o intuito de explorar as experiências de 14 indivíduos com
fibromialgia relativamente às sessões educativas integradas no programa de fisioterapia em que participaram.
Para a recolha de dados foram conduzidos quatro grupos focais, baseados num guião de entrevista
semiestruturada. Os grupos focais foram gravados em formato áudio e vídeo e posteriormente transcritos e
analisados através de análise temática. Numa primeira fase, os dados foram analisados de forma
independente, por dois investigadores e, posteriormente, as análises foram discutidas. Para garantir a
qualidade do estudo foram utilizadas diversas estratégias: triangulação de investigadores; “member checking”
(revisão pelos participantes); “audit trail” (auditoria); e diário reflexivo.
Resultados: Da análise dos dados emergiram 5 temas que foram agrupados em duas dimensões principais:
I. Contributo das sessões educativas para a capacidade de autogestão da fibromialgia; II. Características da
intervenção promotoras da capacidade de autogestão. Na dimensão I. foram integrados os temas: (1)
Aprendizagem; (2) Validação; (3) Reinterpretação; (4) Empoderamento; enquanto a dimensão II. englobou o
tema (5) Características da Abordagem Clínica.
Conclusões: O conhecimento adquirido durante as sessões educativas, integradas num programa de
fisioterapia, parece ter contribuído para a reinterpretação da fibromialgia, dos seus sintomas e da forma como
as participantes se relacionavam com os outros, fomentado a sua perceção de empoderamento e a sua
capacidade de autogestão da condição clínica. A educação baseada na partilha das suas narrativas clínicas,
juntamente com a possibilidade de contactarem com outras pessoas com fibromialgia, bem como a
personalização das sessões, por parte da fisioterapeuta, foram considerados essenciais para a promoção da
capacidade de autogestão da fibromialgia.
Introduction: Fibromyalgia (FM) is a chronic condition characterized by widespread musculoskeletal pain. Non pharmacological therapy is the first-line therapy recommended for the management of FM and should include exercise and patient self-management education. A better understanding of self-management strategies and their impact has been identified as a research priority, in the context of fibromyalgia. The deep understanding of patients` illness and treatment experiences, may provide relevant information to refine and implement physiotherapy interventions centred on their needs and expectations as well as achieve better outcomes in the future. Aim: This study aimed to explore the perceptions of individuals diagnosed with fibromyalgia about the role of educational sessions, integrated in a physiotherapy programme, in the ability to self-manage fibromyalgia. Secondly, we aimed to identify and analyse the clinical approach features they considered most relevant to the promotion of self-management. Methods: A qualitative study was carried out to explore the perceptions of 14 individuals with fibromyalgia about the educational sessions integrated in a physiotherapy program, in which they had participated. Four focus groups were conducted, based on a semi-structured interview schedule. The meetings were audio recorded and videotaped, transcribed verbatim and thematically analysed. Data were analysed independently by two researchers, and then both analyses were discussed. In order to ensure the quality of this study, several strategies were used: investigator triangulation; member checking; audit trail; and reflexive diary. Results: Following thematic analysis, five themes emerged and were grouped into two overarching themes: I. The role of educational sessions to self-management of fibromyalgia; II. Clinical Approach Features promoting self-management ability. The overarching theme I. integrated four themes: (1) Learning; (2) Validation; (3) Reinterpretation; (4) Empowerment; and the overarching theme II. encompassed one theme: (5) Clinical Approach Features. Conclusions: The knowledge acquired by participants after participating in the educational sessions, seems to have contributed to the reinterpretation of illness, its symptoms and the way they related to other people. These aspects increased their perception of empowerment and their ability to self-manage fibromyalgia. The participants considered that the possibility of sharing their illness narratives and meeting patients diagnosed with fibromyalgia, as well as the physiotherapist`s capacity to personalize treatment were important factors to enable them for self-management
Introduction: Fibromyalgia (FM) is a chronic condition characterized by widespread musculoskeletal pain. Non pharmacological therapy is the first-line therapy recommended for the management of FM and should include exercise and patient self-management education. A better understanding of self-management strategies and their impact has been identified as a research priority, in the context of fibromyalgia. The deep understanding of patients` illness and treatment experiences, may provide relevant information to refine and implement physiotherapy interventions centred on their needs and expectations as well as achieve better outcomes in the future. Aim: This study aimed to explore the perceptions of individuals diagnosed with fibromyalgia about the role of educational sessions, integrated in a physiotherapy programme, in the ability to self-manage fibromyalgia. Secondly, we aimed to identify and analyse the clinical approach features they considered most relevant to the promotion of self-management. Methods: A qualitative study was carried out to explore the perceptions of 14 individuals with fibromyalgia about the educational sessions integrated in a physiotherapy program, in which they had participated. Four focus groups were conducted, based on a semi-structured interview schedule. The meetings were audio recorded and videotaped, transcribed verbatim and thematically analysed. Data were analysed independently by two researchers, and then both analyses were discussed. In order to ensure the quality of this study, several strategies were used: investigator triangulation; member checking; audit trail; and reflexive diary. Results: Following thematic analysis, five themes emerged and were grouped into two overarching themes: I. The role of educational sessions to self-management of fibromyalgia; II. Clinical Approach Features promoting self-management ability. The overarching theme I. integrated four themes: (1) Learning; (2) Validation; (3) Reinterpretation; (4) Empowerment; and the overarching theme II. encompassed one theme: (5) Clinical Approach Features. Conclusions: The knowledge acquired by participants after participating in the educational sessions, seems to have contributed to the reinterpretation of illness, its symptoms and the way they related to other people. These aspects increased their perception of empowerment and their ability to self-manage fibromyalgia. The participants considered that the possibility of sharing their illness narratives and meeting patients diagnosed with fibromyalgia, as well as the physiotherapist`s capacity to personalize treatment were important factors to enable them for self-management
Description
Keywords
Fibromialgia Estudo Qualitativo Análise Temática Grupos Focais Educação Autogestão Narrativas Clínicas Fibromyalgia Qualitative Research Thematic Analysis Focus Groups Education Self-management Illness Narratives