Conceptuación de la fibromialgia: ¿consenso o discrepancia entre profesionales clínicos de España?

• Published in: Revista española de salud pública 2020-01 (94)
• Main Authors: Fernández Carreño, David, Uclés Juárez, Rubén, Fernández-Miranda López, Sergio, Cangas, Adolfo J
• Format: Article
• Language: Spanish
• Subjects: Actitudes; Atención primaria; Attitudes; Beliefs; Chronic pain; Clinical management; Conocimientos; Creencias; Dolor crónico; Fibromialgia; Fibromyalgia; Healthcare providers; Knowledge; Manejo clínico; Médicos; Percepción; Perception; Physicians; Primary care; Profesionales de la salud
• ISSN: 1135-5727
• DOI: 10.4321/S1135-57272020000100018

Background: The clinical approach of fibromyalgia is a cause of frustration for some professionals due to the controversy on its diagnosis, etiopathology and clinical management. The aim of this study was to explore the beliefs and knowledge on fibromyalgia among health professionals from different specialties of the public health service from Almería province. Methods: A descriptive and cross-sectional study was carried out. A questionnaire prepared ex profeso was applied to a sample of 103 clinicians from Primary Care Physicians, Mental Health, Internal Medicine and Rheumatology. The chisquare test was performed to explore the relationships among variables. Results: 59.7% of Primary Care providers and 66.7% of Internal Medicine conceptualized fibromyalgia as a somatization. Likewise, 58.9% of Primary Care indicated that fibromyalgia should be considered in no case as a disabling illness, compared to 16.7% from Rheumatology, as well as for 42.5% of them the fibromyalgia diagnosis is not essential, compared to the amount of other specialties. Mood disorders were mentioned by 53.4% of Primary Care as entities from which fibromyalgia is difficult to discriminate. Sleep or gastrointestinal problems were mentioned by 83.3% and 50% of Rheumatology professionals, respectively. Conclusions: A high percentage of professionals considered fibromyalgia as a psychogenic entity, especially among Internal Medicine and Primary Care, highlighting in the last one a position against the consideration of disability and its difficult differentiation from mood disorders. These latest findings could be explained by beliefs or attitudes on the amplification of pain behaviors and secondary gains. A deeper knowledge on fibromyalgia symptoms from Rheumatology is highlighted. Methodological limitations and recommendations are discussed. Fundamentos: El abordaje clínico de la fibromialgia es causa de frustración para algunos profesionales por la controversia en su diagnóstico, etiopatología y manejo clínico. El objetivo del presente estudio fue explorar cuáles son las creencias y conocimientos hacia la fibromialgia por parte de profesionales de distintas especialidades del ámbito público de salud de la provincia de Almería. Métodos: Se trató de un estudio descriptivo y transversal. Se aplicó un cuestionario elaborado ex profeso a una muestra de 103 clínicos de Atención Primaria, Salud Mental, Medicina Interna y Reumatología. Se exploró la relación de las variables mediante la prueba