Accessing and assessing fibromyalgia through pain drawings

Abstract

Simple body outlines are commonly used in the documentation of pain in rheumatology clinics. However, the explicit guidelines given to patients when completing these often restrict the potential for patient communication and expression of pain and distress. This research program explored an innovative method that used the simple body outline as a means for patients to express and communicate their symptoms of pain and distress more freely. Chapter
One provides a general overview of the historical use of the simple body outline in clinical practice. More specifically, a focus on the use within rheumatology clinics is presented. The study in Chapter Two compares the drawings of women with either fibromyalgia (FM) or osteoarthritis (OA). The results of this study indicated differences between the two groups. Jndeed, visual assessment alone identified distinct and dramatic differences. The FM group's drawings are more creative and dramatic, suggesting this would be a good method of
communicating pain for this patient group. Given that individuals with FM were able to utilize this innovative method in order to communicate their pain and distress, Chapter Three aims to explore the process and meaning ascribed by these participants when completing the simple body outline, by use of a semi-structured interview. Previous research has found that a proportion of patients diagnosed with Rheumatoid Arthritis (RA) a lso have co-morbid FM.
This co-morbidity has implications for the management and treatment of these conditions.
Consequently, the study presented in Chapter Four further explores the application of the simple body outline specifically to highlight its clinical utility in identifying the presence of FM. The drawings on the simple body outline were compared to clinical diagnostic methods for identifying FM. The results from this study provide evidence that the use of the simple body outline can differentiate between these two conditions. Chapter Five reports a series of case studies where the simple body outline and other standardized measures were used as
outcomes following a course of six sessions of a Complementary Alternative Medicine (CAM) therapy. The results of this study indicated that patients with FM benefited more from CAM than patients with RAFM and patients with RA only. The final chapter in this thesis brings together all of the findings from the previous chapters to provide some overall conclusions regarding the clinical utility of the simple body outline in rheumatologic conditions.
Additionally, the strengths and weaknesses of the research programme are addressed along with directions for future research.

Date of Award	2010
Original language	English
Awarding Institution	Bangor University