title: How can group-based multidisciplinary rehabilitation for patients with fibromyalgia influence patients' self-efficacy and ability to cope with their illness: a grounded theory approach.
abstract: OBJECTIVE
  To describe how group-based multidisciplinary rehabilitation for patients with fibromyalgia can influence patients' self-efficacy and ability to cope with their illness.
  
  
  BACKGROUND
  Multidisciplinary rehabilitation is recommended in the management of fibromyalgia. Self-efficacy is said to influence and predict adaptive coping behaviours and functioning. However, knowledge is lacking on how rehabilitation programmes may influence self-efficacy and ability to cope, from the patients' perspective.
  
  
  METHODS
  Grounded theory study of semi-structured focus group interviews.
  
  
  METHODS
  Participants (n = 17) were included in four focus groups that had completed a two-week multidisciplinary rehabilitation programme together. Interviews were conducted four weeks after each group had completed the programme. The analysis was conducted constant comparatively applying open, axial and selective coding.
  
  
  RESULTS
  Categories (in italics) were derived from data in which the explanatory core category was identified: Learning to accept and live with pain as a life condition, and linked to three categories mutually influencing each other: Increased self-acceptance of living with the illness, experiencing acceptance from others and developing new coping strategies. Thus, patients benefitted from multidisciplinary rehabilitation with stronger self-efficacy and expectations to their future coping. However, limitations in the programme were identified, as the programme was short and intensive with no subsequent follow-up, and social welfare was not sufficiently addressed. Participants also found it difficult to maintain knowledge and were lacking individual sessions with the psychologist and had waited long to receive rehabilitation.
  
  
  CONCLUSIONS
  Multidisciplinary rehabilitation may advantageously be offered to patients with fibromyalgia. However, earlier action with longer programmes, in which patients' social situation is addressed, comprising individual sessions with the psychologist, with multiple repetitions of the content and follow-up sessions, may further enhance the patients' self-efficacy and coping with their illness.
authors.affiliation: Department of Rheumatology, The Parker Institute, Bispebjerg and Frederiksberg Hospital, Capital Region of Copenhagen, Frederiksberg, Denmark.|Institute of Public Health, University of Southern Denmark, Odense C, Denmark.
authors.forename: Marianne Uggen
authors.identifier: http://orcid.org/0000-0001-9257-3073
authors.initials: MU
authors.lastname: Rasmussen
authors.affiliation: Department of Rheumatology, The Parker Institute, Bispebjerg and Frederiksberg Hospital, Capital Region of Copenhagen, Frederiksberg, Denmark.
authors.forename: Kirstine
authors.initials: K
authors.lastname: Amris
authors.affiliation: Research Unit of Clinical Nursing, Bispebjerg and Frederiksberg Hospital, Capital Region of Copenhagen, København NW, Denmark.|Section for Nursing Department of Public Health, Aarhus University, Aarhus, Denmark.
authors.forename: Susan
authors.initials: S
authors.lastname: Rydahl-Hansen
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D005260:Female; D005356:Fibromyalgia / Q000523:psychology / Q000534:rehabilitation*; D017144:Focus Groups; D066296:Grounded Theory; D006801:Humans; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000209:etiology / Q000534:rehabilitation*; D011788:Quality of Life / Q000523:psychology*; D020377:Self Efficacy
keywords: coping; focus groups; grounded theory; multidisciplinary; pain; rehabilitation; self-efficacy