Resumen
Objetivo: Evaluar las diferentes estrategias de afrontamiento que pueden contribuir a la reducción de síntomas y a la mejora de la calidad de vida de pacientes con fibromialgia en la Atención Primaria de Salud. Métodos: Revisión integradora de 15 estudios (2009-2023), seleccionados en las bases Latindex, PubMed, y Biblioteca Virtual em Saúde (BVS), utilizando los descriptores "Fibromyalgia", "Coping" y "Primary Healthcare". Se incluyeron estudios en idioma portugués, inglés y español, analizados mediante tablas estructuradas. Resultados: Quince estudios cumplieron con los criterios de inclusión, destacándose enfoques multidisciplinares (33,3%), terapia cognitivo-conductual (20%) y soporte social (26,67%). Estrategias activas como aceptación de la enfermedad, ejercicio físico y técnicas de relajación mostraron asociación positiva con la disminución del dolor y mejora funcional. Las terapias grupales y las intervenciones remotas también reforzaron los efectos beneficiosos en la reducción de ansiedad, depresión y catastrofización, mejorando la resiliencia emocional. Conclusión: Las estrategias de afrontamiento integradas, como los enfoques multidisciplinares y el apoyo social, son eficaces en el manejo de la fibromialgia en la APS. La síntesis de la evidencia refuerza la necesidad de prácticas adaptadas al contexto local; las investigaciones futuras deben priorizar la estandarización metodológica para ampliar la aplicabilidad.
Referencias
ARFUCH VM, et al. Patients’ Lived Experience in a Multicomponent Intervention for Fibromyalgia Syndrome in Primary Care: A Qualitative Interview Study. International Journal of Environmental Research and Public Health, 2022; 19(20): 13322.
BIDONDE J, et al. Aerobic exercise training for adults with fibromyalgia. Cochrane Database of Systematic Reviews, 2017; 2017(6).
BOURGAULT P et al. Multicomponent interdisciplinary group intervention for self-management of fibromyalgia: a mixed-methods randomized controlled trial. PloS One, 2015; 10(5): e0126324.
BOYER AL et al. Comparing fibromyalgia patients from primary care and rheumatology settings: clinical and psychosocial features. Rheumatology International, 2009; 29(10): 1151 1160.
CLAUW DJ. Fibromyalgia: A Clinical Review. JAMA, 2014; 311(15): 1547 1555.
CHEN AT. Information Seeking over the Course of Illness: The Experience of People with Fibromyalgia. Musculoskeletal Care, 2012; 10(4): 212 220.
COOPER S, GILBERT L. The role of ‘social support’ in the experience of fibromyalgia - narratives from South Africa. Health & Social Care in the Community, 2017; 25(3): 1021 1030.
DAFFIN M, et al. A qualitative study of risk and resilience in young adult women with a history of juvenile-onset fibromyalgia. Pediatric Rheumatology, 2021; 19(1): 128.
EWERT C et al. Self-Compassion and Coping: a Meta-Analysis. Mindfulness, 2021; 12(5): 1063 1077.
GANONG LH. Integrative reviews of nursing research. Research in Nursing & Health, 1987; 10(1): 1 11.
GOLDENBERG DL. Diagnosing Fibromyalgia as a Disease, an Illness, a State, or a Trait?. Arthritis Care & Research, 2019; 71(3): 334 336.
HERMONT AP et al. Revisões integrativas: conceitos, planejamento e execução. Arq. odontol, 2021; p. 3–7.
KUNDAKCI B et al. International, multidisciplinary Delphi consensus recommendations on non-pharmacological interventions for fibromyalgia. Seminars in Arthritis and Rheumatism, 2022; 57: 152101.
LERA S, et al. Multidisciplinary treatment of fibromyalgia: Does cognitive behavior therapy increase the response to treatment?. Journal of Psychosomatic Research, 2009; 67(5): 433–441.
MARTÍN J, et al. Six-and 12-month follow-up of an interdisciplinary fibromyalgia treatment programme: results of a randomised trial. Clinical and Experimental Rheumatology, 2012; 30(6 Suppl 74): 103–111.
MCBETH J, et al. Cognitive Behavior Therapy, Exercise, or Both for Treating Chronic Widespread Pain. Archives of Internal Medicine, 2012; 172(1): 48.
MONTEIRO EAB, et al. Aspectos Psicológicos da Fibromialgia – Revisão Integrativa. Mudanças: Psicologia da Saúde, 2021; 29(1): 65–76.
MONTESÓ-CURTO P, et al. Nurses’ Perceptions of Patient Fibromyalgia Illness Experiences after Performing Group-Based Problem-Solving Therapy: A Qualitative Research Study. Healthcare (Basel, Switzerland), 2023; 11(11): 1531.
NIJS J et al. Central sensitisation in chronic pain conditions: latest discoveries and their potential for precision medicine. The Lancet Rheumatology, 2021; 3(5): e383–e392.
PERES MFP, LUCCHETTI G. Coping Strategies in Chronic Pain. Current Pain and Headache Reports, 2010; 14(5): 331–338.
PÉREZ-ARANDA A, et al. A randomized controlled efficacy trial of mindfulness-based stress reduction compared with an active control group and usual care for fibromyalgia: the EUDAIMON study. Pain, 2019; 160(11): 2508–2523.
PINXSTERHUIS I, et al. Development of a group-based self-management programme for individuals with chronic fatigue syndrome: a pilot study. Scandinavian Journal of Occupational Therapy, 2015; 22(2): 117–125.
ROBLES VR, et al. Fibromialgia en Chile: revisión de la literatura y propuesta para una futura política pública en atención primaria de salud. ARS med. (Santiago, En línea), 2022; p. 69–80.
RUBIO FL, et al. Coping and Beliefs as Predictors of Functioning and Psychological Adjustment in Fibromyalgia Subgroups. Pain Research and Management, 2022; 2022: 1066192.
SIMISTER HD, et al. Randomized Controlled Trial of Online Acceptance and Commitment Therapy for Fibromyalgia. The Journal of Pain, 2018; 19(7): 741–753.
SOUSA MND, et al. Trilhando o caminho do conhecimento: o método de revisão integrativa para análise e síntese da literatura científica. OBSERVATÓRIO DE LA ECONOMÍA LATINOAMERICANA, 2023; 21(10): 18448–18483.
SOUZA JBD, PERISSINOTTI DMN. The prevalence of fibromyalgia in Brazil – a population-based study with secondary data of the study on chronic pain prevalence in Brazil. Brazilian Journal Of Pain, 2018; 1(4).
STEIN KF, MICLESCU A. Effectiveness of multidisciplinary rehabilitation treatment for patients with chronic pain in a primary health care unit. Scandinavian Journal of Pain, 2013; 4(4): 190–197.
VALLEJO MA, et al. Internet versus face-to-face group cognitive-behavioral therapy for fibromyalgia: A randomized control trial. Journal of Psychiatric Research, 2015; 68: 106–113.
WANG C, et al. Effect of tai chi versus aerobic exercise for fibromyalgia: comparative effectiveness randomized controlled trial. BMJ (Clinical research ed.), 2018; 360: k851.
