A Qualitative Exploration of the Family Relationships of Individuals with Fibromyalgia

Abstract

This thesis presents an in-depth qualitative exploration of the family relationships of individuals with fibromyalgia and consists of three separate papers. Paper one presents a qualitative systematic review and thematic synthesis that sought to understand how women with fibromyalgia experience and understand family relationships. Data from 27 studies were thematically synthesised and five analytical themes were identified: 1) The impact of fibromyalgia on women and family life: “there was nothing left of me, just pain, what if I can’t take care of my children”, 2) A changing view of the present and future self: “How can you love me now, if I’m not the person I was”, 3) Searching for understanding and support in the midst of an invisible contested illness: “I’m having a bad day and you need to understand what that means”, 4) Hidden pain and feelings: “I don’t want to give up ... I don’t want to show people that I am in pain”, and 5) Accepting and moving towards the future-self: “he decided that he is going to be there forever, no matter what”. A changing view of the self, relational difficulties, and communication barriers may have implications for well-being and family adjustment. In light of these findings it appears that treatment approaches with an increased focus on interpersonal difficulties and communication skills could be beneficial. Paper two presents an empirical study that explored the romantic relationships of individuals with fibromyalgia who remained distressed or disabled by their pain despite receiving tertiary-level treatment in a multidisciplinary pain management programme. Seventeen semi-structured interviews were conducted and analysed using inductive thematic analysis. Three core themes were identified: the relational impact of fibromyalgia, factors contributing to relational distress, and moving towards the future. Results demonstrated that fibromyalgia can lead to changed relationships, interpersonal difficulties, and relational tension. However, participants generally struggled to adapt to and accept these changed circumstances. A range of potential contributing factors were identified including a perceived lack of communication, understanding, and support. It therefore appears that treatments with a specific focus on relational difficulties, partner support, and communication skills may enhance therapeutic outcomes for some. Paper three presents a critical appraisal of the work conducted within this thesis and the researcher’s personal reflections on the research process. The critical consideration of the work encompasses the planning, methodology, and implementation of the systematic review and empirical study. The implications of the work and dissemination plans are also discussed.

Date of Award	31 Dec 2020
Original language	English
Awarding Institution	The University of Manchester
Supervisor	Richard Brown (Supervisor) & Adam Danquah (Supervisor)