Browse > Article
http://dx.doi.org/10.4040/jkan.21025

Effects of a Cognitive Behavior Therapy Program for Patients with Fibromyalgia Syndrome: A Randomized Controlled Trial  

Kong, Kyoung Ran (College of Nursing, Ulsan College)
Lee, Eun Nam (College of Nursing, Dong-A University)
Publication Information
Journal of Korean Academy of Nursing / v.51, no.3, 2021 , pp. 347-362 More about this Journal
Abstract
Purpose: This study developed a cognitive behavioral therapy program aimed at altering the physical condition, emotions, and behaviors of fibromyalgia patients, and confirmed the program's clinical applicability. The program was developed by analyzing previous studies conducting in-depth interviews with fibromyalgia patients, drawing on cognitive behavior theory to establish the program contents, recruiting experts to test its validity, and conducting a preliminary survey. Methods: To confirm the program's effect, this study used a randomized controlled trial design. The participants were outpatients diagnosed with fibromyalgia in Dong-A University Hospital, Busan. The 30 patients in the experimental group took part in the program, which comprised 8 sessions (90 to 120 minutes) based on cognitive behavior theory, delivered over 8 weeks. Hypothesis testing was carried out using the repeated measures ANOVA. Results: The analysis revealed significant differences between the experimental and control groups in positive automatic thoughts, pain, fatigue, depression, and interpersonal relationships. However, there was no significant difference between the groups in terms of sleep disorders and negative automatic thoughts. Conclusion: This program is a positive effect on physical condition, emotions, and behaviors. It is thus expected to be used to help fibromyalgia patients improve their disease conditions.
Keywords
Fibromyalgia; Cognitive Behavior Therapy; Depression; Sleep;
Citations & Related Records
연도 인용수 순위
  • Reference
1 Kang EY, Kim JM, Jeong HN. The development and effect of cognitive behavioral therapy program for psychosocial adjustment of infertile women. Korean Journal of Counseling. 2015;16(3):451-471. https://doi.org/10.15703/kjc.16.3.201506.451   DOI
2 Lim SH, Lee MY, Kim JM. Cognitive-behavioral grief therapy for middle-aged women after spousal bereavement. Cognitive Behavior Therapy in Korea. 2013;13(2):173-191.
3 Heinrich S, Rozental A, Carlbring P, Andersson G, Cotter K, Weise C. Treating tinnitus distress via the Internet: A mixed methods approach of what makes patients seek help and stay motivated during Internet-based cognitive behavior therapy. Internet Interventions. 2016;4:120-130. https://doi.org/10.1016/j.invent.2016.04.001   DOI
4 Kim HY, Kim JM, Lee MY. Development and its effect of empathy training program based on the cognitive behavior therapy for the student nurses. Cognitive Behavior Therapy in Korea. 2016;16(4):567-594.
5 Lee JY, Kim JH. Assessment of positive cognition: A standardization study of Korean Automatic Thought Questionnaire - Positive: ATQ-P. Korean Journal of Clinical Psychology. 2002;21(3):647-664.
6 Anderson FJ, Winkler AE. Benefits of long-term fibromyalgia syndrome treatment with a multidisciplinary program. Journal of Musculoskeletal Pain. 2006;14(4):11-25. https://doi.org/10.1300/J094v14n04_03   DOI
7 Wolfe F, Brahler E, Hinz A, Hauser W. Fibromyalgia prevalence, somatic symptom reporting, and the dimensionality of polysymptomatic distress: Results from a survey of the general population. Arthritis Care & Research. 2013;65(5):777-785. https://doi.org/10.1002/acr.21931   DOI
8 Spaeth M, Rizzi M, Sarzi-Puttini P. Fibromyalgia and sleep. Best Practice & Research. Clinical Rheumatology. 2011;25(2):227-239. https://doi.org/10.1016/j.berh.2011.03.004   DOI
9 Schlein SP, Guerney B, Stover L. The interpersonal telationship scale (IRS). In: Guerney BG, editor. Relationship enhancement. San Francisco (CA): Jossey-Bass; 1977. p. 349-354.
10 Menga G, Ing S, Khan O, Dupre B, Dornelles AC, Alarakhia A, et al. Fibromyalgia: Can online cognitive behavioral therapy help? The Ochsner Journal. 2014;14(3):343-349.
11 Hollon SD, Kendall PC. Cognitive self-statements in depression: Development of an automatic thoughts questionnaire. Cognitive Therapy and Research. 1980;4(4):383-395. https://doi.org/10.1007/BF01178214   DOI
12 Jones GT, Atzeni F, Beasley M, Fluss E, Sarzi-Puttini P, Macfarlane GJ. The prevalence of fibromyalgia in the general population: A comparison of the American College of Rheumatology 1990, 2010, and modified 2010 classification criteria. Arthritis & Rheumatology. 2015;67(2):568-575. https://doi.org/10.1002/art.38905   DOI
13 Kwon SM. Reliability, validity and factor structure of the Korean version of dysfunctional attitude scale. Psychological Science. 1994;3(1):100-111.
14 Smets EM, Garssen B, Bonke B, De Haes JC. The Multidimensional Fatigue Inventory (MFI) psychometric qualities of an instrument to assess fatigue. Journal of Psychosomatic Research. 1995;39(3):315-325. https://doi.org/10.1016/0022-3999(94)00125-o   DOI
15 Lami MJ, Martinez MP, Sanchez AI, Miro E, Diener FN, Prados G, et al. Gender differences in patients with fibromyalgia undergoing cognitive-behavioral therapy for insomnia: Preliminary data. Pain Practice. 2016;16(2):E23-E34. https://doi.org/10.1111/papr.12411   DOI
16 Tang NK. Cognitive-behavioral therapy for sleep abnormalities of chronic pain patients. Current Rheumatology Reports. 2009;11(6):451-460. https://doi.org/10.1007/s11926-009-0066-5   DOI
17 Friesen LN, Hadjistavropoulos HD, Schneider LH, Alberts NM, Titov N, Dear BF. Examination of an Internet-delivered cognitive behavioural pain management course for adults with fibromyalgia: A randomized controlled trial. Pain. 2017;158(4):593-604. https://doi.org/10.1097/j.pain.0000000000000802   DOI
18 Castel A, Fontova R, Montull S, Perinan R, Poveda MJ, Miralles I, et al. Efficacy of a multidisciplinary fibromyalgia treatment adapted for women with low educational levels: A randomized controlled trial. Arthritis Care & Research. 2013;65(3):421-431. https://doi.org/10.1002/acr.21818   DOI
19 Martin J, Torre F, Padierna A, Aguirre U, Gonzalez N, Garcia S, 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.
20 Vazquez-Rivera S, Gonzalez-Blanch C, Rodriguez-Moya L, Moron D, Gonzalez-Vives S, Carrasco JL. Brief cognitive-behavioral therapy with fibromyalgia patients in routine care. Comprehensive Psychiatry. 2009;50(6):517-525. https://doi.org/10.1016/j.comppsych.2009.01.008   DOI
21 Lazaridou A, Kim J, Cahalan CM, Loggia ML, Franceschelli O, Berna C, et al. Effects of cognitive-behavioral therapy (CBT) on brain connectivity supporting catastrophizing in fibromyalgia. The Clinical Journal of Pain. 2017;33(3):215-221. https://doi.org/10.1097/AJP.0000000000000422   DOI
22 Edinger JD, Wohlgemuth WK, Krystal AD, Rice JR. Behavioral insomnia therapy for fibromyalgia patients: A randomized clinical trial. Archives of Internal Medicine. 2005;165(21):2527-2535. https://doi.org/10.1001/archinte.165.21.2527   DOI
23 Clauw DJ. Fibromyalgia: An overview. The American Journal of Medicine. 2009;122(12 Suppl):S3-S13. https://doi.org/10.1016/j.amjmed.2009.09.006   DOI
24 Karlsson B, Burell G, Anderberg UM, Svardsudd K. Cognitive behaviour therapy in women with fibromyalgia: A randomized clinical trial. Scandinavian Journal of Pain. 2015;9(1):11-21. https://doi.org/10.1016/j.sjpain.2015.04.027   DOI
25 Chun SK. The social skills training for social adjustment of the schizophrenic patients. Mental Health & Social Work. 1995;2:33-50.
26 Thorn BE, Kuhajda MC. Group cognitive therapy for chronic pain. Journal of Clinical Psychology. 2006;62(11):1355-1366. https://doi.org/10.1002/jclp.20315   DOI
27 Carbonell-Baeza A, Aparicio VA, Chillon P, Femia P, Delgado-Fernandez M, Ruiz JR. Effectiveness of multidisciplinary therapy on symptomatology and quality of life in women with fibromyalgia. Clinical and Experimental Rheumatology. 2011;29(6 Suppl 69):S97-S103.
28 Bernardy K, Fuber N, Kollner V, Hauser W. Efficacy of cognitive-behavioral therapies in fibromyalgia syndrome: A systematic review and metaanalysis of randomized controlled trials. The Journal of Rheumatology. 2010;37(10):1991-2005. https://doi.org/10.3899/jrheum.100104   DOI
29 Sarzi-Puttini P, Atzeni F, Salaffi F, Cazzola M, Benucci M, Mease PJ. Multidisciplinary approach to fibromyalgia: What is the teaching? Best Practice & Research. Clinical Rheumatology. 2011;25(2):311-319. https://doi.org/10.1016/j.berh.2011.03.001   DOI
30 Luciano JV, Sabes-Figuera R, Cardenosa E, T Penarrubia-Maria M, Fernandez-Vergel R, Garcia-Campayo J, et al. Cost-utility of a psychoeducational intervention in fibromyalgia patients compared with usual care: An economic evaluation alongside a 12-month randomized controlled trial. The Clinical Journal of Pain. 2013;29(8):702-711. https://doi.org/10.1097/AJP.0b013e318270f99a   DOI
31 Mease P, Arnold LM, Choy EH, Clauw DJ, Crofford LJ, Glass JM, et al. Fibromyalgia syndrome module at OMERACT 9: Domain construct. Journal of Rheumatology. 2009;36(10):2318-2329. https://doi.org/10.3899/jrheum.090367   DOI
32 Wolfe F, Clauw DJ, Fitzcharles MA, Goldenberg DL, Katz RS, Mease P, et al. The American College of Rheumatology preliminary diagnostic criteria for fibromyalgia and measurement of symptom severity. Arthritis Care & Research. 2010;62(5):600-610. https://doi.org/10.1002/acr.20140   DOI
33 Branco JC, Bannwarth B, Failde I, Abello Carbonell J, Blotman F, Spaeth M, et al. Prevalence of fibromyalgia: A survey in five European countries. Seminars in Arthritis and Rheumatism. 2010;39(6):448-453. https://doi.org/10.1016/j.semarthrit.2008.12.003   DOI
34 Vallejo MA, Ortega J, Rivera J, Comeche MI, Vallejo-Slocker L. Internet versus face-to-face group cognitive-behavioral therapy for fibromyalgia: A randomized control trial. Journal of Psychiatric Research. 2015;68:106-113. https://doi.org/10.1016/j.jpsychires.2015.06.006   DOI
35 Redondo JR, Justo CM, Moraleda FV, Velayos YG, Puche JJ, Zubero JR, et al. Long-term efficacy of therapy in patients with fibromyalgia: A physical exercise-based program and a cognitive-behavioral approach. Arthritis Care & Research. 2004;51(2):184-192. https://doi.org/10.1002/art.20252   DOI
36 Castel A, Cascon R, Padrol A, Sala J, Rull M. Multicomponent cognitive-behavioral group therapy with hypnosis for the treatment of fibromyalgia: Long-term outcome. The Journal of Pain. 2012;13(3):255-265. https://doi.org/10.1016/j.jpain.2011.11.005   DOI
37 Lee SS. Diagnosis and treatment of fibromyalgia syndrome. The Korean Journal of Medicine. 2013;84(5):650-658. https://doi.org/10.3904/kjm.2013.84.5.650   DOI
38 Verbunt JA, Pernot DH, Smeets RJ. Disability and quality of life in patients with fibromyalgia. Health and Quality of Life Outcomes. 2008;6:8. https://doi.org/10.1186/1477-7525-6-8   DOI
39 Sarzi-Puttini P, Buskila D, Carrabba M, Doria A, Atzeni F. Treatment strategy in fibromyalgia syndrome: Where are we now? Seminars in Arthritis and Rheumatism. 2008;37(6):353-365. https://doi.org/10.1016/j.semarthrit.2007.08.008   DOI
40 Bjorkegren K, Wallander MA, Johansson S, Svardsudd K. General symptom reporting in female fibromyalgia patients and referents: A population-based case-referent study. BMC Public Health. 2009;9:402. https://doi.org/10.1186/1471-2458-9-402   DOI
41 Beck JS. Cognitive therapy: Basics and beyond. New York (NY): Guilford Press; 1995. p. 71-80.
42 Solano C, Martinez A, Becerril L, Vargas A, Figueroa J, Navarro C, et al. Autonomic dysfunction in fibromyalgia assessed by the Composite Autonomic Symptoms Scale (COMPASS). Journal of Clinical Rheumatology. 2009;15(4):172-176. https://doi.org/10.1097/RHU.0b013e3181a1083d   DOI
43 Han SS, Bak WS, Yang HI. The effect of a Tai-Chi self-helf program for fibromyalgia patient. Journal of Muscle and Joint Health. 2007;14(2):169-180.
44 Saral I, Sindel D, Esmaeilzadeh S, Sertel-Berk HO, Oral A. The effects of long- and short-term interdisciplinary treatment approaches in women with fibromyalgia: A randomized controlled trial. Rheumatology International. 2016;36(10):1379-1389. https://doi.org/10.1007/s00296-016-3473-8   DOI
45 Salaffi F, Ciapetti A, Gasparini S, Atzeni F, Sarzi-Puttini P, Baroni M. Web/Internet-based telemonitoring of a randomized controlled trial evaluating the time-integrated effects of a 24-week multicomponent intervention on key health outcomes in patients with fibromyalgia. Clinical and Experimental Rheumatology. 2015;33(1 Suppl 88):S93-S101.
46 Martinez MP, Miro E, Sanchez AI, Diaz-Piedra C, Caliz R, Vlaeyen JW, et al. Cognitive-behavioral therapy for insomnia and sleep hygiene in fibromyalgia: A randomized controlled trial. Journal of Behavioral Medicine. 2014;37(4):683-697. https://doi.org/10.1007/s10865-013-9520-y   DOI
47 Berger A, Dukes E, Martin S, Edelsberg J, Oster G. Characteristics and healthcare costs of patients with fibromyalgia syndrome. International Journal of Clinical Practice. 2007;61(9):1498-1508. https://doi.org/10.1111/j.1742-1241.2007.01480.x   DOI
48 Ingram RE, Wisnicki KS. Assessment of positive automatic cognition. Journal of Consulting and Clinical Psychology. 1988;56(6):898-902. https://doi.org/10.1037//0022-006x.56.6.898   DOI
49 Thieme K, Flor H, Turk DC. Psychological pain treatment in fibromyalgia syndrome: Efficacy of operant behavioural and cognitive behavioural treatments. Arthritis Research & Therapy. 2006;8(4):R121. https://doi.org/10.1186/ar2010   DOI