Fibromyalgia Beliefs and Attitudes

Beliefs and Attitudes

Beliefs appear to play an important role in FMS. This seems particularly so in patients with post-injury FMS, either localized or generalized. Concerns of persisting tissue damage and the need to continue to search for the cause are common examples of disease attributions in FMS patients. Identification of abnormal beliefs may be the appropriate introduction to a simple education program or a more structured cognitive-behavioral management program.

The Multidimensional Health Locus of Control (MHLC) evaluates the perception of the degree of control over one's environment or health as determined by an individual. 35. It is felt that persons with low locus of control have the expectation that their health is determined by chance or other factors over which they have little control. In contrast, those with high locus of control believe that wellness is a result of their own behavior. The MULCH contains 44 statements to which respondents are asked to answer "true" or "false. 103. One study has shown no difference between results using this measure in FMS patients and those with rheumatoid arthritis without FMS. 106. Perceived threat is an important component of the Health Belief Model, the model designed to explain how and why people adopt certain health behaviors. 56 received threat is the concept that an individual acts in accordance with how potentially serious or dangerous something is to his or her well-being. For instance, perception of the threat of being disabled as a result of post-injury-FMS may result in the individual seeking financial security for the future through compensation. This model consists of dimensions encompassing an individual's desire to avoid illness (or, if ill, to get well) and the conviction that specific health behavior will prevent or ameliorate illness. The concepts of this model seem highly relevant in situations in which FMS has been associated with a perceived cause, for instance, work activities or silicone implants. The level of perceived threat in an asymptomatic subject exposed to these potential stressors may have important input into development of FMS. This model has not been applied to problems in patients with rheumatic diseases or FMS. Learned helplessness is behavior resulting from past unsuccessful experiences characterized by emotional, motivational, and cognitive deficits in coping with stressful situations. 1. These deficits are thought to be produced by the belief that no effective ways to eliminate or reduce the source of the stress are available or that the helpless role is most effective in obtaining stress relief. 35. An arthritis helplessness index, consisting of 15 statements measuring a patient's perception of his or her ability or inability to control arthritis, has been devised. 77 This aspect of a patient's belief and reaction to illness appears highly relevant to FMS, but few, if any, studies have been performed using this instrument. The Fibromyalgia Attitudes Index has 16 subgroups. A 15-item scale measures the patient's sense of control over the condition and feelings of helplessness that may result from the unpredictable nature of the rheumatic diseases. A higher score indicates a greater sense of control 25,78. Pain beliefs and Perceptions Inventory (PBPI) is a 16-item questionnaire that measures three dimensions of patient beliefs: judgments about the stability of pain, self blame, and perceptions of pain as mysterious. The identification of such beliefs might influence management strategies. 105. The Survey of Pain Attitudes(SOPA) assesses beliefs about control, solicitude, medication, disability, emotion, medical cure, and harm. The latter assesses the FMS patient's hesitancy to exercise because of concerns about further possible damage. This is particularly prominent in post-injury FMS patients. 57.

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Patient's Pain Communication Tool