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Fibromyalgia has been increasing worldwide and is considered a public health problem. Nonpharmacological treatment through exercise and education is recommended for fibromyalgia management. In this sense, there is a need for interdisciplinary programs to promote health and improve symptoms in fibromyalgia. The purpose of this study was to verify the effectiveness of interdisciplinary health education programs for individuals with fibromyalgia. This is a systematic review that followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses recommendations and was registered at Prospective Register of Systematic Reviews (CRD4201913228). A search was conducted in the following databases: Scientific Electronic Library Online, Lilacs, Medical Literature Analysis and Retrieval System Online, Scopus, Web of Knowledge ISI, Physiotherapy Evidence Database, Excerpta Medica Database, Cumulative Index to Nursing and Allied Health Literature, Cochrane Library, and SPORTDiscus. The descriptors used were “Fibromyalgia” and “Health Education.” Clinical trials published between 1990 and 2019 were selected. The Jadad Quality Scale and the Cochrane Risk-of-Bias Tool were used to evaluate the risk of bias and the methodological quality of the clinical trials. The search found 2887 articles, and only two studies were included in the analysis. Both studies conducted the interventions through lectures and group activities. In particular, the topics most frequently approached at the interdisciplinary health education programs were general information about fibromyalgia, body practices, physical activities, and pharmacological approaches. An interdisciplinary health education program can improve pain and quality of life in people with fibromyalgia; however, evidence shows low methodological quality. This systematic review indicates that studies are of low quality, interfering with the effectiveness of interdisciplinary health education programs.

RESUMO A fibromialgia (FM) é uma condição de alta prevalência e que causa desconforto físico, sofrimento mental e comprometimento nas relações sociais. Assim, o autocuidado pode ser um aspecto determinante para melhorar a qualidade de vida de indivíduos com FM, pois está relacionado ao ato de se investir de poder. Portanto, o objetivo deste estudo foi avaliar o agenciamento do autocuidado de indivíduos com FM e verificar a associação do autocuidado com variáveis sociodemográficas, sintomas e qualidade de vida. Participaram do estudo 40 indivíduos com FM, que preencheram os critérios diagnósticos do Colégio Americano de Reumatologia de 2010. O autocuidado foi avaliado pela Escala de Avaliação de Agenciamento de Autocuidados Revisada (EAAA-R), a intensidade da dor dos pacientes foi verificada pela Escala Visual Analógica (EVA) e pelo Índice de Dor Generalizada (IDG), enquanto a severidade dos sintomas foi avaliado pela Escala de Severidade dos Sintomas (SS) e a qualidade de vida pelo Questionário de Impacto da Fibromialgia Revisado (QIF-R). Utilizamos o coeficiente de correlação de Pearson (dados paramétricos) e coeficiente de correlação de Spearman (dados não paramétricos), com nível de significância α<0,05. Os resultados mostram valores médios para o agenciamento do autocuidado (52,75±10,25), intensidade da dor (5,84±2,16), IDG (13,32±3,78), SS (9,30±1,68), e QIF-R (63,98±17,26). Houve associação do autocuidado com a classe social (r=0,391) e associação com domínios do QIF-R: função (r=-0,338), impacto geral (r=-0,315), sintomas (r=-0,332) e escore total (r=-0,375). O estudo sugere moderado agenciamento de autocuidado e fraca associação do autocuidado com a qualidade de vida e com a classe social em indivíduos com fibromialgia.

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BackgroundFibromyalgia is a condition of high prevalence, which causes physical discomfort, mental distress and impairment of social relationships. Self-care may be a relevant factor to improve the quality of life in individuals with fibromyalgia, since it is related to the act of empowerment, leading individuals to have dominion over their own life.ObjectivesTo assess self-care agency of individuals with fibromyalgia and verify its association with symptoms, quality of life and sociodemographic variables.MethodsThe study included 40 women, aged between 19 and 59 years, with fibromyalgia according to the 2010 American College of Rheumatology diagnostic criteria, and elementary education. This study was approved by the Research Ethics Committee of the School of Medicine of the University of Sao Paulo. Informed consent was obtained from all study participants. Sociodemographic and clinical data (age, civil status, educational level, social status and disease duration) were collected. Self-care was measured with the Appraisal Self-Care Agency Scale-Revised, pain with the Visual Analog Scale (VAS) and the Widespread Pain Index (WPI), severity of symptoms with the Symptom Severity (SS) Scale, and quality of life with the Revised Fibromyalgia Impact Questionnaire (FIQR). In data analysis, Pearson correlation coefficient was used for parametric data, and the Spearman correlation coefficient was used for non-parametric data. The level of significance adopted was 5%.ResultsModerate values were found for self-care agency (52,75 ± 10,25), VAS pain (5,84 ± 2,16), WPI (13,32 ± 3,78) and SS (9,30± 1,68). Severe impact on quality of life was found with the FIQR (63,98 ± 17,26). Additionally, significant correlations of self-care agency with social status (r=0,391), function (r=-0,338), overall impact (r=-0,315), symptoms domains (r=-0,332) and total score (r=-0,375) of the FIQR were observed.ConclusionThe study suggests that individuals with fibromyalgia have a moderate level of self-care agency, and there is a weak association of self-care with quality of life and social status.References[1] Bennett RM, Friend R, Jones KD, Ward R, Han BK, Ross RL. The Revised Fibromyalgia Impact Questionnaire (FIQR): validation and psychometric properties. Arthritis Res Ther. 2009;11(4):R120.[2] Bennett RM, Bushmakin AG, Cappelleri JC, Zlateva G, Sadosky AB. Minimal clinically important difference in the fibromyalgia impact questionnaire. J Rheumatol. 2009;36(6):1304-11.[3] Boonstra AM, Schiphorst Preuper HR, Balk GA, Stewart RE. Cut-off points for mild, moderate, and severe pain on the visual analogue scale for pain in patients with chronic musculoskeletal pain. Pain. 2014;155(12):2545-50.[4] Damasio BF, Koller SH. The Appraisal of Self-Care Agency Scale - Revised (ASAS-R): adaptation and construct validity in the Brazilian context. Cadernos de Saúde Pública. 2013;29(10):2071-82.[5] Fleiss JL. The design and analysis of clinical experiments. 1st ed. New York Wiley; 1986.[6] Marques AP, Assumpcao A, Matsutani LA, Pereira CAB, Lage L. Pain in Fi...