Solicitous and invalidating responses are associated with health-care visits in fibromyalgia

Rheumatol Adv Pract. 2019 Mar 4;3(1):rkz008. doi: 10.1093/rap/rkz008. eCollection 2019.

Abstract

Objectives: Health-care use in FM is substantial. Besides the severity of the disease and psychological factors, previous research suggests that the social environment can influence patients' health-care use. In this study, we describe health-care use in patients with FM and investigate the relationship of social responses of the partner and family with health-care use.

Methods: Cross-sectional data of 280 patients with FM were analysed. Sociodemographic variables, health-status variables, health-care use, partner's solicitous and punishing responses, and invalidation (i.e. discounting and lack of understanding) by family were assessed. Heath-care use was defined as the number of visits to physicians and health professionals. Associations of independent variables with health-care use were examined using univariate and hierarchical regression analyses.

Results: In the preceding 6 months, 99% of the patients visited at least one physician and 66% visited at least one health professional. The mean (s.d.) total health-care visits and the number of different disciplines consulted were 18.5 (17.7) and 3.6 (1.7), respectively. Being female, paid employment, having a co-morbid condition, a higher severity of FM, more partner's solicitous responses and more invalidating responses by family were univariately associated with visits to a physician. Having a co-morbid condition, severity of FM and invalidation by family were uniquely associated with visits to a physician. No other associations were found.

Conclusion: Therapeutic attention to patients' close social environment might be a useful approach to improve health-related outcomes, including health-care use, in patients with FM.

Keywords: fibromyalgia; health-care resources; health-care use; invalidation; punishing responses; social environment; solicitous responses.