Does the Rural Environment Influence Symptomatology and Optimize the Effectiveness of Disease Acceptance? A Study Among Women With Fibromyalgia

Abstract

The present study aims to explore whether the symptoms associated with fibromyalgia are contextually influenced by the area of residence (rural/urban). Furthermore, it is analyzed whether the effect of the acceptance of the disease on the emotional, cognitive and physical symptoms is moderated by the patients’ place of residence. Using a cross-sectional design, a total of 234 women with fibromyalgia (mean age = 56.91 years; SD = 8.94) were surveyed, of which 55.13% resided in rural areas and 44.87% in urban areas. Self-reported questionnaires were used to assess pain severity, anxiety and depression, functional limitation, physical and mental fatigue and acceptance of the disease. The results show significant differences in acceptance (p = 0.040), pain (p < 0.001), and physical and mental fatigue (p = 0.003 and p = 0.004, respectively) between patients from rural and urban areas. The rural area patients presented higher levels of acceptance and pain and lesser levels of physical and mental fatigue compared to the urban area. The moderation analysis add that, only in patients from the rural area, the variables of physical symptoms (pain, functional limitation, and physical fatigue) were significantly and negatively associated with acceptance. This study addresses for the first time the role of the place of residence in suffering from fibromyalgia, suggesting that the rural or urban environment plays a relevant role in the severity and/or management of symptoms in fibromyalgia women. Limitations and practical implications are also discussed.

Do Cognitive Abilities Influence Physical and Mental Fatigue in Patients with Chronic Pain after Walking According to a Clinical Guideline for Physical Exercise?

“…The selection of these dimensions was motivated by their conceptualization of fatigue as a physical symptom on the one hand, and as a cognitive symptom on the other hand. Mental and physical fatigue are consistent with the theoretical model of fatigue in fibromyalgia and, specifically, with the previous literature on the relationship between (1) fatigue and walking behavior [ 4 ] and (2) fatigue and cognitive processes [ 15 , 19 , 20 ]. In the present work, the internal consistency for both subscales was good (0.83 for mental fatigue and 0.80 for physical fatigue).…”

“…Specifically, cognitive fusion has been negatively related to a commitment to activities [ 16 , 17 ], fatigue [ 15 ], well-being [ 16 ] and general health perceived as worse [ 18 ]. The acceptance of chronic pain has been related to an improvement in the quality of life related to physical and mental health [ 19 , 20 ] and to the pain-related functioning and disease impact [ 21 , 22 ]. Likewise, some studies mention that both variables could mediate the perception of health improvements [ 21 , 23 ].…”

Extended Follow-Up and Analysis of Non-secretory IgG-Type Multiple Myeloma in a Patient With Fibromyalgia: A Case Report

“…The complexity of FM is underscored by its varied symptomatology and potential triggers, including stress, trauma, infections, and genetic predispositions [ 9 ]. This variability necessitates a comprehensive differential diagnosis to exclude other conditions, particularly those with similar clinical features but different underlying pathophysiology [ 10 ]. In this case, the lack of inflammatory markers and absence of clinical signs of inflammation initially supported the FM diagnosis, consistent with existing literature emphasizing FM's non-inflammatory nature.…”