The contents and significance of the soothing system in fibromyalgia: a concept mapping study
Summary
The biomedical understanding of fibromyalgia is a predominant paradigm that excludes relevant psychological and social factors. This thesis was based on ‘the integrative model of fibromyalgia’, adopting a psychosomatic perspective. One of the core components of this model are soothing influences experienced over fibromyalgia. The aim was to examine the contents of the soothing system, as well as their perceived importance and association with the severity of somatic symptoms. The procedure involved two phases, the first of which consisted of an online survey with open questions. In it, 724 participants from South America and Europe identified soothing influences over their somatic symptoms. The second phase comprised a card sorting task meant to structure these soothing influences, solved by 74 Dutch participants (72 women and 2 men, 22 to 65 years old). Additionally, participants rated the severity of their symptoms using the Patient Health Questionnaire-15 (PHQ-15). A hierarchical cluster analysis yielded four categories of soothers: (1) ‘Social support’, (2) ‘Good condition’, (3) ‘Professional help’ and (4) ‘Self-care’; in which, ‘good condition’ was the most calming soother and ‘self-care’ the least calming one. A significant heterogeneity in what participants considered to be a soothing influence was observed. Furthermore, a higher perceived soothing influence of ‘professional help’ was significantly associated with somatic symptoms. Results reflect the individuality of soothing systems in fibromyalgia and contribute to an intersectional understanding of this condition that can be used in clinical practice (e.g., in the diagnostic phase) and in research (e.g., classifying subgroups of patients).